Board investigations · California peer review

Hospital Peer Review and California 805 Reports: How a Privileges Action Reaches the Board

A plain-language map of what happens between a hospital peer review action and the Medical Board of California: which actions trigger an 805, 805.01 or 805.8 report, when the 15-day clock starts, what you are entitled to see and say, and what the board actually does once the report lands.

Reviewed October 2026 against Cal. Bus. & Prof. Code sections 800, 805, 805.01, 805.1, 805.5, 805.8, 809 to 809.5, 2027 and 2220.05, California Attorney General Opinion No. 15-301, the Medical Board of California 2024-25 and 2025-26 Annual Reports, and 45 CFR Part 60

Physicians, PAs, podiatristsTrigger matrixPeer review to board, step by step

Short answer: In California, when a hospital medical staff or other peer review body denies, revokes or restricts a physician's privileges for a "medical disciplinary cause or reason", the chief of staff and the facility administrator must file an 805 report with the Medical Board of California within 15 days of the action taking effect. The board places the report in your confidential central file, can inspect the peer review record, screens the case and may open its own investigation. You receive a copy of the report and have the right to add a written statement, which travels with the report whenever it is disclosed.

Key takeaways

Section 805 is triggered by denial, termination or revocation of privileges, restrictions imposed or voluntarily accepted totaling 30 days or more in any 12-month period, a summary suspension lasting more than 14 days, or a resignation or leave taken after notice of an investigation.
The California Attorney General has said the 15-day clock usually runs from when the decision becomes final after your internal appeal, not from the first proposed action (Opinion No. 15-301, 2020).
Section 805.01 is the exception: for incompetence causing death or serious bodily injury, impairment, excessive prescribing or sexual misconduct, the report is due within 15 days of the final decision or recommendation, whether or not a hearing has been held.
Section 805.8, in force since January 1, 2020, requires facilities to report, within 15 days, any allegation of sexual abuse or sexual misconduct made in writing by a patient or the patient's representative. It is an allegation report, not a finding.
In fiscal year 2025-26 the Medical Board received 130 Section 805 reports; at year end 109 were pending and 21 had been closed. In 2024-25, 127 reports produced one accusation by year end.
Your written statement is the one part of the file you control. It goes into the board file and is sent with the report to hospitals that request it.

What triggers an 805 report, and who files it

Section 805 of the Business and Professions Code is California's peer review reporting law. It sits alongside, and is stricter than, the federal reporting rules for the National Practitioner Data Bank (NPDB). If you have read our guide to state board discipline, think of 805 as one of the main ways a case reaches the board without any patient complaint at all.

Three definitions do most of the work:

Peer review body. The medical staff of a licensed hospital or clinic, certain outpatient surgery settings, health care service plans and disability insurers, qualifying professional societies, and peer review committees of organizations with more than 25 licensees of the same class, such as large medical groups.
Medical disciplinary cause or reason. An aspect of your competence or professional conduct that is "reasonably likely to be detrimental to patient safety or to the delivery of patient care." Actions taken for purely administrative reasons do not qualify.
Staff privileges. Read broadly. It covers any arrangement under which you are allowed to practice in or provide care for patients in a facility, including temporary, courtesy and locum tenens privileges and contracts to provide professional services. Actions on your membership or employment are reportable too.

The duty to file falls on the chief of staff, medical director or administrator of the peer review body and on the chief executive officer or administrator of the facility; one designated signature on the form satisfies it. Filing is not optional for them: a willful failure to file can bring a fine of up to $100,000 per violation, and any other failure up to $50,000. That is why hospitals tend to file whenever a case is borderline.

