(1)Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would require long-term health care facilities to provide residents with a notice of a facility-initiated transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be acknowledged by the signature of the resident or, if applicable, the residents representative. The bill would make a violation of these provisions a class B violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident and, if applicable, the residents representative in a translated or accessible format at the same time as the written notice in English if the residents primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest, under penalty of perjury, to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a residents primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class B violation.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the residents representative by facsimile machine, email, or first-class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

Because a willful or repeated violation of long-term care facilities provisions is a crime and because the crime of perjury is expanded, the bill would impose a state-mandated local program.

(2)Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the departments Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would authorize the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

(1)Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would require long-term health care facilities to provide residents with a notice of a facility-initiated transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be signed by acknowledged by the signature of the resident or, if applicable, the residents representative, and by a facility staff member who declares they delivered the notice to the resident and, if applicable, the residents representative. The bill would make a violation of these provisions a class B violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident and, if applicable, the residents representative in a translated or accessible format at the same time as the written notice in English if the residents primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest, under penalty of perjury, to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a residents primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class B violation subject to a $1,000 civil penalty. violation.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the residents representative by facsimile machine, email, or first-class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

Because a willful or repeated violation of long-term care facilities provisions is a crime and because the crime of perjury is expanded, the bill would impose a state-mandated local program.

(2)Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the departments Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would authorize the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

(1)Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would, consistent with federal law, would require long-term health care facilities to provide residents with a notice of a facility-initiated transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be signed by the resident or, if applicable, the residents representative, and by a facility staff member who declares they delivered the notice to the resident and, if applicable, the residents representative. The bill would make a violation of these provisions a class B violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident and, if applicable, the residents representative in a translated or accessible format at the same time as the written notice in English if the residents primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest attest, under penalty of perjury, to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a residents primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class B violation subject to a $1,000 civil penalty.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the residents representative by facsimile machine, email, or first-class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

Because a willful or repeated violation of long-term care facilities provisions is a crime and because the crime of perjury is expanded, the bill would impose a state-mandated local program.

(2)Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the departments Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would require authorize the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification by the State Department of Health Care Services that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the State Department of Health Care Services notifies the State Department of Public Health that the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

(1)Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would, consistent with federal law, require long-term health care facilities to provide residents with a notice of transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be signed by the resident or or, if applicable, the residents representative representative, and by a facility staff member who declares they delivered the notice to the resident or and, if applicable, the residents representative. The bill would make a violation of these provisions a class B violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident or and, if applicable, the residents representative in a translated or accessible format at the same time as the written notice in English if the residents primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a residents primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class B violation subject to a $1,000 civil penalty.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the residents representative by facsimile machine, email, or first class first-class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

Because a willful or repeated violation of long-term care facilities provisions is a crime and because the crime of perjury is expanded, the bill would impose a state-mandated local program.

(2)Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the departments Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would require the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification by the State Department of Health Care Services that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the State Department of Health Care Services notifies the State Department of Public Health that the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

(1)Existing law provides for the licensing and regulation of health facilities, including, but not limited to, long-term health care facilities, as defined, by the State Department of Health Care Services. Existing law requires a contract for admission to a long-term care facility to state that a resident shall not be involuntarily transferred within, or discharged from, a long-term health care facility unless the resident is given reasonable notice in writing, and transfer or discharge planning, as specified. Willful or repeated violations of the provisions relating to long-term health care facilities is a misdemeanor.

This bill would, consistent with federal law, require long-term health care facilities to provide residents with a notice of transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. The bill would require the notice of transfer or discharge to be signed by the resident or the residents representative and by a facility staff member who declares they delivered the notice to the resident or the residents representative. The bill would make a violation of these provisions a class B violation and would make knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation for purposes of the criminal provision described above.

The bill would require a notice of discharge or transfer to be provided to a resident or the residents representative in a translated or accessible format at the same time as the written notice in English if the residents primary language is not English or if the resident is vision impaired or blind, as specified. The bill would also require the translated or accessible-format notices to be made available to the local long-term care ombudsman upon request. The bill would require the translator to attest to the accuracy of the translation, thereby expanding the crime of perjury. The bill would require a residents primary language or sensory impairments to be included in the minimum dataset maintained by the facility. The bill would make a violation of these provisions a class B violation subject to a $1,000 civil penalty.

Existing law requires that a copy of the notice of transfer or discharge be sent to the local long-term care ombudsman at the same time notice is provided to the resident or the residents representative by facsimile machine, email, or first class mail, as specified. Existing law requires, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the notice to be provided to the local long-term care ombudsman as soon as practicable.

This bill would instead require the notices described above to be sent to the long-term care ombudsman by facsimile, email, or other electronic means. For emergency transfer notices, the bill would require a copy of the notice to be provided to the local long-term care ombudsman as soon as practicable, but in no event later than 24 hours after the transfer.

Because a willful or repeated violation of long-term care facilities provisions is a crime and because the crime of perjury is expanded, the bill would impose a state-mandated local program.

(2)Existing law requires the State Department of Public Health to establish an inspection and reporting system to ensure that long-term health care facilities are in compliance with state statutes and regulations. Existing law, the Medi-Cal Long-Term Care Reimbursement Act, requires, among other things, that long-term health care facilities timely comply with hearing decisions issued by the departments Office of Administrative Hearings and Appeals for improperly transferring, discharging, or refusing to readmit a resident. Existing law authorizes the department to assess a penalty of $750 for each calendar day a facility fails to comply with the hearing decision and caps aggregate penalties for each individual hearing decision at $75,000.

The bill would require the State Department of Public Health to prohibit the admission of new residents to a long-term health care facility upon notification by the State Department of Health Care Services that a facility has failed to timely comply with a hearing decision. The bill would require the prohibition to remain in effect until the State Department of Health Care Services notifies the State Department of Public Health that the facility has achieved compliance, the maximum aggregate of penalties have been collected, or the facility has formally sought judicial review of the hearing decision.

The bill would increase the daily penalty described above to $1,000 for each calendar day and increase the maximum aggregate penalty amount to $100,000.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

SENATE COMMITTEE ON

Senator Sabrina Cervantes, Chair

2025 - 2026 Regular Session

AB 2135 (Kalra) - Long-term health care facilities

Bill Summary:

AB 2135 would revise and expand requirements on long-term care facilities related to providing notices of transfer and discharge to residents.

Fiscal Impact:

• The California Department of Public Health (CDPH) estimates annual costs of $218,000 beginning in 2027-28 and ongoing thereafter to investigate complaints related to new notice requirements, issue deficiencies, and review plans of correction (Licensing and Certification Fund).   
• The Department of Health Care Services (DHCS) does not anticipate costs for state administration.
• Unknown, potential workload costs to the courts related to adjudicating misdemeanor cases and enforcement of civil penalties under the bill (Trial Court Trust Fund, General Fund). While the courts are not funded on a workload basis, an increase in workload could result in delayed court services and would put pressure on the General Fund to increase the amount appropriated for trial court operations.

Background:

Under federal requirements, a long-term care (LTC) facility is only allowed to transfer or discharge a resident for certain reasons, including: when necessary for the resident’s welfare and the resident’s needs cannot be met in the facility; when the resident’s health has improved sufficiently; failure to pay, under certain circumstances; or, the safety of individuals in the facility is endangered due to the clinical or behavioral status of the resident. While a notice of transfer or discharge is required to be made at least 30 days before transfer or discharge, there are a number of exceptions where notice is only required to be made “as soon as practicable.” Federal regulations require the transfer or discharge to be documented in the resident’s medical record, which is required to include the basis for the transfer, and in cases where the transfer is because the resident’s needs cannot be met at the facility, the facility’s attempts to meet the resident’s needs, and the service available at the receiving facility to meet the needs. The notice is required to be in writing and in a language and manner the resident understands, and a copy is required to be sent to the LTC ombudsman.

