2007 California Health and Safety Code Chapter 3.9. Skilled Nursing And Intermediate Care Facility Patient\'s Bill Of Rights

CA Codes (hsc:1599-1599.4)

1599.  It is the intent of the Legislature in enacting this chapter
to expressly set forth fundamental human rights which all patients
shall be entitled to in a skilled nursing or intermediate care
facility, as defined in Section 1250, and to ensure that patients in
such facilities are advised of their fundamental rights and the
obligations of the facility.



1599.1.  Written policies regarding the rights of patients shall be
established and shall be made available to the patient, to any
guardian, next of kin, sponsoring agency or representative payee, and
to the public. Those policies and procedures shall ensure that each
patient admitted to the facility has the following rights and is
notified of the following facility obligations, in addition to those
specified by regulation:
   (a) The facility shall employ an adequate number of qualified
personnel to carry out all of the functions of the facility.
   (b) Each patient shall show evidence of good personal hygiene and
be given care to prevent bedsores, and measures shall be used to
prevent and reduce incontinence for each patient.
   (c) The facility shall provide food of the quality and quantity to
meet the patients' needs in accordance with physicians' orders.
   (d) The facility shall provide an activity program staffed and
equipped to meet the needs and interests of each patient and to
encourage self-care and resumption of normal activities. Patients
shall be encouraged to participate in activities suited to their
individual needs.
   (e) The facility shall be clean, sanitary, and in good repair at
all times.
   (f) A nurses' call system shall be maintained in operating order
in all nursing units and provide visible and audible signal
communication between nursing personnel and patients. Extension cords
to each patient's bed shall be readily accessible to patients at all
times.
   (g) (1) If a facility has a significant beneficial interest in an
ancillary health service provider or if a facility knows that an
ancillary health service provider has a significant beneficial
interest in the facility, as provided by subdivision (a) of Section
1323, or if the facility has a significant beneficial interest in
another facility, as provided by subdivision (c) of Section 1323, the
facility shall disclose that interest in writing to the patient, or
his or her representative, and advise the patient, or his or her
representative, that the patient may choose to have another ancillary
health service provider, or facility, as the case may be, provide
any supplies or services ordered by a member of the medical staff of
the facility.
   (2) A facility is not required to make any disclosures required by
this subdivision to any patient, or his or her representative, if
the patient is enrolled in an organization or entity that provides or
arranges for the provision of health care services in exchange for a
prepaid capitation payment or premium.
   (h) (1) If a resident of a long-term health care facility has been
hospitalized in an acute care hospital and asserts his or her rights
to readmission pursuant to bed hold provisions, or readmission
rights of either state or federal law, and the facility refuses to
readmit him or her, the resident may appeal the facility's refusal.
   (2) The refusal of the facility as described in this subdivision
shall be treated as if it were an involuntary transfer under federal
law, and the rights and procedures that apply to appeals of transfers
and discharges of nursing facility residents shall apply to the
resident's appeal under this subdivision.
   (3) If the resident appeals pursuant to this subdivision, and the
resident is eligible under the Medi-Cal program, the resident shall
remain in the hospital and the hospital may be reimbursed at the
administrative day rate, pending the final determination of the
hearing officer, unless the resident agrees to placement in another
facility.
   (4) If the resident appeals pursuant to this subdivision, and the
resident is not eligible under the Medi-Cal program, the resident
shall remain in the hospital if other payment is available, pending
the final determination of the hearing officer, unless the resident
agrees to placement in another facility.
   (5) If the resident is not eligible for participation in the
Medi-Cal program and has no other source of payment, the hearing and
final determination shall be made within 48 hours.
   (i) Effective July 1, 2007, Sections 483.10, 483.12, 483.13, and
483.15 of Title 42 of the Code of Federal Regulations in effect on
July 1, 2006, shall apply to each skilled nursing facility and
intermediate care facility, regardless of a resident's payment source
or the Medi-Cal or Medicare certification status of the skilled
nursing facility or intermediate care facility in which the resident
resides, except that a noncertified facility is not obligated to
provide notice of Medicaid or Medicare benefits, covered services, or
eligibility procedures.



1599.2.  Written information informing patients of their rights
shall include a preamble or preliminary statement in substantial form
as follows:
   (a) Further facility requirements are set forth in the Health and
Safety Code, and in Title 22 of the California Administrative Code.
   (b) Willful or repeated violations of either code may subject a
facility and its personnel to civil or criminal proceedings.
   (c) Patients have the right to voice grievances to facility
personnel free from reprisal and can submit complaints to the State
Department of Health Services or its representative.



1599.3.  Any rights under this chapter of a patient judicially
determined to be incompetent, or who is found by his physician to be
medically incapable of understanding such information, or who
exhibits a communication barrier, shall devolve to such patient's
guardian, conservator, next of kin, sponsoring agency, or
representative payer, except when the facility itself is the
representative payer.



1599.4.  In no event shall this chapter be construed or applied in a
manner which imposes new or additional obligations or standards on
skilled nursing or intermediate care facilities or their personnel,
other than in regard to the notification and explanation of patient's
rights or unreasonable costs.