Council Votes to Support State and Federal Accountability in Regulating Skilled Nursing Facilities

As part of Monday’s consent calendar, the City Council voted to amend its 2021 legislative platform regarding the quality of healthcare provided by skilled nursing facilities.

The amendment adds the phrase “As such, the City is committed to exploring ways to hold federal and state regulatory agencies accountable to fulfilling their regulatory roles, as well as identifying local mechanisms to support healthcare quality.”

The city prepares a legislative platform each year to serve as the foundation for a focused advocacy strategy. The platform outlines the city’s position on a broad range of  current issues providing staff and lobbyists with direction to pursue advocacy on these issues. Among the many issues included in this year’s platform are priorities for healthcare delivery.

A staff report explains, “Pasadena is home to 15 skilled nursing facilities with a combined 1,201 licensed beds. The health and safety of this medically frail population is entirely dependent on the quality of healthcare provided by for-profit facility operators and their staff, and the ability of the California Department of Public Health to license, inspect, cite, and regulate them.”

A report by the county Office of Inspector General (OIG) that appeared on the March 31 council agenda questioned whether the agency responsible for oversight of skilled nursing facilities can effectively address crises and protect residents’ health.

The assessment of the county’s Health Facilities Inspection Division (HFID) centered on emergency evacuations of two Pasadena facilities in June and October.

“On June 11, 2020, more than 60 residents were evacuated from Golden Cross Health Care (Golden Cross) in Pasadena after the facility’s license was suspended due to ongoing quality-of-care issues,” the report states.

Less than four months later, on Oct. 1 health inspectors responded to Foothill Heights Care Center (Foothill Heights) in Pasadena where more than 30 residents were evacuated due to excessive indoor temperatures.

According to the report, “the evacuations revealed issues with state and local mechanisms for triggering a crisis response, efficacy of HFID’s oversight and enforcement actions and coordination and communication between HFID and partner agencies.”

These events “highlight flaws in HFID’s crisis identification and response and resident abuse and neglect investigations,” the report states.

The council was forced to table a discussion of that report during a joint meeting with Supervisor Kathryn Barger due to time constraints.

“Staff recommends the City Council amend the state legislative platform to include support for legislation which assures that the quality of healthcare provided by skilled nursing facility operators meets or exceeds state and federal (US Centers for Medicare and Medicaid) regulatory standards and is delivered ethically, responsibly, and equitably,” according to Monday’s staff report.

The council also approved a $954,549 purchase order contract with South Coast Fire Equipment, Inc. for the purchase of one 2021 Pierce Arrow XT Triple Combination Engine Pumper Truck. The new fire apparatus will be housed at Fire Station 33 and placed into front line service to assist with over 3,500 service calls received at this station annually.

The city will replace an older pumper and place a second one in reserve. Both of those pumpers have more than 150,000.

The final item approves and files proposed amendments to the rules and regulations for the seven commissions staffed by the Parks, Recreation and Community Services (PRCS) Department.

The Accessibility and Disability Commission, the Commission on the Status of Women, the Human Relations, Human Services, Northwest, Recreation and Parks, and Hahamongna Watershed Park Advisory commissions will be impacted by the changes.

The amendments include:

• An update to the rules and regulations to be consistent with the provisions of Title 2 of the Pasadena Municipal Code.

• Updating or eliminating outdated language.

• For the Human Services and Northwest Commissions, update the language in the rules and regulations to be consistent with HUD regulations on grant funding, and to allow for flexibility by these commissions when HUD modifies its rules.

• For the Human Services and Senior commissions, clarify the process of recommending an organizational representative to the City Council.

• Clarify and provide consistency between the seven commissions on how business is conducted, including requiring each commission except Recreation and Parks, to elect a parliamentarian. The Recreation and Parks Commission did not support including the position of the parliamentarian as an officer and instead expressed support for staff to continue in the role of resolving questions regarding parliamentary procedures.

The City Council also directed the city attorney to prepare an ordinance amending the Municipal Code related to PRCS commissions.

• Revise references to City Council members to replace the former title of Director.

• Revise the date of annual officer elections to be at commissions’ annual meetings (not its first meeting of the year).

• Revise the number of commission members required to approve and forward to the City Council rules and regulations, such that a majority of members must approve, in lieu of a specific number of commission members.

The item was briefly pulled by Councilmember Steve Madison, who leads the City Council’s Legislative Policy Committee, and Vice Mayor Andy Wilson before the council approved it.