Long-term health facilities: informed consent.

Existing law requires the attending physician of a resident in a skilled nursing facility or intermediate care facility that prescribes or orders a medical intervention of a resident that requires the informed consent of a patient who lacks the capacity to provide that consent, as specified, to inform the skilled nursing facility or intermediate care facility. Existing law requires the facility to conduct an interdisciplinary team review of the prescribed medical intervention prior to the administration of the medical intervention, subject to specified proceedings. Existing law authorizes a medical intervention prior to the facility convening an interdisciplinary team review in the case of an emergency, under specified circumstances. Existing law requires the team to meet within one week of the emergency for an evaluation of the medical intervention if the emergency results in the application of physical or chemical restraints. Existing law imposes civil penalties for a violation of these provisions. This bill would expand the above-described process, as specified, and would impose additional duties on a physician who prescribes a medical intervention under these provisions and on skilled nursing facilities and intermediate care facilities, as defined, under these provisions. Among other things, the bill would require a physician who prescribes a medical intervention to document certain information in the medical record of the resident. The bill would require a skilled nursing facility or intermediate care facility to notify the resident of a determination of a physician pursuant to the above within 48 hours of his or her determination, as prescribed. The bill would authorize a patient or representative of the patient, as described, to take certain action in response to a medical intervention. Under circumstances in which an emergency results in the application of physical or chemical restraints, or the administration of antipsychotic medications, the bill would require the interdisciplinary team to meet for an evaluation of the emergency intervention. The bill would impose additional requirements on the administration of antipsychotic medications by a facility, as prescribed, which would include, among other things, an independent medical review of the appropriateness of the proposed medical intervention.