New monetary penalties for SNFs in California is ‘major policy change’

Skilled nursing facilities in California will face much higher fines for not complying with transfer discharge hearing decisions under a new bill signed into law last week by Gov. Gaivin Newsom (D).

The policy in Assembly Bill 133 raises fines 15-fold, from $50 a day to $750 a day and took effect immediately.

“This represents a major policy change for California providers. The California Department of Public Health and [federal Centers for Medicare & Medicaid Services] already have the authority to fine facilities for failure to comply with transfer discharge hearing decisions,” Deborah Pacyna, director of public affairs at the California Association of Health Facilities, told the McKnight’s Business Daily.

According to CAHF, which represents 80% of SNFs in the state, the transfer hearing process is flawed. 

“We did not have the opportunity to discuss how the current transfer discharge hearing process could be improved — specifically, whether an administrative law judge should adjudicate hearings rather than hearing officers,” Pacyna said. 

LeadingAge California agreed.

“While LeadingAge California is opposed to improper discharges of residents, this trailer bill does not holistically address the flawed process in place that determines if a resident was improperly discharged. This approach also does not consider California Department of Public Health’s existing authority to issue penalties for improper discharge,” Eric Dowdy, MPPA,  chief government affairs officer for LeadingAge California, told the McKnight’s Business Daily.

Further, Pacyna said that the proposal denies due process to operators, where decisions on discharging residents often are related to safety concerns.

“There are a variety of reasons why residents may be discharged. Facilities cannot continue to provide care for a resident that places residents and staff at risk and creates legal exposure for the facility,” she said. “In other cases, a resident is recovered and no longer needs skilled nursing care and is using a bed needed by other patients discharging from a hospital.”