The report goes to the board that licenses you, not automatically to the Medical Board:

Your license	805 and 805.01 reports go to	805.8 reports go to
Physician and surgeon (MD)	Medical Board of California	Medical Board of California
Osteopathic physician (DO)	Osteopathic Medical Board of California	Osteopathic Medical Board of California
Physician assistant	Physician Assistant Board	Physician Assistant Board
Doctor of podiatric medicine	Medical Board of California (its 805 and 805.01 forms cover podiatrists)	Medical Board of California (its 805.8 form covers podiatrists)

Source: Cal. Bus. & Prof. Code 805(a) and 805.8; MBC forms ENF-805, ENF-805.01 and 805.8 (Rev 07/26), which cover physicians, podiatrists and licensed midwives and direct reports on osteopathic physicians and physician assistants to their own boards; Physician Assistant Board 805 reporting form. Section 805 also covers psychologists, therapists, dentists, midwives and independent nurse practitioners, each reported to their own board.

Trigger matrix: 805, 805.01, 805.8 or NPDB?

Most confusion comes from the fact that one hospital event can create two, three or even four reports, each with its own threshold and clock. The matrix below lines them up. "NPDB" means the federal Data Bank report that hospitals must file for physicians and dentists under the Health Care Quality Improvement Act; the details are in our board discipline hub and, for payments, in our guide to malpractice settlements and the NPDB.

Hospital event	805	805.01	805.8	NPDB
Application for privileges denied for a medical disciplinary cause	Yes 15 days after final	Only if based on one of the four serious categories	No	Yes if based on competence or conduct
Privileges terminated or revoked	Yes	If one of the four categories	No	Yes
Restriction (e.g. mandatory concurrent proctoring) of 30 days	Yes 30 days or more in total in 12 months	If one of the four categories	No	No must exceed 30 days
Restriction of more than 30 days	Yes	If one of the four categories	No	Yes
Summary suspension lasting 15 to 30 days	Yes if in effect over 14 days	No on its own	No	No
Summary suspension lasting more than 30 days	Yes	No on its own	No	Yes
Resignation, leave or withdrawn application after notice of an investigation	Yes 15 days after you act	No	No	Yes for a surrender, or a withdrawn renewal application, while under investigation; a withdrawn initial application generally is not reported
Final proposed action after a formal investigation into the four serious categories, before any hearing	Later, once final	Yes 15 days after the decision or recommendation	No	Only when the action is taken
Written patient allegation of sexual abuse or sexual misconduct	Only if an action follows	Only if a formal investigation leads to a proposed action	Yes 15 days after receipt	No unless an action follows
Routine proctoring, retrospective chart review, privileges lapsing for administrative reasons	No	No	No	No

Source: Cal. Bus. & Prof. Code 805, 805.01 and 805.8; 45 CFR 60.5 and 60.12; NPDB Guidebook, Chapter E. The "four serious categories" are listed in the next section.

Watch the thresholds

California's restriction threshold is 30 days or more in total across any 12-month period, so two shorter restrictions can add up to a report. The NPDB threshold is a single action of more than 30 days. A summary suspension becomes reportable to the board after 14 days, long before it reaches the federal threshold.

The 15-day clocks and when each one starts

Every California report in this area runs on 15 days, but each clock starts at a different moment. Knowing which one applies tells you how much time you have before the board hears about the matter.

Section 805: the action has to be final

The statute says the report is due within 15 days "after the effective date" of the action. In 2020, at the Medical Board's request, the Attorney General concluded that "effective date" means the date the decision becomes final, after any appeal to the peer review body has concluded, except where the law expressly says otherwise. A recommendation you are still challenging inside the hospital is usually not yet reportable under Section 805. If you do not request a hearing, the decision generally becomes final when your time to do so runs out.

Two triggers do not wait for finality. A summary suspension is reported within 15 days of being imposed once it has stayed in effect for more than 14 days, and a resignation, leave or withdrawn application after notice of an investigation is reported within 15 days of the step you take.

