Supervisor Duties Dumped on HFENs


Health Facilities Evaluator Nurses (HFENs) have been working non-stop to ensure that health facilities follow State and Federal laws to protect the public.  This has been an especially hard task given that the pandemic has made health facilities an area of great concern.  

Recently, HFENs in several offices across the state reported that management has assigned them review and approval of Plans of Corrections (POCs).  POCs are a health facility’s plan to correct things they have done wrong, such as not following COVID-19 requirements, not protecting patients from abuse and preventable deaths, and avoidable surgical mistakes.

On September 24, 2021, a Joint Labor Management Committee (JLMC) meeting occurred.  A selection of HFENs from the Statewide HFENs United (SHU, a group of HFENs fighting for HFEN rights and concerns), met with the Center for Health Care Quality (CHCQ) management to address the unfair practice of assigning HFENs to the supervisory task of reviewing and approving POCs.

During the JLMC, HFENs presented evidence that POC review and approval is a supervisorial task based on many factors, the main one being that the supervisors are responsible for the oversight of the health facilities assigned to them.  The supervisor knows everything that is written about the facilities under their care. The supervisorial oversight role includes enforcement actions as well as the ultimate decision concerning whether a health facility should be back in compliance with the State and Federal laws.  This is what the POC review/approval task achieves.  In comparison, HFENs focus on their specific write-up before moving to the next required task. Due to many factors, they sometimes won’t see the same facility again for several years.

The JLMC discussion included ongoing concerns that the HFEN’s written findings about a health facility are often sterilized by supervisors (missing original intent, facts/findings altered, and findings sometimes dropped) and often with no notice to the affected HFENs.  This heightens the depth of issues of a HFEN reviewing/approving a POC about a finding that has been completely altered by supervisory edits.

Also included in the JLMC were other important factors, including:

  • The recent settlement of the Unfair Labor Practice whereby CHCQ agreed to rescind the revised HFEN duty statement that included the disputed language that POC review/approval was a HFEN task and CHCQ agreed to go back to the prior HFEN duty statement that did not include the POC review/approval task.
  • Increased HFEN liability concerns due to the addition of this potentially liable act of overseeing if a facility is truly back in compliance (as well as other potential legal ramifications).
  • That some POCs are for surveys, which is a collection of a team of HFEN findings. As a result, assigning one HFEN to review/approve the POC brings up other legal concerns, including that an oversight/supervisory role is being inappropriately given to HFENs
  • The high HFEN vacancy rates, including certain offices being particularly hard hit with lack of staffing and trouble with long-term retention of HFENs.
  • Management emails noting that the POC assignment was due to a lack of supervisors/management.
  • That what little POC training is given to HFENs states that POC review/approval is a supervisor task.
  • That the exit conference script indicates everything is subject to supervisory review/approval.
  • Other key evidence and testimony that POC review and approval is a supervisor task.
  • After the HFEN concerns and evidence was presented regarding the POC task, CHCQ Management read a prepared directive, which stated that they saw no reason to change things given the pandemic workload and that “this is how it’s always been done.”

A JLMC should be a joint discussion and effort to develop amicable solutions.  This response from management was unacceptable. As a result, the Union contacted the State on behalf of the HFENs. Meanwhile, CHCQ Management continued to not rescind their directive. 

On October 25, 2021, a Cease & Desist was served on the State by the Union on behalf of the HFENs. The Cease & Desist demands that CDPH cease and desist from instructing or directing HFENs to perform POC review and/or approval.

Please circulate the Cease & Desist within your office if management is requiring HFENs to review and approve facility POCs, which is a supervisor task.  If management asks for the HFENs help with this task, you should request an “Out-of-Class” / Assignment” form for the allotted 90-120 days. (Note: An “Out-of-Class / Assignment” form gives interested individuals an opportunity for managerial experience, which can be helpful, should you desire to promote in the future. If management still insists you perform the work without out-of-class designation, you should fill out an “Assignment Despite Objection form,” and email it to so we can gather evidence of these directives.)  

On October 26, 2021, SEIU Local 1000 filed an Unfair Labor Practice charge with PERB against CDPH arguing that requiring HFENs to Review/Approve POCs violated the prior settlement agreement and constituted an improper unilateral change in violation of the state’s duty to bargain in good faith. We will keep you updated and apprised of next steps if an acceptable resolution is not met.

Our next JLMC discussion is scheduled for Wednesday, November 3rd, 2021. We will continue to work-on high-priority HFEN concerns.

Thank you for your emails and feedback. Please continue sending your questions, comments, and feedback to  We read each email and try to respond accordingly in our updates.

In addition, if you have any individual or group issues you need help with, please call the SEIU Local 1000 Member Resource Center (MRC) at 866.471.SEIU (7348).