Status Of The California State Auditor’s Recommendations To Improve Oversight Of Substandard Nursing Home (SNF) Quality Of Care – Nothing Has Been Implemented? – And What About ESG And/Or GRC?

On occasion I look at the website of the California State Auditor. The Auditor audits State of California agencies and State of California programs that pay or distribute money to other organizations or entities. The Auditor also provides status updates relating to its recommendations.

Quite a while ago (it looks like 2018) the Auditor made some recommendations to improve oversight of substandard nursing home (SNF) conditions. Nursing homes are highly regulated by both federal and California statutes and regulations, although those statutes and regulations proscribe only minimum levels of care and for only those areas for which the statutes and regulations have been enacted.

Some nursing homes meet, or sometimes exceed, the minimum requirements, whereas other nursing homes fail to meet some or all of the minimum requirements.

Based on my experience in nursing home cases (suing on behalf of residents and their families for improper care and elder abuse) and as a past board member of a county Long-Term Care Ombudsman Services program, and based on observations and comments by other people for many years, it has long been clear that residents are better cared for when the care and daily living conditions that they are provided, and that they are not provided, and detailed documentation of those matters, are and can be observable and obtained by family members, friends, family councils, Ombudsman Services, and other outside stakeholders and interested people.

Everyone would agree that nursing home residents individually and as a group are vulnerable and are dependent on other people for their health, care, and well-being. So I came across the below status update by the California State Auditor about recommendations (apparently made in 2018) for improved oversight of substandard nursing home conditions, and it is with great disappointment that apparently none of the recommendations have actually come to be.

I have provided below a link to the Auditor’s status update report, and snapshots of the report (please note that the length of the report really is too long for a good single snapshot so I have divided the report into the three snapshots that I have provided below (the snapshots are one after the other just as they appear in the Auditor’s report), and you can also click on the below link).

And I add, briefly, where do ESG (environmental, social, and governance) reporting and expectations come into play and requirement for nursing homes. I’m not seeing that it is required. Or a prior acronym that mostly isn’t used anymore but which would also be relevant for nursing home care and its oversight: GRC or governance, risk, and compliance. Nothing of the sort will become implemented or voluntarily standard for nursing homes and other providers of care and services to elders, dependent adults, and other people with disabilities unless there is interest and push by their family members, friends, stakeholders, and other people and organizations.

Best to you, Dave Tate, Esq.

Here is the link to the California State Auditor’s status report

And below are the best that I could do for snapshots of the report:


Remember, every case and situation is different. It is important to obtain and evaluate all of the evidence that is available, and to apply that evidence to the applicable standards and laws. You do need to consult with an attorney and other professionals about your particular situation. This post is not a solicitation for legal or other services inside of or outside of California, and, of course, this post only is a summary of information that changes from time to time, and does not apply to any particular situation or to your specific situation. So . . . you cannot rely on this post for your situation or as legal or other professional advice or representation.

Thank you for reading this post. I ask that you also pass it along to other people who would be interested as it is through collaboration that great things and success occur more quickly. And please also subscribe to this blog and my other blog (see below), and connect with me on LinkedIn and Twitter.

Best to you, David Tate, Esq. (and inactive California CPA) – practicing in California only.

I am also the Chair of the Business Law Section of the Bar Association of San Francisco.

Blogs: Trust, estate/probate, power of attorney, conservatorship, elder and dependent adult abuse, nursing home and care, disability, discrimination, personal injury, responsibilities and rights, and other related litigation, and contentious administrations; Business, D&O, board, director, audit committee, shareholder, founder, owner, and investor litigation, governance, responsibilities and rights, compliance, investigations, and risk management

Ombudsman Services San Mateo County – A Snapshot Of Great Accomplishments

The following are two snapshots of the accomplishments of Ombudsman Services of San Mateo County. As you might be aware, Ombudsman services are mandated by law to advocate on behalf of better and proper care of residents at care facilities, to work to improve the care provided by the facility, to investigate situations and improper care, and report improper care and abuse. The following are two snapshots of activities from Ombudsman Services of San Mateo County, which is an active advocate on behalf of care facility residents – and you can view their website at the following link CLICK HERE



Ombudsman Services – San Mateo County – Annual Report 2014-2015 – 4,497 Care Facility Visits – 1,624 Investigations – And More Good Work

Ombudsman Services SMC Visits Investigations FY 2014-2015

Below is a link to the San Mateo County, California, Ombudsman Services annual report for 2014-2015. The report shows amazingly substantial services for the year, including for example, 4,497 facility visits, and 1,624 investigations. As you might know, Ombudsman Services of San Mateo County, Inc. is committed to working with residents, families, facilities and stakeholders to create a community dedicated to protecting the rights of all residents living in long term care in San Mateo County. They challenge long-term care facilities to deliver the highest standards of individualized care for their residents, and advocate for the health, safety, and dignity of these residents and broader changes in the system.

The following is a link to the annual report – please take a look at this worthwhile organization that does good work on behalf of and protecting the rights of residents living in long term care facilities in San Mateo County, CLICK HERE

And please do pass this information and blog post to other people who would be interested in these very important services. Thank you.

Dave Tate, Esq., San Francisco and throughout California, civil, trust, estate, conservatorship and elder abuse litigation, and contentious administrations. My two blogs: and

There Needs To Be A Law – Petitioning For Conservatorship Should Not Disinherit You

Short and sweet. I’m not sure what the wording should be, but we need a law that to some extent protects a person from being disinherited for filing a petition for conservatorship.

The situation that I have in mind: a son or daughter files a petition for conservatorship of their mother or father. In doing so, the son or daughter risks that mom or dad will be very angry with the petition and will seek to change their estate planning to exclude or disinherit the son or daughter.  There needs to be some protection for the son or daughter, whether the petition for conservatorship is granted or not.

I’m not saying that I favor conservatorships. A conservatorship can be a serious restriction on a person’s constitutional rights and freedom. All I’m saying is that a son or daughter should not have to fear possible disinheritance for filing a petition for conservatorship in a situation where there is no finding that the petition was filed in bad faith or where there is evidence that a conservatorship might be necessary even if less restrictive options are available.

Dave Tate, Esq. (San Francisco and California), click link to this blog, Law Office of David W. Tate, and also working with Albertson & Davidson LLP, northern and southern California click link to Albertson & Davidson website.

Mandated Elder & Dependent Adult Abuse Reporting – Then What’s Next – Community Response