Section 805.01: the serious-conduct report before the hearing

Section 805.01 was written so that the board does not wait months for a hearing to end in the most serious cases. When a formal investigation leads a peer review body to a final decision or recommendation that one of the following "may have occurred", a report is due within 15 days, regardless of whether a hearing under Section 809.2 is held:

Incompetence, or gross or repeated deviation from the standard of care, involving death or serious bodily injury, to the extent it is dangerous or injurious to any person or the public.
Use of controlled substances, dangerous drugs or alcohol to a degree that is dangerous to the clinician, patients or the public, or that impairs the ability to practice safely.
Repeated clearly excessive prescribing, furnishing or administering of controlled substances, or repeated prescribing without a good faith prior examination and medical reason. Prescribing for intractable pain consistent with lawful practice is excluded.
Sexual misconduct with one or more patients during a course of treatment or an examination.

These four categories closely track the investigation priorities the Legislature set for the Medical Board in Section 2220.05, which is why an 805.01 report tends to be looked at quickly. It is not a substitute for an 805: once the action becomes final, a full 805 report follows.

Section 805.8: from the day the allegation arrives

The 805.8 clock starts when the facility receives a written allegation from a patient or the patient's representative. No peer review step is needed. The 15-day deadline also means the board may learn of the allegation before your own facility has finished looking into it.

NPDB: 30 days from the action

The federal report is due within 30 days of the action, and the hospital must send a copy to the state licensing board. In practice the Medical Board can receive both an 805 and a copy of the NPDB report about the same event.

Your fair hearing rights before the action becomes final

Because the 805 report usually follows the final decision, the hospital hearing is where the content of the eventual report is decided. Sections 809 to 809.5 set minimum procedures for any hearing on an action that would have to be reported under Section 805.

Written notice of the proposed action (809.1): that an action has been proposed which, if adopted, will be reported under Section 805, what it is, that you may request a hearing, and the deadline for doing so.
Notice of the charges: if you request a hearing, the reasons for the action, including the acts or omissions charged, and the time and place of the hearing.
An unbiased trier of fact (809.2): an arbitrator acceptable to both sides or a panel of members who gain no direct financial benefit and did not act as accuser, investigator or initial decision maker. You may question and challenge them.
Access to documents: the right to inspect and copy relevant documents, and on request an exchange of witness lists and exhibits.
A prompt start: the hearing must begin within 60 days of your request unless you agree to a delay or the presiding officer finds you did not comply with the document rules.
Hearing rights (809.3): a record of the proceedings, the right to call and cross-examine witnesses, to present and rebut evidence, and to submit a written statement at the close. For an existing member, the peer review body must prove by a preponderance of the evidence that its action is reasonable and warranted.
A written decision (809.4) with findings of fact and a conclusion connecting the evidence to the result, and an explanation of any appeal process.

Whether you may bring an attorney to the hearing depends on the hospital's written rules, but the peer review body cannot use one if you are not represented. Given that the result of this hearing becomes the substance of a report to your licensing board, this is a sensible point to talk to a healthcare or licensing attorney, ideally before you decide whether to request a hearing at all.

Immediate suspensions

Section 809.5 allows a peer review body to suspend or restrict privileges immediately when failing to act may result in imminent danger to the health of any individual. Your notice and hearing rights still apply afterward. If the suspension lasts more than 14 days, the 805 report is due regardless of how the later hearing comes out.

From peer review to the Medical Board, step by step

This is the sequence a typical case follows. The board stages are described in the Medical Board's own complaint and investigation materials; how long each stage takes is covered in our guide to medical board investigation timelines.