The CDPH is responsible for licensing LTC facilities, which includes skilled nursing facilities. State law requires that a contract of admission to an LTC facility must state that, except in an emergency, a resident may not be involuntarily transferred or discharged from an LTC facility unless the resident and, if applicable, the resident’s representative, are given reasonable notice in writing and transfer or discharge planning, as specified. State law requires that if a resident is notified in writing of a facility-initiated transfer or discharge from an LTC facility, the facility must also send a copy of the notice to the local LTC ombudsman at the same time notice is provided to the resident or the resident’s representative. However, if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, the facility must provide a copy of the notice to the LTC ombudsman as soon as practicable.

State law establishes a civil penalty structure for LTC facilities, categorized into “AA,” “A,” and “B” violations: “A” violations are where CDPH determines that the violation presents either imminent danger of death or serious harm, or a substantial probability that death or serious harm to residents would result; “AA” violations (the most severe) are those that meet the criteria for a class “A” violation that CDPH determines was a direct proximate cause of the death of a resident of an LTC facility; and, “B” violations are those that CDPH determines have a direct or immediate relationship to the health, safety, or security of LTC facility residents.

The DHCS is responsible for state-level administration of the Medi-Cal program, including enforcement of rules regarding Medi-Cal reimbursements to eligible LTC facilities. State law requires an LTC facility to timely comply with a hearing decision, as issued by the department’s Office of Administrative Hearings and Appeals, that finds that the LTC facility improperly transferred, discharged, or refused to readmit a resident. DHCS may, if an LTC facility fails to timely comply with a hearing decision, assess certain penalties.

Proposed Law:

Specific provisions of the bill would:

• Require that the notice to the LTC ombudsman that is required if a resident is subject to a facility-initiated transfer to a general acute care hospital on an emergency basis, be made in no event later than 24 hours after the transfer.
• Require that a notice of a facility-initiated transfer or discharge must be made by the facility at least 30 days before a resident is transferred or discharged, except as provided; require that receipt of the notice of transfer or discharge must be acknowledged by the signature of the resident or, if applicable, the resident’s representative, as specified, and that knowingly making a false verification regarding the delivery of a notice of transfer or discharge pursuant to this requirement is a willful violation subject to being guilty as a misdemeanor, as specified; and provide that a facility’s failure to comply with these requirements constitutes a class “B” violation.
• Require that a notice of a facility-initiated transfer or discharge meet the following requirements:
  • If the primary language of the resident is not English, the facility must provide a written translation of the notice in the resident’s primary language, as specified.
  • If the resident is vision impaired or blind, the facility must provide the written notice in large print or braille upon the resident’s request, as specified.
• Provide that failure to provide a translated or accessible-format copy to the resident and, if applicable, the resident’s representative or to the local LTC ombudsman upon request must constitute an automatic class “B” violation.
• Increase the penalties that the DHCS may assess if an LTC facility fails to timely comply with a hearing decision issued by the department’s Office of Administrative Hearings and Appeals, as specified.
• Require that if an LTC facility fails to timely comply with a hearing decision, the DHCS must promptly notify the CDPH; and authorize CDPH to prohibit the admission of new residents to the facility, as specified.

-- END --

SENATE COMMITTEE ON HEALTH

Senator Akilah Weber Pierson, Chair

BILL NO: AB 2135

SUBJECT: Long-term health care facilities

SUMMARY:

Revises and expands notices of transfer and discharge from long-term care facilities, including by imposing minimum prior notice of facility-initiated transfers or discharge of 30 days, 14 days, or as soon as practicable, depending on the reason for the transfer or discharge. Requires certain conditions to be met in order to transfer or discharge a resident to protect the health or safety of individuals in the facility, including by documenting efforts to address the resident’s endangerment to individuals, and requires the discharge notice to include a description of how the care or support the discharge location can provide is expected to address the resident’s endangerment to individuals. Requires a written translation, in the resident’s primary language or in an accessible format to the vision impaired, of the discharge and transfer notices. Permits the California Department of Public Health to prohibit new admissions to a long-term care facility if the facility is not in compliance with a hearing decision that the facility improperly transferred, discharged, or refused to readmit a resident.

Existing law:

1. Licenses and regulates long-term care (LTC) facilities by the California Department of Public Health (CDPH). LTC facilities include skilled nursing facilities (SNFs), intermediate care facilities (ICFs), ICF/developmentally disabled (ICF/DD), ICF/DD-habilitative, ICF/DD-nursing, and congregate living health facilities. [HSC §1250, et seq., and §1418]
2. Establishes a civil penalty structure for LTC facilities, categorized into “AA,” “A,” and “B” violations: “A” violations are where CDPH determines that the violation presents either imminent danger of death or serious harm, or a substantial probability that death or serious harm to residents would result; “AA” violations (the most severe) are those that meet the criteria for a class “A” violation that CDPH determines was a direct proximate cause of the death of a resident of an LTC facility; and, “B” violations are those that CDPH determines have a direct or immediate relationship to the health, safety, or security of LTC facility residents. [HSC §1424]
3. Requires all contracts of admission to LTC facilities to state that except in an emergency, a resident cannot be involuntarily transferred within, or discharged from, the facility unless the resident is given reasonable notice in writing and transfer or discharge planning as required. Requires the written notice to state the reason for the transfer or discharge, and requires the facility to immediately notify the Office of the State Long-Term Care Ombudsman (LTC Ombudsman) in every case of involuntary discharge, as specified. [HSC §1599.78]
4. Requires an LTC facility, if a resident of an LTC facility is notified in writing of a facility-initiated transfer or discharge, to also send a copy of the notice to the local LTC ombudsman at the same time notice is provided to the resident or the resident’s representative. [HSC §1439.6(a)]
5. Requires an LTC facility, within 48 hours of giving a required written notice of an involuntary transfer or discharge, to provide the resident, and if applicable, the resident’s representative, a copy of all of the following:
   1. The evaluation of the resident’s discharge needs and discharge plan as required by federal law or the most current discharge plan; and,
   2. In the case of the transfer or discharge being necessary for the resident’s welfare because the resident’s needs cannot be met in the facility, all of the following information (if not included in the most current discharge plan):
      1. A written description of the specific resident’s needs that cannot be met;
      2. Facility attempts to meet the resident’s needs; and,
      3. The services available at the receiving facility that meet the resident’s needs. [HSC §1439.6(f)]
6. Establishes the Long-Term Care Ombudsman Program (LTC Ombudsman Program), within the Department of Aging, pursuant to a grant from the federal government under the Older Americans Act, as specified, to hear, investigate, and resolve complaints made by or on behalf of patients or residents of long-term care facilities relating to matters that may affect the health, safety, welfare, and rights of these patients or residents, among other duties. [WIC §9700, et seq.]
7. Prohibits an LTC facility that participates as a provider under the Medi-Cal program from seeking to evict out of the facility, or transfer within the facility, any resident as a result of the resident changing his or her manner of purchasing the services from private payment or Medicare to Medi-Cal, except that a facility is permitted to transfer a resident from a private room to a semiprivate room. [WIC §14124.7]
8. Imposes penalties on long-term care facilities for noncompliance with a hearing decision issued by Department of Health Care Services (DHCS) that orders readmission of a resident after a finding that the facility improperly transferred, discharged, or failed to readmit a resident. Sets these penalties at $750 for each calendar day the facility fails to comply with the hearing decision, up to a maximum of $75,000 for each individual heating decision. [WIC §14126.029]

Existing federal law:

1. Prohibits LTC facilities that participate in the Medicaid or Medicare program from transferring or discharging a resident from the facility unless under one of the following conditions:
   1. The transfer or discharge is necessary for the resident’s welfare and the resident’s needs cannot be met in the facility;
   2. The transfer or discharge is appropriate because the resident’s health has improved sufficiently so the resident no longer needs the services provided by the facility;
   3. The safety of individuals in the facility is endangered due to the clinical or behavioral status of the resident;
   4. The health of individuals in the facility would otherwise be endangered;
   5. The resident has failed, after reasonable and appropriate notice, to pay for (or have paid under Medicare or Medicaid) a stay at the facility. Specifies that for a resident who becomes eligible for Medicaid after admission to a facility, the facility may charge a resident only allowable charges under Medicaid; or,
   6. The facility ceases to operate. [42 CFR §483.15(c)]
2. Prohibits an LTC facility from transferring or discharging a resident while an appeal is pending, as specified, unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility. Requires the facility to document the danger that failure to transfer or discharge would pose. [42 CFR §483.15(c)]

