HOUSE BILL No. 4176


     January 30, 1997, Introduced by Reps. Leland, Freeman, DeHart, Wojno, Goschka, Mathieu, Agee, Murphy, Harder, LaForge, Quarles, Thomas, Schauer, Tesanovich, Cherry, Schermesser, Hale, Baird, Varga, Hanley, Brater, Price, Rocca, Middaugh, Stallworth, Brown, Kilpatrick, Kukuk, Martinez, Brewer, Dobronski, Olshove, Gire, Willard, Gubow, Prusi and Baade
and referred to the Committee on Health Policy.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   by amending section 21720a (MCL 333.21720a).

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         Sec. 21720a.  (1)  A  THE DEPARTMENT SHALL NOT LICENSE A

 2    nursing home  shall not be licensed  under this part unless that

 3    nursing home has on its staff at least 1 registered nurse with

 4    specialized training or relevant experience in the area of geron-

 5    tology  ,  who  shall serve  SERVES as the director of nursing

 6    and who  shall be  IS responsible for planning and directing

 7    nursing care.  The  A nursing home APPLYING FOR LICENSURE shall

 8    have at least 1 licensed nurse on duty at all times and shall

 9    employ additional registered PROFESSIONAL NURSES and licensed

10    practical nurses in accordance with subsection (2).  This

11     subsection shall not take effect until January 1, 1980. 


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 1         (2)  A nursing home  SUBJECT TO SUBSECTION (3), A LICENSEE

 2    shall employ nursing personnel sufficient to provide continuous

 3    24-hour nursing care and services sufficient to meet the needs of

 4    each patient in the nursing home.  Nursing  THE DIRECTOR OF

 5    NURSING SHALL SUPERVISE NURSING personnel employed in the nursing

 6    home.  shall be under the supervision of the director of

 7     nursing.  A licensee shall maintain a nursing home staff suffi-

 8    cient to provide not less than  2.25  2.65 hours of nursing care

 9    by employed nursing  care  personnel per patient per day.  The 

10    A LICENSEE SHALL MAINTAIN A ratio of patients to UNLICENSED nurs-

11    ing  care  personnel during a morning shift  shall not exceed  OF

12    NOT MORE THAN 8  patients  to 1;  nursing care personnel; the  A

13    ratio of patients to UNLICENSED nursing  care  personnel during

14    an afternoon shift  shall not exceed  OF NOT MORE THAN 12

15     patients  to 1;  nursing care personnel; and the  AND A ratio of

16    patients to UNLICENSED nursing  care  personnel during a night-

17    time shift  shall not exceed  OF NOT MORE THAN 15  patients  to

18    1.  nursing care personnel and there  A LICENSEE shall  be  HAVE

19    sufficient nursing  care  personnel available on duty to assure

20    coverage for patients at all times during the shift.  A LICENSEE

21    SHALL MAINTAIN A RATIO OF PATIENTS TO LICENSED NURSING PERSONNEL

22    OF NOT MORE THAN 30 TO 1 DURING THE MORNING AND AFTERNOON SHIFTS,

23    AND NOT MORE THAN 50 TO 1 DURING THE NIGHTTIME SHIFT. An employee

24    designated as a member of the nursing staff shall not  be engaged

25     in providing  PROVIDE basic services such as food preparation,

26    housekeeping, laundry, or maintenance services, except in an

27    instance of natural disaster or other emergency reported to and



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 1    concurred in by the department.  A PERSON EMPLOYED TO PROVIDE

 2    SUCH BASIC SERVICES SHALL NOT PROVIDE NURSING CARE TO PATIENTS.

 3    In a nursing home having 30 or more beds, the DEPARTMENT SHALL

 4    NOT INCLUDE THE director of nursing  shall not be included  in

 5    counting the minimum ratios of nursing personnel required by this

 6    subsection.

 7         (3) A LICENSEE THAT MAINTAINS A NURSING HOME STAFF SUFFI-

 8    CIENT TO PROVIDE 3 OR MORE HOURS OF CARE BY UNLICENSED NURSING

 9    PERSONNEL PER PATIENT PER DAY IS NOT SUBJECT TO THE

10    STAFF-TO-PATIENT RATIO REQUIREMENTS OF SUBSECTION (2).

11         (4)  (3)  In administering this section, the department

12    shall take into consideration a natural disaster or other

13    emergency.

14         (5) AS USED IN THIS SECTION, "UNLICENSED NURSING PERSONNEL"

15    MEANS PERSONS WHO PERFORM IN A NURSING HOME ONLY THOSE FUNCTIONS

16    FOR WHICH A LICENSE IS NOT REQUIRED UNDER THIS ACT.

























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