HLB Successfully Defeats Delayed Citation: A Significant Victory for Skilled Nursing Facilities Facing Untimely CDPH Enforcement
California law requires the California Department of Public Health (CDPH) to serve a citation within 30 days after completing its investigation. The requirement promotes prompt enforcement while facts are fresh, witnesses are available, and records remain accessible.
Delayed citations create serious problems. Evidence may be lost, employees may leave, memories may fade, and regulatory and financial consequences may arise years after the underlying event. For years, CDPH has often disregarded this timing requirement while holding facilities strictly accountable for their own appeal deadlines.
Hooper, Lundy & Bookman recently secured summary judgment dismissing a Class AA citation because CDPH issued it years after completing its investigation. The court also vacated the penalty and all enforcement consequences. The result is a significant victory for providers facing stale enforcement actions.
Understanding Class A and Class AA Citations
A Class A citation generally involves a violation presenting an imminent danger or a substantial probability of death or serious harm to a resident.
A Class AA citation applies when a Class A violation was a substantial factor in causing a resident’s death. These citations can carry consequences extending beyond the civil penalty, including public reporting and reimbursement effects.
Why the 30-Day Deadline Matters
Health and Safety Code section 1423 requires CDPH to serve a state citation within 30 days after completing its investigation. California’s statutory scheme emphasizes prompt sanctions and expedited resolution of citation disputes.
The deadline protects residents by encouraging timely correction. It also protects facilities from having to defend stale allegations after witnesses, memories, or records are no longer available. CDPH should not be permitted unlimited time to issue a citation while facilities remain bound by strict deadlines to appeal.
A Major Summary Judgment Victory
HLB obtained summary judgment dismissing a delayed Class AA citation without a trial on the underlying allegations. The court concluded that CDPH’s failure to comply with the statutory deadline invalidated the citation. The associated penalty and all enforcement consequences were vacated.
The decision shows that untimeliness can provide a dispositive defense. Facilities should not assume that a citation is enforceable merely because CDPH issued it.
Downstream Impact: Protecting WQIP Payments
Challenging a delayed citation can protect more than the amount of the civil penalty. The Skilled Nursing Facility Workforce and Quality Incentive Program (WQIP) provides supplemental payments to eligible facilities based on workforce and quality measures.
A Class AA citation may result in the recoupment or withholding of 100% of applicable WQIP payments. A Class A citation may result in a 40% reduction or recoupment. When CDPH issues a citation years late, a managed care plan may seek repayment of WQIP funds paid years earlier.
If the citation is dismissed as untimely, the basis for the WQIP recoupment may also fall away. Facilities should therefore evaluate whether challenging a delayed citation could preserve supplemental payments already received.
Key Takeaway
Facilities receiving a delayed Class A or Class AA citation should promptly determine when CDPH completed its investigation and whether the citation was served within 30 days. A successful timing challenge may eliminate the citation, its penalty, and significant downstream consequences, including WQIP recoupment.