This bill:

1. Requires an LTC facility to provide notice to the resident of a facility-initiated transfer or discharge, within 30 days before a resident is transferred or discharged, except as required in 2) and 3) below.
2. Requires an LTC facility to provide notice to the resident of a facility-initiated transfer or discharge at least 14 days before a resident is transferred or discharged in either of the following circumstances:
   1. The resident’s health has improved sufficiently to allow a more immediate transfer or discharge; or,
   2. The resident has not resided in the facility for 30 days.
3. Requires an LTC facility to provide a notice of transfer or discharge as soon as practicable before a resident is transferred or discharged when the health or safety of individuals in the facility would be endangered. Requires the following conditions to be met before this notice is provided:
   1. A licensed health care practitioner, acting within their scope of practice, engaged with the resident and, if applicable, the resident’s representative, to address the situation that is causing the health or safety of individuals in the facility to be endangered; and,
   2. The facility has documented its efforts to execute the health care practitioner’s orders regarding the modifications to the care plan to address the resident’s endangerment to the health and safety of individuals.
4. Requires a notice of transfer or discharge under 3) above to include a description of how the health or safety of individuals in the facility would be endangered and the type of care, services, or supports the discharge location can provide that are expected to address the resident’s endangerment to the health and safety of individuals.
5. Requires receipt of the notice of transfer or discharge to be acknowledged by the signature of the resident or, if applicable, the resident’s representative. Requires a facility staff member, if the signature of the resident or the resident’s representative cannot be obtained, to sign the notice and verify that they delivered the notice to the resident and, if applicable, the resident’s representative and state the name or names of the person or persons they delivered the notice to and the date or dates on which the notice was delivered. Requires copies of the signed notice to be given to the resident and, if applicable, their representative.
6. Specifies that nothing in the provisions of law governing transfer and discharge requirements, including the changes made by this bill, prohibits a resident who poses a danger to themselves or others from being detained pursuant to specified provisions of the Lanterman Petris Short Act governing the involuntary detainment of individuals who are a danger to themselves or others.
7. Specifies that knowingly making a false verification regarding the delivery of a notice of transfer or discharge is a willful violation, subject to existing misdemeanor penalties of a fine of up to $2,500 or up to 180 days in the county jail, or both.
8. Specifies that an LTC facility’s failure to comply with the notice requirements in this bill constitutes a class “B” violation, as specified.
9. Requires an LTC facility to provide a written translation of the transfer or discharge notice in the resident’s primary language, and requires the translated notice to be provided to the resident at the same time as the written notice in English. Requires the LTC facility or the individual or entity providing the translation to attest, under penalty of perjury, to the accuracy of the written translation in the translated document.
10. Requires an LTC facility, if the resident is vision impaired or blind, to provide the written notice in large print or braille upon the resident’s request. Requires the accessible-format notice to be provided to the resident at the same time as the written notice, and requires the entity providing the transcript or format conversion to attest, under penalty of perjury, to the accuracy of the content. Requires braille transcriptions to include the complete and unabridged text of the original written notice. Requires electronic braille transcription files to be used where applicable.
11. Requires the resident’s primary language and sensory impairments to be included in the minimum dataset maintained by the LTC facility, pursuant to specified requirements of existing law.
12. Specifies that a failure to provide a translated or accessible-format copy of the notice to the resident or to the local LTC ombudsman upon request constitutes an automatic class “B” violation.
13. Increases the penalties that may be assessed by DHCS against an LTC facility after a hearing that finds that the LTC facility improperly transferred, discharged, or refused to readmit a resident, from $750 to $1,000 for each calendar day the facility fails to comply with the hearing decision, up to a maximum aggregate of $100,000 per hearing decision (up from $75,000).
14. Requires DHCS to promptly notify CDPH if an LTC facility fails to timely comply with a hearing decision.
15. Permits CDPH, upon notification that an LTC facility has failed to timely comply with a hearing decision that the facility improperly transferred, discharged, or refused to readmit a resident, to prohibit the admission of new residents to the facility, and requires this prohibition to remain in effect until any of the following has occurred, as verified by CDPH prior to lifting the prohibition:
    1. The facility has achieved compliance;
    2. The maximum aggregate amount of penalties has been collected; or,
    3. The facility has formally sought judicial review of the hearing decision.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, costs of an unknown, but likely minor and absorbable amount, to CDPH. No costs to the Department of Justice and DHCS.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, wrongful nursing facility initiated discharges and unlawful evictions can leave residents without essential medical care, disrupt continuity of treatment, and place older adults and people with disabilities at serious risk of homelessness and declining health. LTC ombudsman and other resident advocates have long warned about evictions as one of the most common, urgent, and threatening issues that residents of nursing homes frequently encounter. This bill strengthens protections for nursing home residents facing eviction by requiring clear, timely, and verifiable discharge notices in a language and format residents understand. It addresses gaps that allow facilities to issue inadequate notice, avoid oversight, and prioritize profit over care, while improving enforcement to ensure wrongfully discharged residents are readmitted.
2. Transfer and discharge requirements under federal law. Under federal requirements, an LTC facility is only allowed to transfer or discharge a resident for certain reasons, including: when necessary for the resident’s welfare and the resident’s needs cannot be met in the facility; when the resident’s health has improved sufficiently; failure to pay, under certain circumstances; or, the safety of individuals in the facility is endangered due to the clinical or behavioral status of the resident. While a notice of transfer or discharge is theoretically required to be made at least 30 days before transfer or discharge, there are a number of exceptions where notice is only required to be made “as soon as practicable,” including in most of the allowed reasons for transfer or discharge, or when a resident has not resided in the facility for 30 days. Federal regulations require the transfer or discharge to be documented in the resident’s medical record, which is required to include the basis for the transfer, and in cases where the transfer is because the resident’s needs cannot be met at the facility, the facility’s attempts to meet the resident’s needs, and the service available at the receiving facility to meet the needs. The notice is required to be in writing and in a language and manner the resident understands, and a copy is required to be sent to the LTC ombudsman. A resident is allowed to appeal a transfer or discharge, and the facility is not allowed to transfer or discharge while the appeal is pending, unless the failure to transfer or discharge would endanger the health or safety of the resident or other individuals in the facility.
3. Setting a higher standard than federal regulations. Some of the provisions of this bill codify federal requirements for LTC facilities, either more or less directly, or with some additional details. For example, federal regulations require the discharge notice to be “in writing and in a language and manner the resident understands.” This bill incorporates this federal requirement by clearly stating that the facility is required to provide a written translation of the notice in the resident’s primary language, or in large print or braille upon request for a visually impaired resident. Other requirements in this bill go beyond federal requirements. For example, there are a number of exceptions from the federal requirement that a notice of transfer or discharge be made by the facility at least 30 days before transfer or discharge. If the transfer or discharge falls into one of those exceptions, the federal requirement defaults to “as soon as practicable before transfer or discharge.” Under this bill, however, instead of “as soon as practicable,” the discharge notice would have to be made at least 14 days before the transfer or discharge in some cases. This includes when a resident’s health has improved sufficiently to allow a more immediate transfer or discharge, or when the resident has not resided in the facility for 30 days. It is important to note that these requirements are for “facility-initiated” transfers or discharges; a resident can always voluntarily leave earlier. However, under this bill, if a resident is transferred from a hospital to an LTC facility for rehabilitation, and after two to three weeks, improves to the point where the LTC facility believes the resident can be safely discharged, rather than an “as soon as practicable” discharge notice, the facility would be required to give the resident a 14 day notice. The only federal exceptions to the 30-day rule where this bill retains the flexibility for a facility to provide a notice “as soon as practicable,” is where the health or safety of other individuals in the facility would be endangered. While an LTC facility is permitted to discharge a resident after providing a notice as soon as practicable in these circumstances, this bill does impose certain conditions that must be met. Some of these conditions are consistent with federal regulations or federal guidance, such as ensuring a licensed health care practitioner has engaged with the resident to address the situation that is causing the danger, and documenting efforts to address the issue. However, the requirement that the notice include a description of “the type of care, services, or supports the discharge location can provide that are expected to address the resident’s endangerment to the health and safety of individuals” goes beyond federal requirements.
4. State and local LTC Ombudsman Programs. The LTC Ombudsman Program is a federally authorized program, partially funded by the federal government, to advocate for the rights of residents in LTC facilities. In California, there is the Office of the State LTC Ombudsman, which is housed with the Department of Aging, and develops policy and provides oversight to the 35 local Ombudsman Program Coordinators. The LTC ombudsman’s advocacy role takes two forms: a) to receive and resolve individual complaints and issues by, or on behalf of, LTC facility residents; and, b) to pursue resident advocacy in the LTC system, its laws, policies, regulations, and administration through public education and consensus building. Residents or their family members can file a complaint directly with the local LTC Ombudsman, and all LTC facilities are required to post, in a conspicuous location, the phone number for the local LTC ombudsman office and the statewide CRISIS line, which is available 24 hours a day, seven days a week to take calls and refer complaints. State law gives LTC ombudsmen the right to enter and move within LTC facilities and residential care facilities to identify, hear, investigate, and resolve complaints; to observe and monitor conditions of residents and facilities; to speak confidentially with residents; and to provide services to assist residents in protecting their health, safety, welfare, and rights. There are 35 local LTC ombudsman programs, with both paid staff, and numerous certified volunteers who advocate on behalf of the residents of LTC facilities.
5. Double referral. This bill is double referred. Should it pass out of this committee, it will be referred to the Senate Judiciary Committee.
6. Prior legislation. AB 1309 (Reyes, Chapter 835, Statutes of 2023) requires nursing homes, within 48 hours of giving a required written notice of an involuntary transfer or discharge, to provide the resident with a copy of certain discharge related documents, including a description of specific needs that cannot be met and the facility’s attempts to meet those needs when the basis of the transfer or discharge is because the resident’s needs cannot be met in the facility.
   
