Facility Resident Services
Advocacy
Ombudsmen regularly advocate for improvements in resident care and work to improve their quality of life. In addition, during conflicts the Ombudsman acts as a neutral third party representing the interests of the care facility resident.
Complaint Investigation and Resolution
Ombudsmen investigate complaints made by or on behalf of care facility residents. Complaints can be made regarding any issue; most involve problems with care or abuse.
Eviction Assistance and Prevention
Ombudsmen work with facility residents and their families to prevent evictions whenever appropriate. Many residents are unaware of eviction regulations and may become subject to improper evictions without Ombudsman intervention.
CA Code of Regulations
Title 22 Sec. 87589
Eviction Procedures.-RCFE
(a)The licensee may, upon (30) days written notice to the resident, evict the resident for one or more of the following reasons:
(1)Nonpayment of the rate for basic services within ten days of the due date.
(2)Failure of the resident to comply with state or local law after receiving written notice of the alleged violation.
(3)Failure of the resident to comply with general policies of the facility. said general policies must be in writing,must be for the purpose of making it possible for residents to live together and must, be made part of the admission agreement.
(4)If,after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87587, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident.
(5)Change of use of the facility.
(b)The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction upon a finding of good cause. Good cause exists if the resident is engaging in behavior which is a threat to the mental and/or physical health or safety of himself or to the mental and/or physical health or safety of others in the facility.
(c)The licensee shall, in addition to either serving thirty (30)days notice or seeking approval from the Department and serving three (3)days notice on the resident, notify or mail a copy of the notice to quit to the resident’s responsible person.
(d)The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.
(e)Upon the request of a resident, or his/her designated representative, the Department shall, pursuant to the provisions of Section 1569.35 of the Health and Safety Code, investigate the reasons given for the eviction.
(f)A written report of any eviction shall be sent to the licensing agency within five(5)days.
(g)This section shall not apply to a particular resident who has entered into a continuing care contract with a facility pursuant to health and Safety Code, Chapter 10, Division 2.
(h)Nothing in this section is intended to preclude the licensee or resident from invoking any other available remedy.
(i)Nothing in Section 87589 precludes the licensee from initiating the urgent relocation to a licensed health facility of a terminally ill resident receiving hospice services when the resident’s condition has changed and a joint determination has been made by the Department, the resident or resident’s health care surrogate decision maker, the resident’s hospice agency, a physician, and the licensee, that the resident’s continued retention in the facility poses a health and safety risk to the resident or any other facility resident.
Title 22 Section 72519
Patient Transfer-SNF
(a)The licensee shall maintain written transfer agreements with other nearby health facilities to make the services of those facilities accessible and to facilitate the transfer of patients. Complete and accurate patient information , in sufficient detail to provide for continuity of care shall be transferred with the patient at time of transfer.
(b)When a patient is transferred to another facility, the following shall be entered in the patient health record:
(1)The date,time,condition of the patient and a written statement of the reason for the transfer.
(2)Informed written or telephone acknowledgement of the patient, patient’s guardian or authorized representative except in an emergency or as provided in Section 72527(a)(5).
Section 72520 Bed Hold.-SNF
(a)If a patient of a skilled nursing facility is transferred to a general acute care hospital as defined in Section 1250(a) of the Health and Safety Code, the skilled nursing facility shall afford the patient a bed hold of seven(7)days, which may be exercised by the patient or the patient’s representative.
(1)Upon transfer to a general acute care hospital, the patient or the patient’s representative shall notify the skilled nursing facility within twenty-four(24) hours after being informed of the right to have the bed held, if the patient desires the bed hold.
(2)Except as provided in Section 51535.1,Title 22, California Administrative Code,any patient who exersises the bedhold option shall be liable to pay reasonable charges, not to exceed the patients daily rate for care in the facility, for bed hold days.
(3)If the patient’s attending physician notifies the skilled nursing facility in writing that the patient’s stay in the general acute care hospital is expected to exceed seven(7)days, the skilled nursing facility shall not be required to maintain the bed hold.
(b)Upon admission of the patient to the skilled nursing facility and upon transfer of the patient of a skilled nursing facility to a general acute care hospital, the skilled nursing facility shall inform the patient, or the patient’s representative, in writing of the right to exercise this bed hold provision. No later than June 1,1985 every skilled nursing facility shall inform each current patient or patient’s representative in writing of the right to exercise the bed hold provision. Each notice shall include information that a non-Medi-Cal eligible patient will be liable for the cost of the bed hold days, and that insurance may or may not cover such costs.
(c)A licensee who fails to meet these requirements shall offer to the patient the next available bed appropriate for the patient’s needs. This requirement shall be in addition to any other remedies provided by law. The provisions of this section do not apply to patients covered only by Medicare, Title XVIII benefits pursuant to Code of Federal Regulations, Title 42, Subsection 489.22(d)(1)
Title 22, Section 72527.-SNF
Patients’ Rights.
(a)Patients have the rights enumerated in this section and the facility shall ensure that these rights are not violated. The facility shall establish and implement written policies and procedures which include these rights and shall make a copy of these policies available to the patient and to any representative of the patient. The policies shall be accessible to the public upon request. Patients shall have the right:
(1)To be fully informed, as evidenced by the patients written acknowledgement prior to or at the time of admission and during stay, of these rights and of all rules and regulations governing patient conduct.
(2)To be fully informed, prior to or at the time of admission and during stay, of services available in the facility and of related charges, including any charges for services not covered by the facility’s basic per diem rate or not covered under Titles XVIII or XIX of the Social Security Act.
(3)To be fully informed by a physician of his or her total health status and to be afforded the opportunity to participate on an immediate and ongoing basis in the total plan of care including the identification of medical, nursing and psychosocial needs and the planning of related services.
(4)To consent to or to refuse any treatment or procedure or participation in experimental research.
(5)To receive all information that is material to an individual patient’s decision concerning whether to accept or refuse any proposed treatment or procedure. The disclosure of material information for administration of psychotherapeutic drugs or physical restraints or the prolonged use of a device that may lead to the inability to regain use of a normal bodily function shall include the disclosure of information listed in Section 72528(b).
(6)To be transferred or discharged only for medical reasons, or the patient’s welfare or that of other patients or for nonpayment for his or her stay and to be given reasonable advance notice to ensure orderly transfer or discharge. Such actions shall be documented in the patient’s health record.
Monitoring Visits
Unannounced visits to Skilled Nursing and Residential Care Facilities for the Elderly to ensure that residents are receiving the highest possible quality of life and care. During the visit, the Ombudsman checks for health and safety issues (such as blocked emergency exits and tripping hazards). The Ombudsman will also meet with individual residents to talk about any concerns, problems or complaints.
Training
Ombudsmen provide training to facility staff,residents, and family regarding care issues, Resident Rights, and elder abuse prevention.
AHCD: Ombudsmen are required to witness these forms for residents in Skilled Nursing Facilities. We also provide forms and information to persons residing in Residential Care Facilities for the Elderly.
Community Services
Advance Health Care Directives
The Ombudsman office provides the public with the most current version of the Advance Health Care Directive. In addition, the Ombudsman staff can provide information and assistance to persons completing the form.
Community Education
We provide education at community events regarding long term care issues.
Placement Assistance
We provide lists of care facilities, checklists for helping to choose a facility, and assistance with reviewing licensing history. We also provide assistance with admission agreements.
Information and Referral
We provide information and referral to other agencies regarding long term care in the community.
Lunchtime Training Seminars
We provide information and trainings for employees of large or small companies regarding long term care issues. These trainings have been developed to help reduce absenteeism and caregiver stress for employees caring for their aging parents.
