AMENDED IN ASSEMBLY OCTOBER 21, 2003

SENIOR ASSEMBLY PROPOSAL NO. 5

INTRODUCED BY SENIOR ASSEMBLY MEMBER MANN

LEGISLATIVE COUNSEL'S DIGEST

AP 5:  SKILLED NURSING FACILITIES:  PATIENT EXAMINATIONS

UNDER EXISTING LAW, THE STATE DEPARTMENT OF8 HEALTH SERVICES REGULATES THE LICENSURE AND OPERATION OF HEALTH FACILITIES, INCLUDING SKILLED NURSING FACILITIES.  EXISTING LAW AUTHORIZES THE DEPARTMENT TO ADOPT REASONABLE RULES AND REGULATIONS IN THIS REGARD.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD REQUIRE THE DEPARTMENT TO ADOPT REGULATIONS; (1) REQUIRING THE CHARGE NURSE AT LEAST ONCE EVERY 24 HOURS AT A LICENSED SKILLED NURSING FACILITY TO PERSONALLY CONDUCT A PHYSICAL EVALUATION OF EACH PATIENT FOR WHOM THE CHARGE NURSE IS RESPONSIBLE, AND TO MAKE A REPORT OF HIS OR HER FINDINGS TO THE DIRECTOR OF NURSES, AND (2) REQUIRING THE DIRECTOR OF NURSES TO INDICATE WHETHER A FOLLOWUP EXAMINATION IS NEEDED AND TO DIRECT THE CHARGE NURSE TO MAKE ANY NECESSARY FOLLOWUP EXAMINATIONS BEFORE THE END OF THE CHARGE NURSE'S SHIFT.

VOTE:  MAJORITY.

AP 5: RELATING TO SKILLED NURSING FACILITIES

WHEREAS, PATIENTS IN SKILLED NURSING FACILITIES CAN EXPERIENCE A DECLINE IN PHYSICAL CONDITION AND PERSONAL HYGIENE OVER AN EXTENDED PERIOD OF TIME AS A RESULT OF SPENDING ALL OR MOST OF THEIR TIME IN BED; AND 

WHEREAS, LACK OF PROPER ATTENTION FOR THESE INDIVIDUALS CAN RESULT IN CONDITIONS SUCH AS BEDSORES, URINARY TRACT INFECTIONS, DEHYDRATION, SEPSIS, AND IN SOME CASES, DEATH; AND 

WHEREAS, CALIFORNIA ADVOCATES FOR NURSING HOME REFORM (CANHR) HAS REPORTED CASES IN WHICH RESIDENTS ARE NOT BEING HELPED TO EAT OR DRINK, NOR ARE THEY BEING KEPT DRY AND CLEAN; AND

WHEREAS, THE FEDERAL GENERAL ACCOUNTING OFFICE RECENTLY REPORTED ON THE UNACCEPTABLY HIGH INCIDENCE OF SERIOUS QUALITY PROBLEMS IN THE NATION'S NURSING HOMES, INCLUDING THOSE IN CALIFORNIA, DESPITE A DECLINE IN SUCH REPORTED PROBLEMS SINCE MID-2000; AND

WHEREAS, THE CERTIFIED NURSE ASSISTANTS (CNA'S) RESPONSIBLE FOR PROVIDING PATIENT CARE IN SKILLED NURSING FACILITIES ARE OFTEN OVERWORKED AND FAIL TO CONDUCT A THOROUGH CHECK OF EACH PATIENT'S PHYSICAL CONDITION, OFTEN RESULTING IN THE FAILURE TO ADDRESS PROBLEMS IN A TIMELY FASHION; AND

WHEREAS, IF EACH CHARGE NURSE ON EVERY SHIFT AT A SKILLED NURSING FACILITY CONDUCTED REGULAR EXAMINATIONS OF EACH PATIENT IN HIS OR HER CHARGE, MANY PROBLEMS COULD BE IDENTIFIED AND ADDRESSED BEFORE THEY BECOME UNMANAGEABLE OR LIFE-THREATENING; NOW, THEREFORE, BE IT

RESOLVED, BY THE SENIOR ASSEMBLY AND THE SENIOR SENATE, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2003 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT THE LEGISLATURE REQUIRE THE STATE DEPARTMENT OF HEALTH SERVICES TO ADOPT REGULATIONS REQUIRING:

(1) THE CHARGE NURSE  EACH AT LEAST ONCE EVERY 24 HOURS AT A LICENSED SKILLED NURSING FACILITY TO PERSONALLY CONDUCT A PHYSICAL EVALUATION OF EACH PATIENT FOR WHOM THE CHARGE NURSE IS RESPONSIBLE, AND TO MAKE A REPORT OF HIS OR HER FINDINGS TO THE DIRECTOR OF NURSES; AND

(2) THE DIRECTOR OF NURSES TO INDICATE, BASED ON THE CHARGE NURSE'S REPORT, WHETHER A FOLLOWUP EXAMINATION IS NEEDED AND TO DIRECT THE CHARGE NURSE TO MAKE ANY NECESSARY FOLLOWUP EXAMINATIONS BEFORE THE END OF THE CHARGE NURSE'S SHIFT; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION WHICH WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER

RESOLVED, THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.

RN0316385

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