   AB 895 (Holden, Chapter 577, Statutes of 2022) requires SNFs and Residential Care Facilities for the Elderly to provide a written notice to a prospective resident, or their representative, that includes the contact information for the local LTC ombudsman, and links to specified websites governing licensing and quality of care.
   
   AB 940 (Weber, Chapter 274, Statues of 2017) requires an LTC facility to notify the local LTC ombudsman when a resident is notified in writing of a facility-initiated transfer or discharge from the facility.
7. Support. This bill is co-sponsored by California Advocates for Nursing Home Reform (CANHR), the California Long-Term Care Ombudsman Association (CLTCOA), the California Council of the Blind, and Disability Rights Education & Defense Fund. CANHR states in support that illegal evictions are one of the most common rights violations that nursing home residents face. According to CANHR, from 2018 to 2024, California nursing homes were cited 2,539 times for deficient discharge practice, and CANHR receives calls on a near-daily basis from consumers across California facing the threat of an illegal nursing home eviction. According to CANHR, the most common reason for eviction is Medi-Cal discrimination. Almost every nursing home resident is admitted after a hospital stay and typically has about 10 to 20 days of rehabilitative services covered by Medicare, which pays a generous rate compared to other payment sources. If a person needs to stay in a nursing home after their Medicare coverage ends, they have to switch to a less lucrative payment source, such as Medi-Cal. This change in payment status creates enormous financial incentives for facilities to evict residents who have exhausted their Medicare benefit and replace them with new residents who have fresh Medicare coverage. When Medicare coverage ends, the nursing home will often issue a Notice of Medicare Non-Coverage (NOMNC), claiming they need to be discharged because Medicare will not cover their services if they stay. However, residents are rarely given information about their right to apply for Medi-Cal as an option for coverage. Instead of complying with discharge notice requirements, nursing homes use the NOMNC to convince residents they must leave to avoid financial liability even if their health has not sufficiently improved. CANHR notes that nursing homes are generally required to provide the resident a 30-day written discharge notice. However, certain exceptions allow facilities to provide notice “as soon as practicable.” One of those exceptions is if the resident has resided in the facility for less than 30 days. Nursing homes take advantage of this undefined phrase to discharge residents within one to two days after Medicare stops providing coverage, and often, no written discharge notice is given at all. In addition, when they are given a written notice of discharge, it is often a standard notice in English, yet 16% of residents requested an interpreter or translator, 22% were vision-impaired, and 56% reported needing assistance reading or understanding written materials from their doctor. Although federal regulations require discharge notices to be in writing and in a language and manner they understand, nursing homes often do not comply. Finally, CANHR states that this bill reinforces residents’ rights by increasing and enforcing penalties for facilities that refuse to readmit their residents after a hospital stay, even after being ordered to readmit by DHCS. CLTCOA makes similar arguments, and states that for vulnerable older adults who rely on nursing homes for their care and safety, an eviction is not merely a housing dispute, it can represent the sudden loss of their home, their support network, their health, and ultimately their stability. This bill provides critical safeguards to ensure nursing home residents are not lawfully or abruptly forced from the place they’ve come to call home.
8. Oppose unless amended. The City and County of San Francisco oppose this bill unless amended. San Francisco owns and operates Laguna Honda Hospital (LHH), which is a 769-bed SNF. LHH is one of the largest SNFs in the United States and represents one of the most extensive commitments by any city or county to therapeutic care for seniors and adults with disabilities. San Francisco is specifically concerned with the proposed change to only allow the transfer or discharge of a resident whose behavior endangers the health and safety of individuals in the facility if the facility can transfer the individual to a facility that is expected to “address the resident’s endangerment to the health and safety of individuals.” San Francisco states that the discharging facility is responsible for safely discharging residents and ensuring they receive the health services and care they need at the discharge location. It is not the discharging facility’s responsibility to ensure the safety of others from that person when they go to another facility. It is not reasonable, nor is it within federal regulations, to put this burden on the discharging facility. As such, San Francisco proposes an amendment to require the notice of transfer or discharge to describe how the discharge location is expected to “address the resident’s needs,” rather than how the discharge location will “address the resident’s endangerment to the health and safety of individuals.”
   
   The California Association of Health Facilities, LeadingAge California, and the California Hospital Association also oppose unless amended, writing jointly that this bill continues to be inconsistent with federal law, increases costs and administrative complexity, and poses challenges for facilities to protect staff and resident safety. This coalition has the same concern with the discharge notice that San Francisco has, although with a different requested amendment. In addition, this coalition has concerns with the written translation requirements, and suggests this would be more appropriately managed by CDPH to ensure accuracy and would align with CDPH’s role in producing other translated documents via their Language Access Services Program. Directing CDPH to translate a standard form and certify that the translated form is accurate will ensure consistency and quality of translation, while the facility will still need to ensure that the actual contents of the form, such as the description of care needs, is in the appropriate language. The coalition also continues to have concerns with provisions requiring a 14 day-notice for discharges or transfers where federal law offers more flexibility, and argue that when an SNF is unable to discharge a resident who is medically cleared for a lower level of care or no longer has coverage for SNF services, the resulting bed occupancy creates bottlenecks throughout the continuum of care.
9. Amendments. The author has agreed to accept amendments from the Committee as follows:
   1. On Page 5, lines 11-16:
      (B) A notice of transfer or discharge made pursuant to this paragraph shall include a description of how the health or safety of individuals in the facility would be endangered and the type of care, services, or supports the discharge location can provide that are expected to address the resident’s endangerment to the health and safety of individuals needs.
   2. On Page 7, between lines 27 and 28, add a new paragraph as follows:
      (3) A facility may use a template form developed and translated by the state or a professional association that meets the requirements of this section, however, the facility shall ensure that patient-specific information as required by this section has been added and meets the translation or accessibility standards required by this section.

