February 28, 2006, Introduced by Reps. Vander Veen, Shaffer, Garfield, Taub, Brandenburg, Zelenko, Clack, Amos, Kooiman and Marleau and referred to the Committee on Senior Health, Security, and Retirement.
A bill to protect and promote long-term health care; to
codify, revise, consolidate, classify, and add to the laws
relating to long-term health care; to provide for the
classification, administration, regulation, financing, and
maintenance of personal and other long-term health services and
activities; to create or continue, and prescribe the powers and
duties of, departments, boards, commissions, councils,
committees, task forces, and other agencies; to prescribe the
powers and duties of governmental entities and officials; to
regulate occupations, facilities, and agencies affecting long-
term health care and adult foster care; to provide for the
imposition of a regulatory fee; to promote the efficient and
economical delivery of long-term health care and adult foster
care services; to provide for the appropriate utilization of
long-term health care facilities and services and adult foster
care facilities and services; to provide for the collection and
use of data and information; to provide for the implementation of
federal law; to provide for penalties and remedies; to provide
for sanctions for violations of this act and local ordinances;
and to repeal acts and parts of acts.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 ARTICLE I
2 GENERAL PROVISIONS
3 PART 1
4 SHORT TITLE, GENERAL DEFINITIONS, AND ADMINISTRATION
5 Sec. 101. This act shall be known and may be cited as the
6 "long-term health care continuum act".
7 Sec. 103. (1) As used in this act:
8 (a) "Act" means the long-term health care continuum act.
9 (b) "Administrative procedures act of 1969" means 1969 PA
10 306, MCL 24.201 to 24.328.
11 (c) "Commission" means the long-term care commission created
12 under part 4.
13 (d) "Consumer" means an individual seeking or receiving
14 public assistance for long-term care.
15 (e) "Department" means the department of community health
16 unless otherwise provided under this act.
17 (f) "Director" means the director of the department.
1 (g) "Long-term care" means those services and supports
2 provided to an individual in a setting of his or her choice that
3 are evaluative, preventative, rehabilitative, or health related
4 in nature.
5 (h) "Medicaid" or "title XIX" means the program for medical
6 assistance established under title XIX of the social security
7 act, 42 USC 1396 to 1396u, and administered by the department of
8 human services under the social welfare act, 1939 PA 280, MCL
9 400.1 to 400.119b.
10 (i) "Medicare" or "title XVIII" means benefits under the
11 federal medicare program established under title XVIII of the
12 social security act, 42 USC 1395 to 1395hhh.
13 (j) "Person" means an individual, partnership, cooperative,
14 association, private corporation, personal representative,
15 receiver, trustee, assignee, or other legal entity.
16 (k) "Public health code" means 1978 PA 368, MCL 333.1101 to
17 333.25211.
18 (l) "Primary consumer" means the actual user of long-term
19 care services.
20 (m) "Rule" means a rule promulgated pursuant to the
21 administrative procedures act of 1969.
22 (n) "Secondary consumer" means a family member or unpaid
23 caregiver of consumers.
24 (2) Unless otherwise provided in this act, the words defined
25 in subsection (1) apply to use of the defined term throughout
26 this act. Other definitions applicable to specific articles,
27 parts, or sections of this act are found in those articles,
1 parts, or sections.
2 Sec. 105. This act is intended to be consistent with
3 applicable federal and state laws, rules, and regulations and
4 shall be construed, when necessary, to achieve that consistency.
5 This act shall be liberally construed for the protection of the
6 health, safety, and welfare of the people of this state.
7 Sec. 107. A heading or title of an article or part of this
8 act shall not be considered as a part of this act or be used to
9 construe the act more broadly or narrowly than the text of the
10 act sections would indicate, but shall be considered as inserted
11 for convenience to users of this act.
12 Sec. 109. The director may promulgate rules as necessary or
13 appropriate to implement and carry out the duties or functions
14 vested by law in the department. Rules promulgated by the
15 department or the director under the former public health code
16 with regard to parts 173, 213, 214, and 217 and in effect on the
17 effective date of this act continue in effect to the extent that
18 they do not conflict with this part and shall continue to be
19 enforced. The rules may be amended or rescinded by the director.