A concern is raised at the facility
A case review, quality signal, incident report or complaint leads the medical executive committee or department to open a focused review. For NPDB purposes, routine, across-the-board review does not count as an investigation, but a targeted inquiry into your practice does, even before you know about it. The California 805 resignation trigger, by contrast, applies once you have received notice of a pending investigation.
The peer review body proposes an action
You receive written notice under Section 809.1. If the investigation concerned one of the four serious categories, an 805.01 report goes to the board within 15 days of this decision or recommendation, and your notice must tell you that you can submit explanatory statements.
Hearing and appeal inside the hospital
If you request a hearing, it takes place under Sections 809.2 to 809.4, followed by any appeal to the governing body. Resigning at this stage does not stop the report: a resignation after notice of an investigation is itself reportable.
The decision becomes final and the 805 report is filed
Within 15 days the facility files the 805 report, with your name, license number and a description of the facts. The peer review body must send you a copy and a notice of your right to submit a statement.
The board logs the report in your central file
Under Section 800 the report and any statement you submit go into your confidential central file. Under Section 805.1 the board may inspect and copy the hearing record: the charges, exhibits, medical charts admitted into evidence, and the findings.
Central Complaint Unit screening
Staff confirm the board has jurisdiction, request records and, for care issues, a written response from you. A medical consultant reviews the material. Cases of an urgent nature, such as sexual misconduct or impairment, can be referred to investigators immediately.
Investigation, if warranted
Investigators from the Department of Consumer Affairs Health Quality Investigation Unit interview witnesses and you, obtain records and arrange an independent expert review on quality-of-care questions.
Outcome
The case may be closed, closed and retained on file, resolved with a citation and fine for minor violations, or referred to the Attorney General's Health Quality Enforcement Section, which decides whether to file an accusation. The board must prove a violation by clear and convincing evidence.

Illustrative example

A proctoring requirement that turned into a report

A surgeon's department requires concurrent proctoring for her next ten cases after two complications. The proctoring lasts 21 days. Four months later, after a further review, a second 14-day restriction is imposed. Neither restriction alone meets the threshold, but together they total 35 days within 12 months, so an 805 report is required once the second action is final. Neither restriction exceeded 30 days on its own, so no NPDB report is triggered. Her best move is a factual, reflective statement that explains what changed in her practice after each review.

Illustrative example based on the thresholds in Cal. Bus. & Prof. Code 805(b)(3) and the NPDB Guidebook. Not a real case.

What the Medical Board does with 805 reports: 2024-25 and 2025-26

The Medical Board's annual reports break out peer review reports separately from patient complaints. The most recent, for fiscal year 2025-26 (July 1, 2025 to June 30, 2026), was released in October 2026. The figures are a useful corrective to the assumption that an 805 report means license discipline.

130Section 805 reports received by the Medical Board (127 the year before)MBC Annual Report, FY 2025-26

2Section 805.01 reports (serious conduct, before hearing), down from 16MBC Annual Report, FY 2025-26

52Section 805.8 sexual misconduct allegation reports, down from 62MBC Annual Report, FY 2025-26

109Of the 130 Section 805 reports still pending at year end; 21 closedMBC Annual Report, FY 2025-26

A few points help put these figures in context:

Most 805 reports come from hospitals and clinics. Of the 130 reports in 2025-26, 100 came from health care facilities or clinics, 19 from health care service plans, 10 from medical groups or employers and 1 from a surgical center. In 2024-25 the split was 96 facilities, 16 medical groups, 13 plans and 2 professional societies.
Outcomes take longer than a year. Of the 127 Section 805 reports received in 2024-25, 85 were pending at that year end, 41 had been closed and one had led to an accusation. The outcome columns show status at year end, not final results, and a report filed in May would almost certainly still be open on June 30.
805.01 numbers swing. The board recorded 1 Section 805.01 report in 2023-24, 16 in 2024-25 and 2 in 2025-26, so a single year says little about a trend. Section 805 volume rose from 91 or 92 in 2023-24 (two tables in that report differ by one) to 127 and then 130.
Scale. For comparison, the board received 12,101 complaints in 2025-26 (9,707 in 2024-25) and had 156,612 physician licenses in effect.

The honest reading is that an 805 report almost always leads to a careful look, and that a single report is rarely the end of a career. It does not mean the board ignores them: the closure figures say nothing about cases retained on file or resolved later.