(3)(4) Failure to provide (.…)

SUPPORT AND OPPOSITION:

Support: California Advocates for Nursing Home Reform (co-sponsor)

California Council of the Blind (co-sponsor)

California Long Term Care Ombudsman Association (co-sponsor)

Disability Rights Education and Defense Fund (co-sponsor)

AARP
Alzheimer's Association
Ars Moriendi Project
California Alliance for Retired Americans
California Association of Area Agencies on Aging
California Coalition on Family Caregiving

California Elder Justice Coalition
California Health Advocates
California Retired Teachers Association
California Senior Legislature
Choice in Aging

Coalition of California Welfare Rights Organizations
Consumer Attorneys of California

Council on Aging, Southern California
Disability Action Center
Disability Rights California

Empowered Aging
Essential Caregivers Coalition
Justice in Aging

Legal Assistance for Seniors

Long-Term Care Ombudsman Program of El Dorado County

Long-Term Care Ombudsman Program of Imperial County

Long-Term Care Ombudsman Program of Kern County

Long-Term Care Ombudsman Program of San Francisco

Long Term Care Ombudsman Program of San Luis Obispo County
Long Term Care Services of Ventura County
Office of the State Long-Term Care Ombudsman
Placer Independent Resource Services
Senior Advocacy Services

Western Center on Law & Poverty

Wise and Healthy Aging

Oppose: California Association of Health Facilities (unless amended)

California Hospital Association (unless amended)

City and County of San Francisco (unless amended)

LeadingAge California (unless amended)

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2135

Author:(Kalra)

As Amended Ver:April 16, 2026

Majority vote

SUMMARY

Requires long-term health care (LTC) facilities to provide residents with a notice of transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. Requires the notice of transfer or discharge to be signed by the resident or the resident's representative and by a facility staff member who declares they delivered the notice to the resident or the resident's representative. Requires, if the language of the resident is not English, the facility to provide a written translation of the notice in the resident's primary language. Requires, if the resident is vision impaired or blind, the facility to provide the written notice in large print or braille upon the residents' request. Makes a violation of these provisions a class "B" violation and knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation. Requires notices to be sent to the LTC Ombudsman by facsimile, email, or other electronic means. Authorizes the Department of Public Health (DPH) to prohibit the admission of new residents to a LTC-health facility if a facility has failed to timely comply with a hearing decision related to a violation of this bill.

Major Provisions

COMMENTS

According to the California Department of Aging Office of the State Long-Term Care Ombudsman 2025 National Ombudsman Reporting System, since 2018, California nursing homes have received more than 2,500 federal deficiencies related to improper discharge practices. In federal fiscal year 2025, California's Long-Term Care Ombudsman Program received 1,518 complaints related to nursing home discharges and evictions.

Minimum Data Set (MDS). According to the Centers for Medicare and Medicaid Services (CMS) MDS is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. Care Area Assessments (CAAs) are part of this process, and provide the foundation upon which a resident's individual care plan is formulated. MDS assessments are completed for all residents in certified nursing homes, regardless of source of payment for the individual resident. MDS assessments are required for residents on admission to the nursing facility, periodically, and on discharge. All assessments are completed within specific guidelines and time frames. In most cases, participants in the assessment process are licensed health care professionals employed by the nursing home. MDS information is transmitted electronically by skilled nursing facilities (SNFs) to the national MDS database at CMS.

SNF Residents in need of accommodations. According to the CMS MDS data from Q4 2025 shows in California, 16% of SNF residents request an interpreter/translator. Additionally, 22% of residents are vision-impaired, and 33% require corrective lenses, which would require their discharge notices to be in an accessible format such as large print or braille. Lastly, 56% of residents report they occasionally or routinely needed help reading/understanding written materials from their doctors.

How do they know they are being told to go? Federal regulations require nursing home discharge notices to be provided to residents “in writing and in a language and manner they understand” (Title 42, Code of Federal Regulations (CFR) Section 483.15(c)(3)(i)). LTC facilities are also required to transmit copies of facility-initiated discharge notices to their local Ombudsman programs. However, facilities are not explicitly required to provide Ombudsmen with copies of the written translations or transcriptions to document they were provided to the residents. Ombudsman across the state report that facilities are often translating these notices orally rather than in writing, in which case there is no documentation the required information was ultimately communicated to the residents. According to the sponsors of this bill, there are Ombudsmen in California who have served in their roles for decades who have never seen an example of a discharge notice provided in another language or accessible format despite these long-standing federal requirements.

All Facilities Letter 25-17. On May 28, 2025, DPH sent an All Facilities Letter (AFL) to remind SNFs of the transfer and discharge notice requirements, as specified in Title 42 CFR Section 483.15(c). The AFL notes that transfer and discharge notices must be in writing and in a language and manner the resident and resident representative(s) understand and that noncompliance with transfer and discharge requirements will be cited as a deficiency and may result in a citation and/or civil action. This bill seeks to strengthen due process protections by requiring clearer and more accessible discharge notices and by improving enforcement when LTC facilities fail to comply with readmission requirements.

According to the Author

Like canaries in coal mines, LTC Ombudsmen and other resident advocates have long warned about evictions as one of the most common, urgent, and threatening issues that residents of nursing homes frequently encounter. The author states that this bill strengthens protections for nursing home residents facing eviction by requiring clear, timely, and verifiable discharge notices in a language and format residents understand. The author concludes this bill addresses gaps that allow facilities to issue inadequate notice, avoid oversight, and prioritize profit over care, while improving enforcement to ensure wrongfully discharged residents are readmitted.

Arguments in Support

California Advocates for Nursing Home Reform (CANHR) are a co-sponsor of this bill and state that this bill ensures vulnerable older and disabled adults have strong protections in the event they face eviction from their nursing facility. CANHR notes that in California, there are approximately 1,166 nursing homes, 108,000 beds, with occupancy rates at 88.5%. Nursing home residents who fill these beds often have high medical needs and rely on care from their facility to receive rehabilitation, get assistance with activities of daily living, or sustain their life. For many, nursing homes are their permanent place of residence because they are unable to live independently. However, CANHR also notes the nursing home industry is a for-profit business and often acts as such. Illegal evictions are one of the most common rights violations that nursing home residents face. From 2018 to 2024, California nursing homes were cited 2,539 times for deficient discharge practices. CANHR contends that the most common reason for eviction is Medi-Cal discrimination. Almost every nursing home resident is admitted after a hospital stay and typically has about ten to twenty days of rehabilitative services covered by Medicare, which pays a generous rate compared to other payment sources. If a person needs to stay in a nursing home for care after their Medicare coverage ends, they have to switch to a less lucrative payment source, such as Medi-Cal. CANHR argues that this change in payment status creates enormous financial incentives for facilities to evict residents who have exhausted their Medicare benefit and replace them with new residents who have fresh Medicare coverage, independent of their care needs. CANHR states that nursing homes are generally required to provide the resident and, if applicable, their representative, a 30-day written discharge notice. However, certain exceptions in the federal regulations allow facilities to provide notice "as soon as practicable." One of the exceptions is if the resident has resided in the facility for less than 30 days. Since Medicare coverage becomes partial at day 20, nursing homes take advantage of the undefined phrase "as soon as practicable" to discharge residents within one to two days. CANHR complains that often, no written discharge notice is given at all.

The California LTC Ombudsman Association (CLTCOA) is a co-sponsor of this bill and states that unsafe and unnecessary transfers can have serious consequences for residents' health and well-being. Research shows that involuntary nursing home transfers can lead to "transfer trauma," also known as Relocation Stress Syndrome, as sudden relocation often causes severe stress, anxiety, and confusion. For residents living with dementia or complex medical conditions, abrupt relocation can result in significant psychological distress, cognitive decline, depression, and other adverse health outcomes, including increased mortality risk. CLTCOA notes that these risks make timely, clear, and accessible transfer-discharge notices essential so that residents can understand and exercise their rights. However, Ombudsman programs regularly encounter residents who receive notices they cannot read or understand. CLTCOA concludes that by establishing clearer, timelier, and accessible notice requirements, as well as strengthening state enforcement of readmission orders, this provides critical safeguards to ensure nursing home residents are not unlawfully or abruptly forced from the place they've come to call home.

