CA AB486

Eliminates the civil court appeal process for class "AA" and "A" citations at long-term health care facilities and instead requires administrative proceedings before an administrative law judge, similar to existing class "B" citation procedures.

Allows administrative law judges to affirm, modify, or dismiss citations, citation classifications, or proposed penalties, with licensees able to seek judicial review of decisions under Code of Civil Procedure Section 1094.5.

Maintains the existing arbitration option for class "B" citations, allowing licensees to submit disputes to binding arbitration through the American Arbitration Association within 60 days of receiving an administrative law judge's decision.

Delays implementation of these changes for Laguna Honda Hospital and Rehabilitation Center in San Francisco until January 1, 2026, or 30 days after the facility obtains federal Medicare and Medicaid recertification, whichever occurs first, allowing the facility to continue appealing class "AA" and "A" citations to superior court during this period.

Specifies that the department bears the burden of proving violations occurred, met the citation classification criteria, and that penalties were appropriate by a preponderance of the evidence.