20 PART 3
21 LONG-TERM CARE COMMISSION
22 Sec. 301. (1) There is created within the department a long-
23 term care commission appointed by the governor to reflect the
24 geographic and cultural diversity of this state. The commission
25 shall be appointed as follows:
26 (a) Twenty-five voting members as follows:
27 (i) Fourteen consumers of which 50% shall be primary
1 consumers and of those primary consumers 50% shall be users of
2 medicaid services. The remainder of the 14 consumers shall be
3 secondary consumers and representatives of consumer
4 organizations.
5 (ii) Seven providers of long-term health care or
6 representatives of provider organizations.
7 (iii) Three direct care workers.
8 (iv) One individual from a state university who has expertise
9 in long-term care research.
10 (b) Five nonvoting ex officio members as follows:
11 (i) State long-term care ombudsman.
12 (ii) Director of the department or his or her designated
13 representative.
14 (iii) Director of the department of human services or his or
15 her designated representative.
16 (iv) Director of the department of labor and economic growth
17 or his or her designated representative.
18 (v) A representative of the designated protection and
19 advocacy system.
20 (2) Voting members of the commission shall serve for terms
21 of 3 years or until a successor is appointed, whichever is later,
22 except that of the members first appointed 9 shall serve for 1
23 year, 8 shall serve for 2 years, and 8 shall serve for 3 years.
24 If a vacancy occurs on the commission, the governor shall make an
25 appointment for the unexpired term in the same manner as the
26 original appointment.
27 (3) The commission shall meet at least 6 times per year. A
1 majority of the voting members serving constitute a quorum for
2 the transaction of business as long as at least 8 of those voting
3 members are consumer members. Members of the commission are
4 entitled to receive per diem compensation and reimbursement of
5 actual and necessary expenses while acting as an official
6 representative of the commission as defined by commission
7 policies and rules. The per diem compensation of the commission
8 and the schedule for reimbursement of expenses shall be as
9 established and appropriated annually by the legislature.
10 (4) The governor shall designate 1 person from among the
11 consumer membership to serve as chairperson of the commission.
12 The chairperson shall serve in that position at the pleasure of
13 the governor.
14 Sec. 303. (1) The commission shall do all of the following:
15 (a) Serve as an effective and visible advocate for all
16 consumers of long-term care supports and services.
17 (b) Participate in the preparation and review, prior to the
18 submission to the governor, of an ongoing, comprehensive
19 statewide plan and budget for long-term care services and
20 supports design, allocations, and strategies to address and meet
21 identified consumer preferences and needs.
22 (c) Ensure the broadest possible ongoing public
23 participation in statewide planning as part of subdivision (b).
24 (d) Ensure broad, culturally competent, and effective public
25 education initiatives are ongoing on long-term care issues,
26 choices, and opportunities for direct involvement by the public.
27 (e) Advise the governor and legislature regarding changes in
1 federal and state programs, statutes, and policies.
2 (f) Establish additional advisory committees, councils, or
3 workgroups as deemed helpful or necessary in pursuit of the
4 commission's mission.
5 (2) The commission may consult with staff from the medical
6 services administration and the office of services to the aging
7 as necessary.
8 Sec. 313. (1) The commission may appoint task forces and
9 advisory committees composed of individuals in a number the
10 commission determines is appropriate when the commission
11 determines that either of the following exists:
12 (a) A task force or advisory committee is appropriate to
13 provide professional or technical expertise related to a
14 department or commission function under this act.
15 (b) A task force or advisory committee is appropriate to
16 provide additional public participation in a department or
17 commission function under this act.
18 (2) The department may request that the commission establish
19 a task force or advisory committee when the department determines
20 that the task force or advisory committee is appropriate to the
21 functions vested in the department by this act.
22 Sec. 315. (1) An advisory committee to the department
23 created in this act or task force created under section 313 shall
24 terminate 2 years after the date of its creation or renewal
25 unless the commission not later than 90 days before an advisory
26 committee or task force is to terminate reviews the need for the
27 continued existence of the advisory committee or task force and
1 thereafter recommends its continuance.