Arguments in Opposition

The California Association of Health Facilities (CAHF), LeadingAge California, and the California Hospital Association (CHA) oppose this bill unless amended. The organizations recognize the author's and sponsors' intent to strengthen protections for residents of nursing homes, they contend is inconsistent with federal law, increases administrative complexity that diverts resources away from direct patient care, disrupts access to care for patients who need to be discharged to skilled nursing facilities and eliminates critical flexibility intended to protect staff and resident safety.

The organizations support residents being informed about transfer and discharge actions in a manner that they can understand and state that in practice, facilities will use live or telephone language translators and verbal explanation to explain the discharge process and the resident’s rights to residents who require additional assistance, in addition to providing the written notice by e-mail to the resident and their representative. When a resident receives a notice of discharge it is noted in the resident’s medical record. It has also become more common for residents to view the discharge notice on a tablet or through other electronic means and electronically acknowledge that they have received the notice. The organizations argue that as facilities increasingly move away from paper-based processes toward fully electronic health record systems, management of additional signed paper documents in the electronic record increases administrative complexity and the development of additional policies and processes. Adding an additional signature requirement to the transfer and discharge notice process is unnecessary as facilities already note in the record when notice has been provided.

FISCAL COMMENTS

According to the Assembly Appropriations Committee, costs of an unknown, but likely minor and absorbable amount, to DPH. No costs to the Department of Justice and the Department of Health Care Services.

VOTES

ASM HEALTH: 14-0-2

YES: Bonta, Addis, Aguiar-Curry, Ahrens, Caloza, Carrillo, Mark González, Johnson, Patel, Rogers, Sanchez, Schiavo, Sharp-Collins, Stefani

ABS, ABST OR NV: Chen, Patterson

ASM APPROPRIATIONS: 12-0-3

YES: Wicks, Hoover, Aguiar-Curry, Caloza, Dixon, Fong, Mark González, Krell, Pacheco, Pellerin, Sharp-Collins, Solache

ABS, ABST OR NV: Arambula, Ta, Tangipa

UPDATED

VERSION: April 16, 2026

CONSULTANT: Lara Flynn / HEALTH / (916) 319-2097 FN: 0002483

Date of Hearing: May 6, 2026

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 2135

Author:(Kalra) – As Amended Ver:April 16, 2026

Urgency: No State Mandated Local Program: Yes Reimbursable: No

SUMMARY:

This bill requires a long-term health care (LTC) facility to provide a resident with a notice of a facility-initiated transfer or discharge at least 30 days before the resident is transferred or discharged. The bill also requires the notice be in an appropriate language and accessible for the vision impaired and increases penalties for violations of transfer requirements.

Specifically, this bill:

1. Requires an LTC facility to provide a resident with a notice of a facility-initiated transfer or discharge at least 30 days before the resident is transferred or discharged, except as provided in item 2, below.
   
2. Requires an LTC facility to provide a notice at least 14 days before a resident is transferred or discharged in any of the following circumstances: (a) the health and safety of individuals in the facility would be endangered, (b) the resident’s health has improved sufficiently to allow a more immediate transfer or discharge, or (c) the resident has not resided in the facility for 30 days.
3. Requires a notice of transfer meet specified requirements related to language and accessibility for the blind and vision impaired.
4. Makes a failure to comply with the above requirements a class “B” violation, and failure to provide accessible notices subject to a $1,000 penalty.
5. Requires the notice of transfer or discharge to be signed by the resident or their representative and by a facility staff member who declares they delivered the notice to the resident or the resident’s representative, and makes knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation.
6. Authorizes the Department of Public Health (CDPH) to prohibit the admission of new residents to a LTC facility that improperly transfers, discharges, or refuses to readmit a resident, as specified.
7. Increases penalties CDPH is authorized to assess for failure of an LTC facility to comply with a hearing decision to $1,000 for each calendar day the facility fails to comply with a hearing decision, up to $100,000 for a single hearing decision.
   

FISCAL EFFECT:

Costs of an unknown, but likely minor and absorbable amount, to CDPH.

No costs to the Department of Justice and the Department of Health Care Services.

COMMENTS:

1. Purpose. This bill is sponsored by California Advocates for Nursing Home Reform (CANHR). According to the author:

Long-Term Care Ombudsmen and other resident advocates have long warned about evictions as one of the most common, urgent, and threatening issues that residents of nursing homes frequently encounter. [This bill] strengthens protections for nursing home residents facing eviction by requiring clear, timely, and verifiable discharge notices in a language and format residents understand. It addresses gaps that allow facilities to issue inadequate notice, avoid oversight, and prioritize profit over care, while improving enforcement to ensure wrongfully discharged residents are readmitted.

1. Background. Since 2018, California nursing homes have received more than 2,500 federal deficiencies related to improper discharge practices. In federal fiscal year 2025, California’s Long-Term Care Ombudsman Program received 1,518 complaints related to nursing home discharges and evictions.
   
   Federal data show 16% of California skilled nursing facility residents request an interpreter/translator. Additionally, 22% of residents are vision-impaired, and 33% require corrective lenses that would require their discharge notices to be in an accessible format such as large print or braille.

Analysis Prepared by: Allegra Kim / APPR. / (916) 319-2081

Date of Hearing: April 14, 2026

ASSEMBLY COMMITTEE ON HEALTH

Mia Bonta, Chair

ABPCA Bill Id:AB 2135

Author:(Kalra) – As Amended Ver:April 6, 2026

SUBJECT: Long-term health care facilities.

SUMMARY: Requires long-term health care (LTC) facilities to provide residents with a notice of transfer or discharge at least 30 days before a resident is transferred or discharged, unless an exception applies. Requires the notice of transfer or discharge to be signed by the resident or the resident’s representative and by a facility staff member who declares they delivered the notice to the resident or the resident’s representative. Makes a violation of these provisions a class “B” violation and knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation. Requires notices to be provided to a resident or their representative in a translated or accessible format, and to be sent to the LTC Ombudsman. Requires the Department of Public Health (DPH) to prohibit the admission of new residents to a LTC facility upon notification by the Department of Health Care Services (DHCS), as specified. Specifically, this bill:

1. Requires, consistent with federal regulations, a notice of resident transfer or discharge to be made by the facility at least 30 days before a resident is transferred or discharged, except as provided in 2) below.
2. Requires a notice of transfer or discharge to be made by the facility at least 14 days before a resident is transferred or discharged in any of the following circumstances:
   1. The health or safety of individuals in the facility would be endangered;
   2. The residents’ health has improved sufficiently to allow a more immediate transfer or discharge; or,
   3. The resident has not resided in the facility for 30 days.
3. Requires the notice of transfer or discharge to be signed by the resident or the resident’s representative, and also be signed by a facility staff member who declares they delivered the notice to the resident or the resident’s representative. Requires, if the signature of the resident or resident’s representative cannot be obtained, a facility staff member to sign the notice and verify that they delivered the notice to the resident or the resident’s representative and state the name of the person they delivered the notice to and the date on which the notice was delivered. Requires copies of the signed notice to be given to the resident and their representative.
4. Makes a facility’s failure to comply with this bill constitute a class “B” violation, as described in 2) of existing law, below.
5. Makes knowingly making a false verification regarding the delivery of a notice of transfer or discharge a willful violation subject to 3) of existing law below.
6. Requires, consistent with federal regulations, a notice required by this bill to meet the following requirements:
   1. If the primary language of the resident is not English, the facility to provide a written translation of the notice in the resident’s primary language. Requires the translated notice to be provided to the resident or the resident’s representative, if applicable, at the same time as the written notice in English. Requires the facility or the individual or entity providing the translation to attest to the accuracy of the written translation in the translated document; and,
   2. If the resident is vision impaired or blind, the facility to provide the written notice in large print or braille upon the residents’ request. Requires the accessible-format notice to be provided to the resident or the resident’s representative, if applicable, at the same time as the written notice. Requires the facility or the individual or entity providing the transcript or format conversion to attest to the accuracy of the content in the accessible-format document. Requires braille transcriptions provided pursuant to this bill to include the complete and unabridged text of the original written notice, including all required attachments, rights statements, and appeal information. Requires electronic braille transcription files to be used where applicable.
7. Requires the resident’s primary language and sensory impairments to be included in the minimum data set (MDS) maintained by the facility pursuant to existing state and federal law which require data for preadmission screening, annual resident reviews, and Medi-Cal treatment authorization requests.
8. Requires failure to provide a translated or accessible-format copy to the resident or the resident’s representative or to the local long-term care ombudsman upon request pursuant to this bill constitute an automatic class “B” violation subject to a one-thousand-dollar ($1,000) civil penalty.
9. States that the provisions of this bill are intended to be consistent with federal law and regulations and not be construed to limit any greater protections provided to residents under state or federal law. States these provisions do not limit the ability of a local long-term care ombudsman to request or receive documents necessary to investigate or advocate regarding a resident’s transfer or discharge.
10. Increases existing fines when a LTC facility has been found to have improperly transferred, discharged, or refused to readmit a resident from $75,000 to $100,000 for each calendar day the LTC facility fails to comply with a hearing decision, pursuant to 3) below of existing law.
11. Requires, DHCS, if a LTC facility fails to timely comply with a hearing decision that finds a facility in violation of this bill, to promptly notify DPH, which is required to prohibit new resident admissions to the facility until DHCS notifies DPH of any of the following:
    1. The facility has achieved compliance;
    2. The maximum aggregate amount of penalties under existing law have been collected; or,
    3. The facility has formally sought judicial review of the hearing decision.

EXISTING LAW:

1. Licenses and regulates skilled nursing facilities (SNFs) and intermediate care facilities (ICFs) by DPH. SNFs are defined as health facilities that provide skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis, and ICFs are defined as health facilities that provide inpatient care to ambulatory or non-ambulatory patients who have recurring need for skilled nursing supervision and need supportive care, but who do not require the availability of continuous skilled nursing care. [Health and Safety Code (HSC) § 1250 (c) and (d)]
2. Establishes a civil penalty structure for LTC facilities, categorized into “AA,” “A,” and “B” violations: “A” violations are where DPH determines that the violation presents either imminent danger of death or serious harm, or a substantial probability that death or serious harm to residents would result; “AA” violations (the most severe) are those that meet the criteria for a class “A” violation that DPH determines have been a substantial factor in the death of a resident of an LTC facility; and, “B” violations are those that DPH determines have a direct or immediate relationship to the health, safety, or security of LTC facility residents. [HSC § 1424]
3. Makes any person who willfully or repeatedly violates provisions of law relating to the operation or maintenance of a LTC facility guilty of a misdemeanor and upon conviction thereof to be punished by a fine not to exceed two thousand five hundred dollars ($2,500) or by imprisonment in the county jail for a period not to exceed 180 days, or by both. Requires, in determining the punishment to be imposed upon a conviction under this provision, the court to consider all relevant facts, including, but not limited to, the following:
   1. Whether the violation exposed the patient to the risk of death or serious physical harm;
   2. Whether the violation had a direct or immediate relationship to the health, safety, or security of the patient;
   3. Evidence, if any, of willfulness;
   4. The number of repeated violations; and,
   5. The presence or absence of good faith efforts by the defendant to prevent the violation. [HSC § 1290]
4. Defines, for the purposes of 3) above, “willfully” or “willful” to mean the person doing an act or omitting to do an act intends the act or omitting to do an act intends the act or omission, and knows the relevant circumstances connected therewith. [Ibid.]
5. Requires DHCS develop, collect, and maintain, in an electronic format, all data elements in the MDS specified by the federal government. Requires the database to incorporate the data required for preadmission screening and annual resident reviews, and Medi-Cal treatment authorization requests. Requires DHCS to make the format of this new database available to the public. [Welfare and Institutions Code (WIC) § 14110.15]
6. Requires all SNFs and nursing facilities required by federal law to complete the MDS form and provide the data to DHCS in a manner and form prescribed by the director. Requires DHCS to design MDS data base in a manner that maintains resident confidentiality and that allows the use of the data by other authorized state agencies, including, but not limited to, the Office of Statewide Health Planning and Development. States that this provision not be construed to prohibit DHCS or any other state agency from requiring additional information that is not available from the MDS database in order to meet other data needs. [Ibid.]

FEDERAL REGULATIONS

1. Requires, in federal regulation, before a LTC facility transfers or discharges a resident, the facility to:
   1. Notify the resident and the resident's representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. Requires the facility to send a copy of the notice to a representative of the Office of the State LTC Ombudsman;
   2. Record the reasons for the transfer or discharge in the resident's medical record; and,
   3. Include in the notice the following:
      1. The reason for transfer or discharge;
      2. The location to which the resident is transferred or discharged;
      3. A statement of the resident's appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request;
      4. The name, address (mailing and email) and telephone number of the Office of the State LTC Ombudsman;
      5. For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000. (Pub. L. 106-402, codified at 42 U.S.C. 15001, et seq.); and,
      6. For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act. [Section 483.15 of Title 42 of the Code of Federal Regulations (CFR)]
2. Requires the notice of transfer or discharge required under 1) above, to be made by the facility at least 30 days before the resident is transferred or discharged. [Ibid.]
3. Requires when the facility transfers or discharges a resident, the facility to ensure that the transfer or discharge is documented in the resident's medical record and appropriate information is communicated to the receiving health care institution or provider. Requires the documentation in the resident's medical record to include:
   1. The basis for the transfer;
   2. The specific resident need(s) that cannot be met, facility attempts to meet the resident needs, and the service available at the receiving facility to meet the need(s); and,
   3. Requires the documentation required to be made by the resident's physician when transfer or discharge is necessary. [Ibid.]

FISCAL EFFECT: Unknown. This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, like canaries in coal mines, LTC Ombudsmen and other resident advocates have long warned about evictions as one of the most common, urgent, and threatening issues that residents of nursing homes frequently encounter. The author states that this bill strengthens protections for nursing home residents facing eviction by requiring clear, timely, and verifiable discharge notices in a language and format residents understand. The author concludes this bill addresses gaps that allow facilities to issue inadequate notice, avoid oversight, and prioritize profit over care, while improving enforcement to ensure wrongfully discharged residents are readmitted.
2. BACKGROUND. According to the California Department of Aging Office of the State Long-Term Care Ombudsman 2025 National Ombudsman Reporting System, since 2018, California nursing homes have received more than 2,500 federal deficiencies related to improper discharge practices. In federal fiscal year 2025, California’s Long-Term Care Ombudsman Program received 1,518 complaints related to nursing home discharges and evictions.
   1. Minimum Data Set (MDS). According to the Centers for Medicare and Medicaid Services (CMS) MDS is part of the federally mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. Care Area Assessments (CAAs) are part of this process, and provide the foundation upon which a resident's individual care plan is formulated. MDS assessments are completed for all residents in certified nursing homes, regardless of source of payment for the individual resident. MDS assessments are required for residents on admission to the nursing facility, periodically, and on discharge. All assessments are completed within specific guidelines and time frames. In most cases, participants in the assessment process are licensed health care professionals employed by the nursing home. MDS information is transmitted electronically by SNFs to the national MDS database at CMS.
   2. SNF Residents in need of accommodations. According to the CMS MDS data from Q4 2025 shows in California, 16% of SNF residents request an interpreter/translator. Additionally, 22% of residents are vision-impaired, and 33% require corrective lenses, which would require their discharge notices to be in an accessible format such as large print or braille. Lastly, 56% of residents report they occasionally or routinely needed help reading/understanding written materials from their doctors.
   3. How do they know they are being told to go? Federal regulations require nursing home discharge notices to be provided to residents “in writing and in a language and manner they understand” (42 CFR § 483.15(c)(3)(i)). LTC facilities are also required to transmit copies of facility-initiated discharge notices to their local Ombudsman programs. However, facilities are not explicitly required to provide Ombudsmen with copies of the written translations or transcriptions to document they were provided to the residents. Ombudsman across the state report that facilities are often translating these notices orally rather than in writing, in which case there is no documentation the required information was ultimately communicated to the residents. According to the sponsors of this bill, there are Ombudsmen in California who have served in their roles for decades who have never seen an example of a discharge notice provided in another language or accessible format despite these long-standing federal requirements.
   4. All Facilities Letter 25-17. On May 28, 2025, DPH sent an All Facilities Letter (AFL) to remind SNFs of the transfer and discharge notice requirements, as specified in Title 42 CFR section 483.15(c). The AFL notes that transfer and discharge notices must be in writing and in a language and manner the resident and resident representative(s) understand and that noncompliance with transfer and discharge requirements will be cited as a deficiency and may result in a citation and/or civil action. This bill seeks to strengthen due process protections by requiring clearer and more accessible discharge notices and by improving enforcement when LTC facilities fail to comply with readmission requirements.
3. SUPPORT. California Advocates for Nursing Home Reform (CANHR) are a co-sponsor of this bill and state that this bill ensures vulnerable older and disabled adults have strong protections in the event they face eviction from their nursing facility. CANHR notes that in California, there are approximately 1,166 nursing homes, 108,000 beds, with occupancy rates

