HOUSE BILL No. 4756

 

May 27, 2003, Introduced by Reps. Lipsey, Vagnozzi, Bieda, Kolb, Zelenko, Dennis, Jamnick, Sak, Tobocman, Gleason, Rivet, Anderson and Plakas 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 21766 (MCL 333.21766), as amended by 2001               

                                                                                

    PA 243, and by adding section 21766a.                                       

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 21766.  (1) A nursing home shall execute a written                     

                                                                                

2   contract solely with an applicant or patient or that applicant's            

                                                                                

3   or patient's guardian or legal representative authorized by law             

                                                                                

4   to have access to those portions of the patient's or applicant's            

                                                                                

5   income or assets available to pay for nursing home care, at each            

                                                                                

6   of the following times:                                                     

                                                                                

7       (a) At the time an individual is admitted to a nursing home.                

                                                                                

8       (b) At the expiration of the term of a previous contract.                   

                                                                                

9       (c) At the time the source of payment for the patient's care                

                                                                                

10  changes.                                                                    

                                                                                


                                                                                

1       (2) A nursing home shall not discharge or transfer a patient                

                                                                                

2   at the expiration of the term of a contract, except as provided             

                                                                                

3   in section 21773.                                                           

                                                                                

4       (3) A nursing home shall specifically notify in writing an                  

                                                                                

5   applicant or patient or that applicant's or patient's guardian or           

                                                                                

6   legal representative of the availability or lack of availability            

                                                                                

7   of hospice care in the nursing home.  This written notice shall             

                                                                                

8   be by way of a specific paragraph located in the written contract           

                                                                                

9   described in subsection (1) and shall require the applicant or              

                                                                                

10  patient or that applicant's or patient's guardian or legal                  

                                                                                

11  representative to sign or initial the paragraph before execution            

                                                                                

12  of the written contract.  As used in this subsection, "hospice"             

                                                                                

13  means that term as defined in section 20106(4).                             

                                                                                

14      (4) A nursing home shall provide a copy of the contract to                  

                                                                                

15  the patient, the patient's representative, or the patient's legal           

                                                                                

16  representative or legal guardian at the time the contract is                

                                                                                

17  executed.                                                                   

                                                                                

18      (5) For a patient supported by funds other than the patient's               

                                                                                

19  own funds, a nursing home shall make a copy of the contract                 

                                                                                

20  available to the person providing the funds for the patient's               

                                                                                

21  support.                                                                    

                                                                                

22      (6) For a patient whose care is reimbursed with public funds                

                                                                                

23  administered by the department of community health, a nursing               

                                                                                

24  home shall maintain a copy of the contract in the patient's file            

                                                                                

25  at the nursing home and upon request shall make a copy of the               

                                                                                

26  contract available to the department of community health.                   

                                                                                

27      (7) The nursing home shall ensure that the contract is                      

                                                                                


                                                                                

1   written in clear and unambiguous language and is printed in not             

                                                                                

2   less than 12-point type.  The form of the contract shall be                 

                                                                                

3   prescribed by the department.                                               

                                                                                

4       (8) The contract shall specify all of the following:                        

                                                                                

5       (a) The term of the contract.                                               

                                                                                

6       (b) The services to be provided under the contract, including               

                                                                                

7   the availability of hospice or other special care, and the                  

                                                                                

8   charges for the services.                                                   

                                                                                

9       (c) The services that may be provided to supplement the                     

                                                                                

10  contract and the charges for the services.                                  

                                                                                

11      (d) The sources liable for payments due under the contract.                 

                                                                                

12      (e) The amount of deposit paid and the general and                          

                                                                                

13  foreseeable terms upon which the deposit will be held and                   

                                                                                

14  refunded.                                                                   

                                                                                

15      (f) The rights, duties, and obligations of the patient,                     

                                                                                

16  except that the specification of a patient's rights may be                  

                                                                                

17  furnished on a separate document that complies with the                     

                                                                                

18  requirements of section 20201.                                              

                                                                                

19      (g) The right of a patient or the patient's legal guardian or               

                                                                                

20  legal representative to deposit amounts due under the contract in           

                                                                                

21  an escrow account pursuant to section 21766a if the nursing home            

                                                                                

22  is in violation of a local ordinance or of this article or a rule           

                                                                                

23  promulgated under this article.                                             

                                                                                

24      (h) The right of the patient or the patient's legal guardian                

                                                                                

25  or other legal representative to seek appropriate relief from a             

                                                                                

26  court of competent jurisdiction for a violation of the contract.            