Your written statement: the part of the file you control

Section 805(f) requires the peer review body to send you a copy of the report and a notice of your right to submit additional statements or other information under Section 800. The board must place what you send in your central file, and under Section 805.5 it is sent along with the 805 report to hospitals and plans that ask for it, subject to the exceptions below. If privileges were revoked and the matter is posted on your profile, your explanatory statement is posted with it.

Read the notice carefully

The statute requires the notice to warn you that information you submit electronically will be publicly disclosed to those who request it. Write every word as if a future credentialing committee, and possibly the public, will read it.

A strong statement is short, factual and forward-looking. Boards and credentialing committees generally look for the same things:

An accurate account of the facts, without disputing findings you did not contest at the hearing.
Context the report leaves out: case volume, the system issues involved, outcomes of the cases reviewed.
Genuine insight: what you would do differently and why, in your own words.
Specific, documented changes: protocols adopted, supervision or mentoring arranged, education completed and how it changed your practice.
The current status of your privileges, including any terms you have already satisfied. When you satisfy the hospital's terms, the facility must file a supplemental report within 30 days.

The same principles apply to the written response the Medical Board may later request; our guide to responding to a medical board complaint covers that letter in detail.

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Who can see an 805 report, and for how long

An 805 report is confidential, but it is not invisible. It reaches several audiences under different rules.

The board

Your central file

The report and your statements sit in your confidential central file. You or your attorney can inspect and copy the file under Section 800(c). Complaints and reports found to lack merit, or not acted on for five years, must be removed.

Hospitals and plans

Credentialing queries

Before granting or renewing privileges, facilities must ask the board whether an 805 report exists. The board sends the report and your statement, unless the action was imposed solely for failure to complete medical records, the board found the report without merit, a court found in a final judgment that the peer review was in bad faith and you notified the board, or three years have passed since the report was filed.

The public

Profile posting

Only final actions that terminated or revoked privileges for a medical disciplinary cause are posted on your public profile, with your explanatory statement. If privileges are restored and you tell the board, the posting comes down 10 years after restoration.

Health care service plans and disability insurers must evaluate a clinician named in an 805 report case by case and may not exclude you automatically. Separately, if an NPDB report was filed, it is visible to every hospital that queries the Data Bank; you can add a statement to it and dispute it through the NPDB's own process.

"An 805 report goes on my public license record."

On the Medical Board profile, only final terminations and revocations of privileges for a medical disciplinary cause are posted. Restrictions, suspensions, resignations and 805.01 reports are not posted.

"If I resign before the hearing, nothing gets reported."

Resigning, taking leave or withdrawing an application after notice of an investigation is itself an 805 trigger, and a surrender while under investigation is reportable to the NPDB.

"An 805.8 report means the hospital found I did something wrong."

Section 805.8 requires a report of the written allegation. It is not a finding, although the board must investigate it.

"The board automatically disciplines after an 805."

The report starts a review. Of the 42 Section 805 reports from 2024-25 that had been resolved by year end, 41 were closed and one led to an accusation, and discipline requires clear and convincing evidence of a violation.

Section 805.8: the separate track for sexual misconduct allegations

Section 805.8 was added by Senate Bill 425 (Chapter 849, Statutes of 2019) and took effect on January 1, 2020. It works differently from Section 805 in four ways.

Section 805

Filed by a peer review body after a final privileges action. Based on a finding that your competence or conduct is a medical disciplinary concern. You receive a copy and can add a statement that travels with the report.

Section 805.8

Filed by any health facility or other entity that allows you to practice, including through locum tenens or contract arrangements, within 15 days of receiving a written patient allegation. No peer review decision is needed. The board must investigate the circumstances.

Sexual misconduct is defined as "inappropriate contact or communication of a sexual nature." The report is confidential and is not subject to discovery, except in a later disciplinary hearing. The facility, not the clinician, pays any fine for failing to file, although the statute adds that a violation may also constitute unprofessional conduct by the licensee.

If you learn that an 805.8 report has been filed about you, avoid any contact with the patient about the allegation, preserve your notes and the chaperone record if one exists, and get legal advice before you respond to the board. Sexual misconduct is among the categories the Medical Board treats as urgent.

