Main Tower and Arcade of the Pasadena City Hall
Pasadena, CA, City Hall (Credit: adibilio / Getty Images)

A California mayor wants the state to grant his city shared control over assisted living communities and nursing homes located there, saying that it would ensure that older adults are receiving quality care.

During a Public Safety Committee meeting last week, Pasadena Mayor Victor Gordo said that the city has a “moral and legal responsibility” to the 2,300 assisted living / residential care facility residents and 1,000 nursing home residents living in the city, according to Pasadena Now.

Pasadena’s long-term care facilities are regulated by state agencies, including the California Department of Public Health, the Department of Social Services Community Care Licensing Division and the Los Angeles County Health Facilities Inspection Division, or HFID.

Under state law, CDPH has the discretion to contract directly with local health departments, using the HFID for state licensing oversight. The HFID also performs oversight of federally certified facilities that receive Medicare and Medicaid reimbursement. Any authority surveying federally certified facilities must receive prior approval from the Centers for Medicare & Medicaid for Medicare, according to LeadingAge California Policy Consultant Brenda Klutz.

The city established the Pasadena Elderly and Dependent Adult Liaisons, or PEDAL, in 2021 as a cross-department group to work toward improving the quality of life for older adults and people with disabilities who live in its long-term care facilities. 

The group is composed of representatives from the city manager’s office, the city prosecutor’s office, the long-term care ombudsman’s office, Huntington Hospital and the areas of public health, fire, police, planning and community development. The group’s charge is to “improve the quality of life for elders and dependent adults residing in long-term care facilities through education, community outreach, code enforcement and prosecution.”

To date, PEDAL has inspected facilities and escalated operational deficiency information to regulatory agencies and is addressing enforceable violations as well as promoting outreach and education to residents and their families. 

Klutz told McKnight’s Senior Living that LeadingAge members in Pasadena were “very appreciative of the extra support and oversight” from the City of Pasadena Public Health Department related to infection prevention and control during the pandemic. She said the public health team used their expertise to help “residents, staff and providers of LTC through pubic health orders, frequent onsite visits and were available for consultation.”

Gordo suggested that the state could allow the city, potentially on a pilot basis, to hire workers to conduct regulation inspections of assisted living communities, nursing homes and foster care facilities — Pasadena has the highest concentration of foster care homes in Los Angeles County, according to the news outlet.

Under the contract between the the state health department and LA County, Klutz said LA County has the authority to “propose” subcontracting with another entity, but such arrangements are completely subject to state approval.

She added that state laws and the federal grant from the Centers for Medicare & Medicaid for Medicare and Medicaid services require the state health department to perform all statutorily mandated work, including periodic surveys, complaint investigations, facility self-reported events, follow-up visits to ensure corrective action, and other specialty surveys — such as infection control surveys required by state and federal authorities.

A co-chair of PEDAL noted Gordo’s recommendation during the Public Safety Committee meeting and said the group would explore crafting policies to enhance services provided to long-term care facilities, according to the news outlet.