HOUSE BILL No. 4345 February 27, 2001, Introduced by Reps. Faunce, Vander Veen, Woronchak, Van Woerkom, Gilbert, Bisbee, Tabor, Allen and Birkholz and referred to the Committee on Senior Health, Security and Retirement. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 21773 (MCL 333.21773). THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 21773. (1) A nursing home shall not involuntarily 2 transfer or discharge a patient except FOR 1 OR MORE OF THE FOL- 3 LOWING PURPOSES:for medical4 (A) MEDICAL reasons.; for the5 (B) THE patient's welfare.or that6 (C) THE WELFARE of other patients orfacilityNURSING HOME 7 employees.; or for nonpayment8 (D) NONPAYMENT for the patient's stay, except as prohibited 9 by title19XIX of the social security act, CHAPTER 531, 49 10 STAT. 620, 42 U.S.C. 1396 to1396k1396r-6 AND 1396r-8 TO 11 1396v. 00295'01 CPD 2 1 (2)Involuntary transfer or discharge of a patient from a2 A licensed nursing home shallbe preceded by a minimumPROVIDE 3 written noticeofAT LEAST 21 days BEFORE A PATIENT IS INVOLUN- 4 TARILY TRANSFERRED OR DISCHARGED. The 21-day requirementshall5 OF THIS SUBSECTION DOES not apply in any of the following 6 instances: 7 (a) If an emergency transfer or discharge is mandated by the 8 patient's health care needs and is in accord with the written 9 orders and medical justification of the attending physician. 10 (b) If the transfer or discharge is mandated by the physical 11 safety of other patients andfacilityNURSING HOME employees as 12 documented in the clinical record. 13 (c) If the transfer or discharge is subsequently agreed to 14 by the patient or the patient's legal guardian, and notification 15 is given to the next of kin and the person or agency responsible 16 for the patient's placement, maintenance, and care in the 17facilityNURSING HOME. 18 (3) The notice required by subsection (2) shall be on a form 19 prescribed by the department OF CONSUMER AND INDUSTRY SERVICES 20 and shall contain all of the following: 21 (a) The stated reason for the proposed transfer. 22 (b) The effective date of the proposed transfer. 23 (c) A statement in not less than 12-point type, which24 THAT reads: "You have a right to appeal the nursing home's deci- 25 sion to transfer you. If you think you should not have to leave 26 this facility, you may file a request for a hearing with the 27 department ofpublic healthCONSUMER AND INDUSTRY SERVICES 00295'01 3 1 within 10 days after receiving this notice. If you request a 2 hearing, it will be heldnot sooner thanAT LEAST 7 days after 3 your request, and you will not be transferred during that time. 4 If you lose the hearing, you will not be transferredbefore the5expiration ofUNTIL AT LEAST 30 daysfollowing receipt of6 AFTER YOU RECEIVED the original notice of the discharge or 7 transfer. A form to appeal the nursing home's decision and to 8 request a hearing is attached. If you have any questions, call 9 the department ofpublic healthCONSUMER AND INDUSTRY SERVICES 10 at the number listed below." 11 (d) A hearing request form, together with a postage paid, 12 preaddressed envelope to the department OF CONSUMER AND INDUSTRY 13 SERVICES. 14 (e) The name, address, and telephone number of the responsi- 15 ble official in the department OF CONSUMER AND INDUSTRY 16 SERVICES. 17 (4) A request for a hearing made under subsection (3) shall 18 stay a transfer pending a hearing or appeal decision. 