                                                                                

27      (9) The nursing home may require a patient's or applicant's                 

                                                                                


                                                                                

1   guardian or legal representative who is authorized by law to have           

                                                                                

2   access to those portions of the patient's or applicant's income             

                                                                                

3   or assets available to pay for nursing home care to sign a                  

                                                                                

4   contract without incurring personal financial liability other               

                                                                                

5   than for funds received in his or her legal capacity on behalf of           

                                                                                

6   the patient.                                                                

                                                                                

7       (10) A nursing home employee may request the appointment of a               

                                                                                

8   guardian for an individual applicant or patient only if the                 

                                                                                

9   nursing home employee reasonably believes that the individual               

                                                                                

10  meets the legal requirements for the appointment of a guardian.             

                                                                                

11      Sec. 21766a.  (1) If a patient residing in a nursing home or                

                                                                                

12  the patient's legal guardian or other legal representative                  

                                                                                

13  described in section 21766(1) has executed a contract under                 

                                                                                

14  section 21766, and if the patient or the patient's legal guardian           

                                                                                

15  or other legal representative has reasonable cause to believe               

                                                                                

16  that a nursing home is in violation of a local ordinance or of              

                                                                                

17  this article or a rule promulgated under this article, the                  

                                                                                

18  patient or the patient's legal guardian or other legal                      

                                                                                

19  representative may suspend payment due the nursing home under the           

                                                                                

20  contract, pursuant to this section.                                         

                                                                                

21      (2) A nursing home patient or the patient's legal guardian or               

                                                                                

22  other legal representative who suspends payment due under a                 

                                                                                

23  nursing home contract pursuant to subsection (1) shall deposit              

                                                                                

24  the amount due in an escrow account with a financial institution            

                                                                                

25  located in this state.  The financial institution with which the            

                                                                                

26  escrow account is established shall pay the funds in the escrow             

                                                                                

27  account to the nursing home to which the funds are owed or shall            

                                                                                


                                                                                

1   pay restitution to the patient when the financial institution               

                                                                                

2   receives written notice from the department of 1 of the                     

                                                                                

3   following:                                                                  

                                                                                

4       (a) That the nursing home is not or is no longer in violation               

                                                                                

5   of a local ordinance or of this article or a rule promulgated               

                                                                                

6   under this article.                                                         

                                                                                

7       (b) That a settlement between the nursing home and the                      

                                                                                

8   patient, legal guardian, or other legal representative has been             

                                                                                

9   reached.                                                                    

                                                                                

10      (c) That the patient, legal guardian, or other legal                        

                                                                                

11  representative has voluntarily resumed payment.                             

                                                                                

12      (d) That the department has found a violation of a local                    

                                                                                

13  ordinance or of this article or the rules promulgated under this            

                                                                                

14  article and has ordered the nursing home to pay restitution to              

                                                                                

15  the patient.                                                                

                                                                                

16      (3) A nursing home patient or the patient's legal guardian or               

                                                                                

17  other legal representative who elects to suspend payment under              

                                                                                

18  subsection (1) shall notify the nursing home and the department             

                                                                                

19  in writing of the suspension of payment and of the provisions of            

                                                                                

20  the local ordinance or of this article or a rule promulgated                

                                                                                

21  under this article that the resident, legal guardian, or other              

                                                                                

22  legal representative believes are being violated.  The notice               

                                                                                

23  shall also contain the name and address of the financial                    

                                                                                

24  institution in which the escrow account is established under                

                                                                                

25  subsection (2).                                                             

                                                                                

26      (4) A nursing home shall not evict a resident solely because                

                                                                                

27  the resident has suspended payment pursuant to this section.                

                                                                                


                                                                                

1       (5) Upon receipt of the notice described in subsection (3),                 

                                                                                

2   the department shall conduct the investigation required under               

                                                                                

3   section 20176 in an expeditious manner.  If the department                  

                                                                                

4   determines that the nursing home is in violation of a local                 

                                                                                

5   ordinance or of this article or a rule promulgated under this               

                                                                                

6   article, the department may order the nursing home to pay                   

                                                                                

7   restitution to the patient.  The department may order restitution           

                                                                                

8   in the form of an abatement of payments due under the contract or           

                                                                                

9   a rebate of payments made under the contract, or both.  If the              

                                                                                

10  department orders a nursing home to pay restitution under this              

                                                                                

11  subsection, the department shall notify the financial institution           

                                                                                

12  with which the amount due under the contract has been deposited             

                                                                                

13  pursuant to subsection (2) to pay the restitution out of the                

                                                                                

14  escrow account.                                                             

                                                                                

15      (6) If the department does not order restitution under                      

                                                                                

16  subsection (5), or if a nursing home patient, legal guardian, or            

                                                                                

17  other legal representative does not use the procedure described             

                                                                                

18  in this section or has reasonable cause to believe that the                 

                                                                                

19  nursing home is in violation of the nursing home contract, he or            

                                                                                

20  she may bring an action in a court of competent jurisdiction.               

                                                                                

21  The patient, legal guardian, or legal representative may seek               

                                                                                

22  appropriate relief from the court, including, but not limited to,           

                                                                                

23  an abatement of payments due under the contract or a rebate of              

                                                                                

24  payments made under the contract, or both.