2 (2) Upon the recommendation of the commission, the director
3 may reappoint or request reappointment of an advisory committee
4 or task force which would have been otherwise terminated pursuant
5 to subsection (1). Subsection (1) does not apply to advisory
6 councils, commissions, boards, task forces, or other advisory
7 bodies that are not specifically designated as advisory
8 committees.
9 (3) Not later than 2 years after the effective date of this
10 act, and biennially thereafter, the commission shall review and
11 advise the director on the need for, and alternatives to, each
12 advisory council, commission, board, task force, or body
13 established in the department.
14 ARTICLE III
15 LONG-TERM CARE FACILITIES
16 PART 31
17 GENERAL PROVISIONS
18 Sec. 3101. (1) As used in this article:
19 (a) "Adult foster care facility" means a governmental or
20 nongovernmental establishment that provides foster care to
21 adults. Subject to section 3526a(1), adult foster care facility
22 includes facilities and foster care family homes for adults who
23 are aged, mentally ill, developmentally disabled, or physically
24 disabled who require supervision on an ongoing basis but who do
25 not require continuous nursing care. Adult foster care facility
26 does not include any of the following:
27 (i) A nursing home.
1 (ii) A home for the aged.
2 (iii) A hospital licensed under article 17 of the public
3 health code.
4 (iv) A hospital for the mentally ill or a facility for the
5 developmentally disabled operated by the department of community
6 health under the mental health code, 1974 PA 258, MCL 330.1001 to
7 330.2106.
8 (v) A county infirmary operated by a county department of
9 human services under section 55 of the social welfare act, 1939
10 PA 280, MCL 400.55.
11 (vi) A child caring institution, children's camp, foster
12 family home, or foster family group home licensed or approved
13 under 1973 PA 116, MCL 722.111 to 722.128, if the number of
14 residents who become 18 years of age while residing in the
15 institution, camp, or home does not exceed the following:
16 (A) Two, if the total number of residents is 10 or fewer.
17 (B) Three, if the total number of residents is not less than
18 11 and not more than 14.
19 (C) Four, if the total number of residents is not less than
20 15 and not more than 20.
21 (D) Five, if the total number of residents is 21 or more.
22 (vii) A foster family home licensed or approved under 1973 PA
23 116, MCL 722.111 to 722.128, that has a person who is 18 years of
24 age or older placed in the foster family home under section 5(7)
25 of 1973 PA 116, MCL 722.115.
26 (viii) An establishment commonly described as an alcohol or a
27 substance abuse rehabilitation center, a residential facility for
1 persons released from or assigned to adult correctional
2 institutions, a maternity home, or a hotel or rooming house that
3 does not provide or offer to provide foster care.
4 (ix) A facility created by 1885 PA 152, MCL 36.1 to 36.12.
5 (b) "County medical care facility" means a nursing care
6 facility, other than a hospital long-term care unit, which
7 provides organized nursing care and medical treatment to 7 or
8 more unrelated individuals who are suffering or recovering from
9 illness, injury, or infirmity and which is owned by a county or
10 counties.
11 (c) "Home for the aged" means a supervised personal care
12 facility, other than a hotel, adult foster care facility,
13 hospital, nursing home, or county medical care facility that
14 provides room, board, and supervised personal care to 21 or more
15 unrelated, nontransient individuals 60 years of age or older.
16 Home for the aged includes a supervised personal care facility
17 for 20 or fewer individuals 60 years of age or older if the
18 facility is operated in conjunction with and as a distinct part
19 of a licensed nursing home.
20 (d) "Hospice" means a health care program that provides a
21 coordinated set of services rendered at home or in an outpatient
22 or institutional setting for individuals suffering from a disease
23 or condition with a terminal prognosis.
24 (e) "License" means an authorization, annual or as otherwise
25 specified, granted by the appropriate department and evidenced by
26 a certificate of licensure granting permission to a person to
27 establish or maintain and operate, or both, a long-term care
1 facility.
2 (f) "Licensee" means the holder of a license to establish or
3 maintain and operate, or both, a long-term care facility.
