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By Miriam Raftery

January 24, 2014 (San Diego)—State Senator Marty Block (D-San Diego) has announced he will introduce Senate Bill 911 to provide oversight  and reforms of residential elderly care facilities (RECF).    

Investigative reports by the California Advocates for Nursing Home Reform (CANHR) and newspapers around the state have highlighted lack of training standards, neglect, ineffective penalties and inadequate enforcement plaguing residential care facilities. According to an in-depth investigative report by the San Diego Union-Tribune, hundreds of seniors have suffered broken bones, deadly bedsores and sexual assaults in San Diego alone.  More troubling, since 2008, 27 elderly residents have died from injuries and neglect suffered in San Diego County RCFEs.

The report details extensive examples of how RCFE staff is not adequately trained to handle residents’ needs. The lack of training has resulted in numerous incidents of neglect and injury that could have been prevented with the proper training. In one case, for instance, a direct care staff member failed to properly fasten a seat belt to a resident before going on a tour in the facilities van. This failure resulted in the resident falling and suffering fatal injuries. Even with the resident in excruciating pain, the facility waited four hours before calling 911 to seek help. The resident died four days later due to her injuries.

Current law regulating these institutions is more than 20 years old and has not kept pace with the greater demand for services due to an increasingly aging population and more serious health conditions faced by elderly residential clients.

Block’s measure is part of the 14-bill Residential Care Facilities for the Elderly (RCFE) Reform Act of 2014.

SB 911 would establish  increased training requirements for all staff, administrators and direct care staff, at Residential Care Facilities for the Elderly (RCFEs). It would also increase training, and require any RCFE  with residents who have restricted or specialized health conditions to employ trained medical personnel on a full or part-time basis. This bill also protects residents and employees from retaliation for calling 911 to help a resident in need.

Over 7,500 RCFEs with 174,000 beds are licensed with the California Department of Social Services. These facilities now serve more residents with serious health problems and higher levels of dementia. Five years ago these residents would have been treated in nursing homes. And although residents’ health care needs are greater, the lack of qualifications and training required of administrators and direct care staff are inadequate to meet the residents’ needs for care and supervision, placing RCFE residents at risk.

This measure will help ensure that staff is adequately trained to provide care for RCFE residents and that residents will receive emergency care when needed, by requiring the following:


  • Administrators: Increased certification training from 40 to 80 hours, and continuing education from 40 to 60 hours every two years.
  • Direct Care Staff: Increased initial training from 10 to 40 hours and continuing education from 4 to 20 hours per year.
  • Dementia Care Staff: Increased initial training from 6 to 15 hours and continuing education from 8 to 12 hours per year. 
  • Staff assisting with Self-Administration of Medicine: Increased training from 6 to 16 hours for staff in facilities with 15 or fewer residents and 16 to 32 hours for staff in facilities with 16 or more residents. Continuing education will increase for all staff, regardless of facility size, from 4 to 8 hours per year.
  • Staff serving at risk residents: Establishes initial training of 15 hours and continuing education of 12 hours per year.
  • Staffing for higher acuity: Require facilities that accept or retain residents with restricted or specialized health conditions to employ a registered nurse on a full or part-time basis.
  • 911 Staff Retaliation: Prohibits facilities from retaliating against an employee or resident who calls 911 when a resident is injured and in need of medical care.  

The  measure is supported by California Advocates for Nursing Home Reform (CANHR) .





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