at 88.5%. Nursing home residents who fill these beds often have high medical needs and rely on care from their facility to receive rehabilitation, get assistance with activities of daily living, or sustain their life. For many, nursing homes are their permanent place of residence because they are unable to live independently. However, CANHR also notes the nursing home industry is a for-profit business and often acts as such. Illegal evictions are one of the most common rights violations that nursing home residents face. From 2018 to 2024, California nursing homes were cited 2,539 times for deficient discharge practices. CANHR contends that the most common reason for eviction is Medi-Cal discrimination. Almost every nursing home resident is admitted after a hospital stay and typically has about ten to twenty days of rehabilitative services covered by Medicare, which pays a generous rate compared to other payment sources. If a person needs to stay in a nursing home for care after their Medicare coverage ends, they have to switch to a less lucrative payment source, such as Medi-Cal. CANHR argues that this change in payment status creates enormous financial incentives for facilities to evict residents who have exhausted their Medicare benefit and replace them with new residents who have fresh Medicare coverage, independent of their care needs. CANHR states that nursing homes are generally required to provide the resident and, if applicable, their representative, a 30-day written discharge notice. However, certain exceptions in the federal regulations allow facilities to provide notice “as soon as practicable.” One of the exceptions is if the resident has resided in the facility for less than 30 days. Since Medicare coverage becomes partial at day 20, nursing homes take advantage of the undefined phrase “as soon as practicable” to discharge residents within one to two days. CANHR complains that often, no written discharge notice is given at all.

The California LTC Ombudsman Association (CLTCOA) is a co-sponsor of this bill and states that unsafe and unnecessary transfers can have serious consequences for residents’ health and well-being. Research shows that involuntary nursing home transfers can lead to “transfer trauma,” also known as Relocation Stress Syndrome, as sudden relocation often causes severe stress, anxiety, and confusion. For residents living with dementia or complex medical conditions, abrupt relocation can result in significant psychological distress, cognitive decline, depression, and other adverse health outcomes, including increased mortality risk. CLTCOA notes that these risks make timely, clear, and accessible transfer-discharge notices essential so that residents can understand and exercise their rights. However, Ombudsman programs regularly encounter residents who receive notices they cannot read or understand. CLTCOA concludes that by establishing clearer, timelier, and accessible notice requirements, as well as strengthening state enforcement of readmission orders, this provides critical safeguards to ensure nursing home residents are not unlawfully or abruptly forced from the place they’ve come to call home.

1. OPPOSE UNLESS AMENDED. The California Association of Health Facilities (CAHF), LeadingAge California, and the California Hospital Association (CHA) are opposed to this bill unless it is amended. The opponents note that federal and state law include important protections for residents of LTC facilities, including written notice requirements for facility-initiated transfers or discharge. Existing law also requires that the information be communicated to residents in a manner that they can understand and that copies of these notices be sent to the local LTC ombudsman. Opponents state this bill would require a facility to retain and make a signed translated or accessible written version of the discharge notice available to the local ombudsman.

The opponents argue that they support residents being informed about transfer and discharge actions in a manner that they can understand. But note that in practice, facilities will use live or telephone language translators and verbal explanation to explain the discharge process and the resident’s rights to residents who require additional assistance, in addition to providing the written notice by e-mail to the resident and their representative. When a resident receives a notice of discharge it is noted in the resident’s medical record. It has also become more common for residents to view the discharge notice on a tablet or through other electronic means and electronically acknowledge that they have received the notice.

The opponents point to existing law which already provides a resident with right to appeal a notice of discharge and specifies that a resident may not be discharged from the facility pending resolution of the appeal, unless they pose a danger to themselves or other residents. Opponents explain that they support maintaining the flexibility of “as soon as practicable” exceptions and oppose defining the prescriptive definition of a minimum length of time. The opponents contend that this flexibility is intentional to reflect the variation in appropriate notice times between, for example, when a resident’s health has improved and they are fit to return home versus when a resident poses an immediate threat to other residents and requires immediate transfer to a more appropriate care setting. They suggest amendments to align the notice periods with federal law or to clarify that the 14-day minimum notice period would not apply under specified situations such as when a resident poses a risk to other residents.

1. PREVIOUS LEGISLATION.
   1. AB 486 (Kalra) of 2023 would have repealed the process whereby LTC facilities can appeal more severe types of citations by filing a civil action in the superior court, and instead subjected those appeals to hearings by an administrative law judge that are currently used for lower level citations. AB 486 was not heard in the Senate Judiciary Committee.
   2. AB 323 (Kara) Chapter 458, Statutes of 2021 revises the criteria under which DPH issues civil penalties against LTC facilities that were found to have caused the death of a resident, so that instead of having to prove the death of a resident was the “direct proximate cause” of a violation by the facility, DPH would have to prove that the violation was a “substantial factor” in the death of a resident, and defines substantial factor as more than a remote or trivial factor but is not required to be the only cause of harm. Additionally, increases the amount of civil penalties assessed against LTC facilities.
2. AMENDMENTS. In order to address some of the concerns raised by stakeholders, the author and committee have agreed to the following amendments:
   1. Authorize, rather than require DPH prohibit new admissions to LTC facilities in violation of the bill;
   2. Delete the cross references to federal regulations;
   3. Clarify that the provisions of the bill only apply to facility-initiated transfers; and,
   4. Clarify that the bill does not require a resident deemed a danger to themselves or others to remain physically in the facility during a 14-day notice period.

REGISTERED SUPPORT / OPPOSITION:

Support

California Advocates for Nursing Home Reform (cosponsor)

California Long-Term Care Ombudsman Association (cosponsor)

California Council of the Blind (cosponsor)

Disability Rights Education & Defense Fund (cosponsor)
AARP

Alzheimer's Association

Ars Moriendi Project

California Coalition on Family Caregiving

California Health Advocates

California Retired Teachers Association

Choice in Aging

Consumer Attorneys of California

Disability Action Center

Disability Rights California

El Dorado County Long-term Care Ombudsman Program

Empowered Aging

Justice in Aging

Kern County Long-term Care Ombudsman Program

Long Term Care Services of Ventura Co, Ombudsman

Long-term Care Ombudsman Program

Office of the State Long-term Care Ombudsman

Placer Independent Resource Services

San Francisco Long Term Care Ombudsman Felton Institute

Senior Advocacy Services

Several individuals

Opposition

None one file

Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097