4 (g) "Long-term care facility" means a county medical care
5 facility, home for the aged, hospice, and nursing home.
6 (h) "Nursing home" means a nursing care facility, including
7 a county medical care facility, that provides organized nursing
8 care and medical treatment to 7 or more unrelated individuals
9 suffering or recovering from illness, injury, or infirmity.
10 Nursing home does not include a unit in a state correctional
11 facility. Nursing home does not include 1 or more of the
12 following:
13 (i) A hospital licensed under article 17 of the public health
14 code.
15 (ii) A veterans facility created under 1885 PA 152, MCL 36.1
16 to 36.12.
17 (iii) A hospice residence that is licensed under this article.
18 (iv) A hospice that is certified under 42 CFR 418.100.
19 (2) In addition, article I contains general definitions
20 applicable to all articles in this act.
21 Sec. 3103. (1) Except as otherwise provided in this article,
22 the department shall utilize the comprehensive system of
23 licensure established pursuant to part 201 of the public health
24 code for the licensure of long-term care facilities under this
25 act.
26 (2) A person shall not establish or maintain and operate a
27 long-term care facility without holding a license from the
1 appropriate department as required by this act. A long-term care
2 facility license issued under former part 213, 214, or 217 of the
3 public health code is a license issued under this article on the
4 effective date of this act until that license expires and then
5 the long-term care facility may renew the license pursuant to
6 this article.
7 (3) Unless otherwise provided by law, the licensing and
8 certification records required by this article are public
9 records.
10 Sec. 3105. (1) A long-term care facility shall apply for
11 licensure or certification on a form authorized and provided by
12 the department. The application shall include attachments,
13 additional data, and information required by the department.
14 (2) An applicant shall certify the accuracy of information
15 supplied in the application and supplemental statements.
16 (3) An applicant or a licensee under part 32 or 33 shall
17 disclose the names, addresses, principal occupations, and
18 official positions of all persons who have an ownership interest
19 in that long-term care facility. If that long-term care facility
20 is located on or in leased real estate, the applicant or licensee
21 shall disclose the name of the lessor and any direct or indirect
22 interest the applicant or licensee has in the lease other than as
23 lessee. A change in ownership shall be reported to the director
24 not less than 15 days before the change occurs, except that a
25 person purchasing stock of a company registered pursuant to the
26 securities exchange act of 1934, 15 USC 78a to 78kk, is exempt
27 from disclosing ownership in the facility. A person required to
1 file a beneficial ownership report pursuant to section 16(a) of
2 the securities exchange act of 1934, 15 USC 78p, shall file with
3 the department information relating to securities ownership
4 required by department rule or order. An applicant or licensee
5 proposing a sale of a nursing home to another person shall
6 provide the department with written, advance notice of the
7 proposed sale. The applicant or licensee and the other parties to
8 the sale shall arrange to meet with specified department
9 representatives and shall obtain before the sale a determination
10 of the items of noncompliance with applicable law and rules which
11 shall be corrected. The department shall notify the respective
12 parties of the items of noncompliance prior to the change of
13 ownership and shall indicate that the items of noncompliance must
14 be corrected as a condition of issuance of a license to the new
15 owner. The department may accept reports filed with the
16 securities and exchange commission relating to the filings. A
17 person who violates this subsection is guilty of a misdemeanor
18 punishable by a fine of not more than $1,000.00 for each
19 violation.
20 (4) An applicant or licensee under part 32 shall disclose
21 the names and business addresses of suppliers who furnish goods
22 or services to an individual nursing home or a group of nursing
23 homes under common ownership, the aggregate charges for which
24 exceed $5,000.00 in a 12-month period which includes a month in a
25 nursing home's current fiscal year. An applicant or licensee
26 shall disclose the names, addresses, principal occupations, and
27 official positions of all persons who have an ownership interest
1 in a business which furnishes goods or services to an individual
2 nursing home or to a group of nursing homes under common
3 ownership, if both of the following apply:
4 (a) The person, or the person's spouse, parent, sibling, or
5 child, has an ownership interest in the nursing home purchasing
6 the goods or services.