19 (5) A copy of the notice required by subsection (3) shall be 20 placed in the patient's clinical record and a copy shall be 21 transmitted to the department OF CONSUMER AND INDUSTRY SERVICES, 22 the patient, the patient's next of kin, patient's representative, 23 or legal guardian, and the person or agency responsible for the 24 patient's placement, maintenance, and care in thefacility25 NURSING HOME. 26 (6) If the basis for an involuntary transfer or discharge is 27 the result of a negative action by the department ofsocial00295'01 4 1servicesCOMMUNITY HEALTH with respect to a medicaid client and 2 a hearing request is filed with that department, the 21-day writ- 3 ten notice periodshallOF SUBSECTION (2) DOES not begin until 4 a final decision in the matter is rendered by the department of 5social servicesCOMMUNITY HEALTH or a court of competent juris- 6 diction and notice of that final decision is received by the 7 patient and thefacilityNURSING HOME. 8 (7) If nonpayment is the basis for involuntary transfer or 9 discharge, the patientshall have the right toMAY redeem up to 10 the date that the discharge or transfer is to be made and then 11shall have the right toMAY remain in thefacilityNURSING 12 HOME. 13 (8) The NURSING HOME ADMINISTRATOR OR OTHER APPROPRIATE 14 NURSING HOME EMPLOYEE DESIGNATED BY THE NURSING HOME ADMINISTRA- 15 TOR SHALL DISCUSS AN involuntary transfer or dischargeshall be16discussedwith the patient, the patient's next of kin or legal 17 guardian, and person or agency responsible for the patient's 18 placement, maintenance, and care in thefacilityNURSING HOME. 19The explanation and discussion of the reasons for involuntary20transfer or discharge shall include the nursing home administra-21tor or other appropriate nursing home representative as the22administrator's designee.THE DISCUSSION SHALL INCLUDE AN EXPLA- 23 NATION OF THE REASON FOR THE INVOLUNTARY TRANSFER OR DISCHARGE. 24 The content of the discussion and explanation shall be summarized 25 in writing and shall include the names of the individuals 26 involved in the discussions and made a part of the patient's 27 clinical record. 00295'01 5 1 (9) The NURSING HOME SHALL PROVIDE THE patientshall2receiveWITH counseling services before and after the 3 INVOLUNTARY transfer OR DISCHARGE to minimize the possible 4 adverse effect of the INVOLUNTARY transfer OR DISCHARGE. 5 (10) IF A NURSING HOME VOLUNTARILY WITHDRAWS FROM PARTICIPA- 6 TION IN THE STATE PLAN FOR MEDICAID FUNDING, BUT CONTINUES TO 7 PROVIDE SERVICES, THE NURSING HOME SHALL NOT, EXCEPT AS PROVIDED 8 IN SUBSECTION (1), INVOLUNTARILY TRANSFER OR DISCHARGE A PATIENT, 9 WHETHER OR NOT THE PATIENT IS ELIGIBLE FOR MEDICAID BENEFITS, WHO 10 RESIDED IN THE NURSING HOME ON THE DAY BEFORE THE EFFECTIVE DATE 11 OF THE NURSING HOME'S WITHDRAWAL FROM PARTICIPATION. THE PROHI- 12 BITION AGAINST TRANSFER OR DISCHARGE IMPOSED BY THIS SUBSECTION 13 CONTINUES UNLESS THE PATIENT FALLS WITHIN 1 OR MORE OF THE EXCEP- 14 TIONS DESCRIBED IN SUBSECTION (1). 15 (11) IF AN INDIVIDUAL BECOMES A PATIENT OF A NURSING HOME 16 AFTER THE DATE THE NURSING HOME WITHDRAWS FROM PARTICIPATION IN 17 THE STATE PLAN FOR MEDICAID FUNDING, THE NURSING HOME, ON OR 18 BEFORE THE DATE THE INDIVIDUAL SIGNS A CONTRACT WITH THE NURSING 19 HOME, SHALL PROVIDE TO THE PATIENT ORAL AND WRITTEN NOTICE OF 20 BOTH OF THE FOLLOWING: 21 (A) THAT THE NURSING HOME IS NOT PARTICIPATING IN THE STATE 22 PLAN FOR MEDICAID FUNDING. 23 (B) THAT THE FACILITY MAY INVOLUNTARILY TRANSFER OR DIS- 24 CHARGE THE PATIENT FOR NONPAYMENT UNDER SUBSECTION (1)(D) EVEN IF 25 THE PATIENT IS ELIGIBLE FOR MEDICAID BENEFITS. 00295'01 Final page. CPD