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 California Court Maintains Law Permitting SNFs to Serve Individuals Who are Incapacitated

The California Court of Appeals, First Appellate District, recently upheld the constitutionality of the “Epple Bill,” a state statute in California that permits skilled nursing facilities (SNFs) to continue to serve individuals who do not have the capacity to make medical decisions for themselves and have no one willing or able to do so on their behalf.

The appellate court’s decision, California Advocates for Nursing Home Reform  v. Smith (formerly Chapman), overturned a 2015 decision by the Alameda County Superior Court that declared the Epple Bill unconstitutional. Since 1992, SNFs have used Health and Safety Code 1418.8 to make medical decisions for residents who lack mental capacity or do not have family or other decision makers available, according to SNF advocates at the California Association of Health Facilities (CAHF), an affiliate of the American Health Care Association.

“This ruling means an interdisciplinary team of caregivers will continue to be able to formulate and implement care plans for up to 12,000 individuals covered by the law,” said Craig Cornett, CAHF president and chief executive officer and president. “We are gratified that the court has brought clarity to this important issue so our members can continue to ensure the well-being of these residents.” 

An interdisciplinary team is comprised of a physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines based on resident need.

CAHF said the new ruling includes the additional requirement of oral and written notice to the affected residents, as well as the presence of independent resident representatives when family members or friends are not available.

“CAHF is committed to work with the California Department of Public Health, member facilities, and other stakeholders to meet the new conditions established by the court,” the group said.

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