7 (b) The aggregate charges for the goods or services
8 purchased exceed $5,000.00 in a 12-month period which includes a
9 month in the nursing home's current fiscal year.
10 (5) An applicant or licensee who makes a false statement in
11 an application or statement required by the department pursuant
12 to this article is guilty of a felony punishable by imprisonment
13 for not more than 4 years or a fine of not more than $30,000.00,
14 or both.
15 Sec. 3106. (1) A licensee shall certify to the department,
16 as part of its application for licensing and certification, that
17 all phases of its operation, including its training programs,
18 comply with state and federal laws prohibiting discrimination.
19 The applicant shall direct the administrator of the long-term
20 care facility to take the necessary action to assure that the
21 facility is, in fact, so operated.
22 (2) This section does not prohibit a long-term care facility
23 from developing facilities and programs of care that are for
24 specific ages or sexes or rating individuals for purposes of
25 determining appropriate reimbursement for care and services.
26 Sec. 3107. (1) Except as otherwise provided in this section,
27 the department shall make annual and other visits to each long-
1 term care facility licensed under this article for the purposes
2 of survey, evaluation, and consultation. A visit made pursuant to
3 a complaint shall be unannounced. The department shall assure
4 that each newly hired nursing home surveyor, as part of his or
5 her basic training, is assigned full-time to a licensed nursing
6 home for at least 10 days within a 14-day period to observe
7 actual operations outside of the survey process before the
8 trainee begins oversight responsibilities. A member of a survey
9 team shall not be employed by a licensed nursing home or a
10 nursing home management company doing business in this state at
11 the time of conducting a survey under this section. The
12 department shall not assign an individual to be a member of a
13 survey team for purposes of a survey, evaluation, or consultation
14 visit at a nursing home in which he or she was an employee within
15 the preceding 5 years.
16 (2) The department shall make at least a biennial visit to
17 each long-term care facility for the purposes of survey,
18 evaluation, and consultation. The department shall semiannually
19 provide for joint training with nursing home surveyors and
20 providers on at least 1 of the 10 most frequently issued federal
21 citations in this state during the past calendar year. The
22 department shall adopt the protocols for the review of citation
23 patterns compared to regional outcomes and standards and
24 complaints regarding the nursing home survey process as developed
25 under the public health code. The review will result in a report
26 provided to the legislature. Each member of a department nursing
27 home survey team who is a health professional licensee under the
1 public health code shall earn not less than 50% of his or her
2 required continuing education credits, if any, in geriatric care.
3 If a member of a nursing home survey team is a pharmacist
4 licensed under article 15 of the public health code, he or she
5 shall earn not less than 30% of his or her required continuing
6 education credits in geriatric care.
7 (3) This section does not prohibit the department from
8 citing a violation of this part during a survey, conducting
9 investigations or inspections pursuant to section 3109, or
10 conducting surveys of long-term care facilities for the purpose
11 of complaint investigations or federal certification. This
12 section does not prohibit the state fire marshal from conducting
13 annual surveys of long-term care facilities.
14 (4) The department or a local health department shall
15 conduct investigations or inspections, other than inspections of
16 financial records, of long-term care facilities without prior
17 notice to the long-term care facility. An employee of a state
18 agency charged with investigating or inspecting the long-term
19 care facility or an employee of a local health department who
20 directly or indirectly gives prior notice regarding an
21 investigation or an inspection, other than an inspection of the
22 financial records, to the long-term care facility or to an
23 employee of the long-term care facility is guilty of a
24 misdemeanor. Consultation visits that are not for the purpose of
25 annual or follow-up inspection or survey may be announced.
26 (5) The department shall maintain a record indicating
27 whether a visit and inspection are announced or unannounced.
1 Information gathered at each visit and inspection, whether
2 announced or unannounced, shall be taken into account in
3 licensure decisions.
4 (6) The department shall require periodic reports, and a
5 long-term care facility shall give the department access to
6 books, records, and other documents maintained by a long-term
7 care facility to the extent necessary to carry out the purpose of
8 this article and the rules promulgated under this article. The
9 department shall respect the confidentiality of a patient's
10 clinical record and shall not divulge or disclose the contents of
11 the records in a manner that identifies an individual except
12 under court order. The department may copy long-term care
13 facility records as required to document findings.
