CDHS: It Has Not Yet Fully Implemented Legislation Intended to Improve the Quality of Care in Skilled Nursing Facilities

This audit investigates the California Department of Health Services (CDHS) efforts to implement a 2004 bill, AB 1629, known as the Skilled Nursing Facilities Quality Assurance Fee and Medi-Cal Long-Term Care Reimbursement Act (Act). The California State Auditor conducted the study to determine Health Services progress in implementing the Act. About 1,300 skilled nursing facilities provide services to patients eligible for Medi-Cal that may be affected by the Act.

Health Services was charged with developing a facility-specific reimbursement rate methodology that reimbursed each facility based on its costs. By the end of 2006, the auditors determined that Health Services had only reviewed about two-thirds of eligible facilities and that Health Services had not followed up with 325 facilities that reported significantly more or fewer patient days than expected.