Health Facility/Peer Review Reporting Form as required by 805
What is an 805 report?
An 805 report is the mechanism in which peer review bodies, most commonly
found in hospitals, are required to report specific information regarding licensees to the Medical Board.
Does the Medical Board of California only process 805 reports filed on physicians?
The Board processes 805 reports on the following health care professionals:
- Physicians and Surgeons (MDs)
- Licensed Midwives (LMs)
- Doctors of Podiatric Medicine (DPMs)
What events must be reported to the Board?
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
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.
What is the timeframe for reporting these events?
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
- 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.
What is “medical disciplinary cause or reason”?
"Medical disciplinary cause or reason" as defined in
805(a)(6) means that aspect of a licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of patient care.
Who files the 805 report?
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.
Who must sign the 805 report?
- 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
What information must be provided in the 805 report?
- Name of licensee (MD, LM, DPM, PA);
- License number; and
Description of the facts and circumstances of the
medical disciplinary cause
and any other relevant information deemed appropriate by the
Are 805 reports confidential?
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
Is 805 information posted to the physician’s profile?
Only if the 805 report indicates hospital disciplinary action that resulted
in the termination or revocation of a licensees' staff privileges based on medical
disciplinary cause or reason. The licensee’s profile will display “Hospital Discipline”
as secondary status. Further details are available under the Public Record Actions section.
The extent of detail available is limited to the reporting entity name, a brief description
of action, and effective date of action.
What are the penalties for failing to file an 805 report?
Failure to report may result in a $50,000 fine per violation. Intentional or willful failure to report may result in a $100,000 fine per violation.
What if the licensee disagrees with the 805 report?
Pursuant to Business and Professions Code Sections 800 and 805(f), a licensee may submit “additional exculpatory or explanatory statements” to supplement the 805 report. This addendum will be disseminated with the 805 report to any eligible requesting party.
What is the 805.01 reporting form?
805.01 report is a mechanism in which peer review bodies are required to report a final decision or
recommendation of certain actions being taken against a licensee after an investigation. View the reasons for investigation, recommended actions, and form
If an 805.01 report was previously filed, is an 805 report still necessary?
Yes. An 805 report is still required once the recommendations are made final by the reporting entity. The main objective of the 805.01 is to allow the Board to expedite the investigation process.
Are 805.01 reports confidential?
805.01 reports are not disseminated and not posted on a licensee’s profile.