Frequently Asked Questions

• Health Facility/Peer Review Reporting Form (805 Report)
• Health Facility Reporting Form - Proposed Action (805.01 Report)

The Board processes 805 reports on the following health care professionals:

• Physicians and Surgeons (MDs)
• Licensed Midwives (LMs)
• Doctors of Podiatric Medicine (DPMs)

An 805 Report must be filed if one of the following actions occurs:

• A peer review body denies or rejects a licensee’s applications for staff privileges or membership for a medical disciplinary cause or reason;
• A licensee’s staff privileges, membership, or employment are revoked for a medical disciplinary cause or reason;
• Restrictions are imposed, or voluntarily accepted, on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period for medical disciplinary reasons;
• If the resignation, leave of absence, withdrawal or abandonment of application or for renewal of privileges occurs after receiving notice of a pending investigation initiated for a medical disciplinary cause or reason;
• A summary suspension of staff privileges, membership, or employment is imposed for a period in excess of 14 days.

An 805 Report must be filed within 15 days after:

• The effective date of the action to deny or reject an application for staff privileges or membership;
• The effective date of the action to revoke staff privileges, membership, or employment;
• The effective date of the action to impose restrictions on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period;
• The Imposition of a summary suspension of staff privileges, membership, or employment for a period in excess of 14 days;
• The licentiate resigns, takes a leave of absence, withdraws or abandons the application for privileges or the application to renew privileges after receiving notice of a pending investigation.

Any peer review body from:

• A health care facility or clinic licensed under Division 2 of the Health and Safety Code or a facility certified to participate in the federal Medicare Program as an ambulatory surgical center.
• A health care service plan licensed under Chapter 2.2 of Division 2 of the Health and Safety Code or a disability insurer that contracts with licentiates.
• A medical or podiatric professional society having as members at least 25% of the eligible licentiates in the area in which it functions, which is not organized for profit and which has been determined to be exempt from taxes.
• A committee organized by any entity consisting of or employing more than 25 licentiates of the same class that functions for the purpose of reviewing the quality of care provided by members or employees.

• The chief of staff of a medical or professional staff;
• Other chief executive officer;
• Medical director, or administrator of any peer review body; or
• Chief executive officer or administrator of any licensed health care facility or clinic.

• Name of licensee (MD, LM, DPM, PA);
• License number; and
• Description of the facts and circumstances of the medical disciplinary cause or reason and any other relevant information deemed appropriate by the reporter.

805 reports are not public documents available to consumers; however, copies may be requested by certain health care facilities licensed pursuant to California Health and Safety Code 1200-1209 for credentialing purposes. This does not cause the 805 report to become public record. Further details regarding the eligibility to obtain copies of 805 reports are located on the Board’s License Verification System page.