California nursing home laws require that facilities are licensed, inspected, regulated, and certified by several public and private agencies. These agencies operate at both state and federal levels. The California Department of Public Health (CDPH) Licensing and Certification Division ensures that facilities comply with California nursing home laws. Facilities that accept Medicare and Medicaid, or Medi-Cal in California, are required to meet basic federal requirements.
There are four basic requirements that dictate California nursing home laws:
- Helping the patient to attain or maintain optimal physical, psychological, and mental well-being
- Ensuring that the patient’s condition does not worsen, unless medically unavoidable
- Maintaining and improving health as much as possible through care, therapies, and treatment
- Providing care, therapies, and treatment subject to the patient’s right to choose
Title 22 Licensing Requirements
Title 22 details the licensing requirements for California nursing homes. If nursing home residents or members of the resident’s family wish to file a legal claim against a nursing home, the attorney should have extensive knowledge of Title 22. Title 22 outlines requirements as they relate to several aspects of the patient’s life in a nursing home.
Title 22 requirements cover topics including:
- Food service
- Personal care and assistance
- Supervision and observation
- Planned activities
- Healthful and safe living accommodations
- Arrangements for obtaining dental and medical care
Elder Abuse and Dependent Adult Civil Protection Act
In 1990, California adopted the Elder Abuse and Dependent Adult Civil Protection Act (EADACPA). It is often used by attorneys to help eliminate nursing home abuse. Patients and family members of patients who are involved in cases of nursing home abuse are able to seek attorney’s fees and punitive damages for injury or harm caused from nursing home abuse.
Under an EADACPA claim, abuse is defined as a civil action. It may include “physical abuse, neglect, fiduciary abuse, abandonment, isolation or other treatment with resulting physical harm or pain or mental suffering, the deprivation by a care custodian of goods or services which are necessary to avoid physical harm or mental suffering.”
Standards for Personal Care – California Nursing Home Abuse Laws
Food and Nutrition
California nursing home laws have a number of requirements to ensure that residents receive adequate nutrition. Facilities must provide patients with palatable, nourishing, and well-balanced diets. These diets are required to meet needs for daily nutrition and special diets for individual patients. Additionally, California nursing home laws require that patients receive sufficient and fresh supplies of fluids to avoid dehydration.
California nursing home laws require that facilities:
- Reasonably accommodate patient preferences for food and mealtime
- Follow and prepare menus which meet national dietary standards
- Use food preparation methods that promote nutritional value, appearance, and flavor
- Offering enough assistance so that each patient can finish meals when help is needed
Daily Care and Hygiene
Residents must be provided with necessary assistance with dressing, eating, bathing, and other personal needs. The patient’s ability to carry out daily are activities may not decline unless medically unavoidable. Nursing homes are required to maintain clean, dry skin for patients. Linens and clothing must be consistently changed and free of urine, feces, and offensive odors.
Medical Care Requirements
The resident or resident’s representative has the right to select a physician without barriers placed by the nursing home. After selection, the physician must generally supervise the resident’s care every 30 days or less. The physician must provide face-to-face evaluation of the resident and the resident’s total program of care provided by the nursing home.
Infection and Disease Control
California nursing home laws state that each nursing home must have an infection control program. If an infection is present, the facility must use the lease restrictive method available to isolate infected residents. In order to prevent the spread of infection, each staff member is required to wash his or her hands after direct contact with a patient.
“Title 22 Regulations.” CDSS. California Department of Social Services. Web. 17 May 2013. http://www.ccld.ca.gov/PG555.htm
Wenger, Neil S, et al. “Implementation of Physician Orders for Life Sustaining Treatment in Nursing Homes in California: Evaluation of a Novel Statewide Dissemination Mechanism.” Journal of General Internal Medicine. 28.1 (2013): 51-57. Web. 17 May. 2013.