Common mistakes after a peer review action

Resigning to make the problem go away. A resignation after notice of an investigation is reported under 805(c), and surrendering privileges while under investigation is also reportable to the NPDB. It also gives up your hearing rights, which are your best chance to shape what is reported.
Missing the hearing request deadline. If you do not request a hearing in time, the proposed action generally becomes final and the 15-day clock starts.
Treating the hearing as an internal matter. The written findings become the factual basis of the 805 report and are available to the board under Section 805.1.
Writing an angry statement. A statement that attacks colleagues or the hospital reads poorly in every audience it reaches, including future credentialing committees.
Leaving it off later applications. Privileging and licensing applications in California and other states commonly ask about past privileges actions. An incomplete answer creates a second, separate problem.
Waiting for the board to call. Remediation started early, and documented, is far more persuasive than education completed after an accusation.

What to do this week if your privileges are under review

Read the hospital's medical staff bylaws and fair hearing plan, and diary every deadline in your notice.
Ask whether the matter is being handled as a formal investigation and whether it falls in an 805.01 category.
Contact your malpractice carrier; some policies include licensing or peer review defense benefits.
Speak to a healthcare or licensing attorney before resigning, accepting a "voluntary" restriction or waiving a hearing.
Request the documents you are entitled to under Section 809.2 and keep your own copies of everything.
Start remediation you can document: mentoring, focused review of your own cases, and education relevant to the concerns raised.
Draft your 805 statement early, then revise it once the final decision is known.
Keep a log of every change you make to your practice, with dates. It will help with the board, the NPDB statement and future applications.

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Frequently asked questions

Will I be told when an 805 report is filed about me?

Yes. Section 805(f) requires the peer review body to send you a copy of the report together with a notice of your right to submit additional statements or information. For an 805.01 report, the notice of proposed action you receive under Section 809.1 must also tell you that you can submit explanatory statements.

Can an 805 report be removed or withdrawn?

The board stops disclosing an 805 report to hospitals after three years, or sooner if it finds the report without merit or a court finally rules the peer review was conducted in bad faith and you notify the board. Material found to lack merit must also be removed from your central file.

Does an 805 report from another state's hospital go to the Medical Board of California?

No. Section 805 applies to California peer review bodies. Actions by out-of-state hospitals are typically reported to the NPDB and to that state's board, and the Medical Board can learn of them through the Data Bank or through your own disclosures on renewal or other applications.

Are residents and fellows subject to 805 reporting?

Section 805 does not contain a general exemption for trainees, so whether an action in a training program is reportable depends on whether it affects staff privileges, membership or employment for a medical disciplinary cause or reason. NPDB guidance says residents and interns generally should not be the subject of clinical privileges reports for actions within a formal graduate education program, although actions based on events outside the program, such as moonlighting, must be reported. A training program's academic decisions are usually handled separately; ask your program and an attorney how a specific action will be treated.

Does an 805 report affect my health plan contracts?

It can be considered, but health care service plans and disability insurers must evaluate a clinician named in an 805 report on a case-by-case basis and may not exclude you automatically on that ground alone.

Is an 805 report the same as a medical malpractice report?

No. Malpractice judgments and settlements are reported under different sections (801.01 and 803) and also to the NPDB. An 805 report concerns an action on your privileges. Our article on malpractice settlements and the board explains that route.

What if the hospital never files the 805 it should have filed?

The obligation is the facility's, and the board can fine the responsible officers up to $50,000 per violation, or $100,000 if the failure was willful. For a clinician, a missing report does not remove the duty to answer application questions about privileges actions truthfully.

Official sources

Checked October 2026.

On this page

What triggers an 805
Trigger matrix
The 15-day clocks
Fair hearing rights
Peer review to board
What the numbers show
Your written statement
Who sees the report
805.8 allegations
Common mistakes
What to do now
FAQs