CHA News

Court Extends Deadline for Patient Representative Mandate for SNF Interdisciplinary Teams

For skilled-nursing facility leaders, compliance officers, case managers

This post has been archived and contains information that may be out of date.


An Alameda County Superior Court judge has issued an amended judgment in CANHR v. Angell, the 2016 court decision that established a requirement to include a designated patient representative for incapacitated skilled-nursing facility (SNF) residents without decision-makers in interdisciplinary team meetings convened to address care decisions

The amended judgment delays the deadline for implementation by 12 months to July 28, 2022.

The decision allows SNFs to continue to admit and to provide care to these vulnerable residents while a new system of patient representation is developed. CHA, in collaboration with the California Association of Health Facilities, worked with the California Department of Public Health and the California Department of Aging (CDA) to support the creation of the Office of the Patient Representative (OPR) within CDA to assist SNFs in identifying a patient representative when necessary. We estimate it will take up to 12 months to establish the OPR, which was approved in the 2021-22 state budget.

During the interim, SNFs are reminded to continue to pursue and document their efforts to identify a patient representative and to complete required notification to the long-term care ombudsman. Hospital case managers may encounter increased difficulty securing SNF placement for unrepresented patients lacking capacity and are encouraged to collaborate with partner SNFs to support efforts to identify a patient representative.