SECTIONS 1599-1599.4

1599.  It is the intent of the Legislature in enacting this chapterto expressly set forth fundamental human rights which all patientsshall be entitled to in a skilled nursing or intermediate carefacility, as defined in Section 1250, and to ensure that patients insuch facilities are advised of their fundamental rights and theobligations of the facility.1599.1.  Written policies regarding the rights of patients shall beestablished and shall be made available to the patient, to anyguardian, next of kin, sponsoring agency or representative payee, andto the public. Those policies and procedures shall ensure that eachpatient admitted to the facility has the following rights and isnotified of the following facility obligations, in addition to thosespecified by regulation: (a) The facility shall employ an adequate number of qualifiedpersonnel to carry out all of the functions of the facility. (b) Each patient shall show evidence of good personal hygiene andbe given care to prevent bedsores, and measures shall be used toprevent and reduce incontinence for each patient. (c) The facility shall provide food of the quality and quantity tomeet the patients' needs in accordance with physicians' orders. (d) The facility shall provide an activity program staffed andequipped to meet the needs and interests of each patient and toencourage self-care and resumption of normal activities. Patientsshall be encouraged to participate in activities suited to theirindividual needs. (e) The facility shall be clean, sanitary, and in good repair atall times. (f) A nurses' call system shall be maintained in operating orderin all nursing units and provide visible and audible signalcommunication between nursing personnel and patients. Extension cordsto each patient's bed shall be readily accessible to patients at alltimes. (g) (1) If a facility has a significant beneficial interest in anancillary health service provider or if a facility knows that anancillary health service provider has a significant beneficialinterest in the facility, as provided by subdivision (a) of Section1323, or if the facility has a significant beneficial interest inanother facility, as provided by subdivision (c) of Section 1323, thefacility shall disclose that interest in writing to the patient, orhis or her representative, and advise the patient, or his or herrepresentative, that the patient may choose to have another ancillaryhealth service provider, or facility, as the case may be, provideany supplies or services ordered by a member of the medical staff ofthe facility. (2) A facility is not required to make any disclosures required bythis subdivision to any patient, or his or her representative, ifthe patient is enrolled in an organization or entity that provides orarranges for the provision of health care services in exchange for aprepaid capitation payment or premium. (h) (1) If a resident of a long-term health care facility has beenhospitalized in an acute care hospital and asserts his or her rightsto readmission pursuant to bed hold provisions, or readmissionrights of either state or federal law, and the facility refuses toreadmit him or her, the resident may appeal the facility's refusal. (2) The refusal of the facility as described in this subdivisionshall be treated as if it were an involuntary transfer under federallaw, and the rights and procedures that apply to appeals of transfersand discharges of nursing facility residents shall apply to theresident's appeal under this subdivision. (3) If the resident appeals pursuant to this subdivision, and theresident is eligible under the Medi-Cal program, the resident shallremain in the hospital and the hospital may be reimbursed at theadministrative day rate, pending the final determination of thehearing officer, unless the resident agrees to placement in anotherfacility. (4) If the resident appeals pursuant to this subdivision, and theresident is not eligible under the Medi-Cal program, the residentshall remain in the hospital if other payment is available, pendingthe final determination of the hearing officer, unless the residentagrees to placement in another facility. (5) If the resident is not eligible for participation in theMedi-Cal program and has no other source of payment, the hearing andfinal determination shall be made within 48 hours. (i) Effective July 1, 2007, Sections 483.10, 483.12, 483.13, and483.15 of Title 42 of the Code of Federal Regulations in effect onJuly 1, 2006, shall apply to each skilled nursing facility andintermediate care facility, regardless of a resident's payment sourceor the Medi-Cal or Medicare certification status of the skillednursing facility or intermediate care facility in which the residentresides, except that a noncertified facility is not obligated toprovide notice of Medicaid or Medicare benefits, covered services, oreligibility procedures.1599.2.  Written information informing patients of their rightsshall include a preamble or preliminary statement in substantial formas follows: (a) Further facility requirements are set forth in the Health andSafety Code, and in Title 22 of the California Administrative Code. (b) Willful or repeated violations of either code may subject afacility and its personnel to civil or criminal proceedings. (c) Patients have the right to voice grievances to facilitypersonnel free from reprisal and can submit complaints to the StateDepartment of Health Services or its representative.1599.3.  Any rights under this chapter of a patient judiciallydetermined to be incompetent, or who is found by his physician to bemedically incapable of understanding such information, or whoexhibits a communication barrier, shall devolve to such patient'sguardian, conservator, next of kin, sponsoring agency, orrepresentative payer, except when the facility itself is therepresentative payer.1599.4.  In no event shall this chapter be construed or applied in amanner which imposes new or additional obligations or standards onskilled nursing or intermediate care facilities or their personnel,other than in regard to the notification and explanation of patient'srights or unreasonable costs.