14 (7) The department may delegate survey, evaluation, or
15 consultation functions to another state agency or to a local
16 health department qualified to perform those functions. However,
17 the department shall not delegate survey, evaluation, or
18 consultation functions to a local health department that owns or
19 operates a hospice or hospice residence licensed under this
20 article. The delegation shall be by cost reimbursement contract
21 between the department and the state agency or local health
22 department. Survey, evaluation, or consultation functions shall
23 not be delegated to nongovernmental agencies, except as provided
24 in this section.
25 (8) If, upon investigation, the department or a state agency
26 determines that an individual licensed to practice a profession
27 in this state has violated the applicable licensure statute or
1 the rules promulgated under that statute, the department, state
2 agency, or local health department shall forward the evidence it
3 has to the appropriate licensing agency.
4 (9) The department shall report to the appropriations
5 subcommittees, the senate and house of representatives standing
6 committees having jurisdiction over issues involving senior
7 citizens, and the fiscal agencies on March 1 of each year on the
8 initial and follow-up surveys conducted on all nursing homes in
9 this state. The report shall include all of the following
10 information:
11 (a) The number of surveys conducted.
12 (b) The number requiring follow-up surveys.
13 (c) The number referred to the Michigan public health
14 institute for remediation.
15 (d) The number of citations per nursing home.
16 (e) The number of night and weekend complaints filed.
17 (f) The number of night and weekend responses to complaints
18 conducted by the department.
19 (g) The average length of time for the department to respond
20 to a complaint filed against a nursing home.
21 (h) The number and percentage of citations appealed.
22 (i) The number and percentage of citations overturned or
23 modified, or both.
24 (10) The department shall report annually to the standing
25 committees on appropriations and the standing committees having
26 jurisdiction over issues involving senior citizens in the senate
27 and the house of representatives on the percentage of nursing
1 home citations that are appealed and the percentage of nursing
2 home citations that are appealed and amended through the informal
3 deficiency dispute resolution process.
4 (11) The department shall adopt the terms, the
5 clarifications of those terms, and the clinical process
6 guidelines and compliance protocols with outcome measures in
7 applying those terms as developed and provided by the
8 clarification workgroup established under section 20155 of the
9 public health code.
10 (12) A long-term care facility shall post the facility's
11 survey report in a conspicuous place within the facility for
12 public review.
13 Sec. 3109. (1) A representative of the department or the
14 state fire marshal division of the department of labor and
15 economic growth, upon presentation of proper identification, may
16 enter the premises of an applicant or licensee at any reasonable
17 time to determine whether the applicant or licensee meets the
18 requirements of this article and the rules promulgated under this
19 article. The director, the director of human services, the state
20 fire marshal, the director of the office of services to the
21 aging, or the director of a local health department, or an
22 authorized representative of the director, the director of human
23 services, the state fire marshal, the director of the office of
24 services to the aging, or the director of a local health
25 department, may enter on the premises of an applicant or licensee
26 under this article at any time in the course of carrying out
27 program responsibilities.
1 (2) The state fire marshal division of the department of
2 labor and economic growth shall enforce rules promulgated by the
3 state fire safety board for long-term care facilities to assure
4 that physical facilities owned, maintained, or operated by a
5 long-term care facility are planned, constructed, and maintained
6 in a manner to protect the health, safety, and welfare of
7 patients.
8 (3) The department shall not issue a license or certificate
9 to a long-term care facility until it receives an appropriate
10 certificate of approval from the state fire marshal division of
11 the department of labor and economic growth. For purposes of this
12 section, a decision of the state fire marshal division of the
13 department of labor and economic growth to issue a certificate
14 controls over that of a local fire department.
15 Sec. 3111. (1) Upon a determination that a long-term care
16 facility is in compliance with this article and the rules
17 promulgated under this article, the department shall issue an
18 initial license within 6 months after the applicant files a
19 completed application. Receipt of the application is considered
20 the date the application is received by any agency or department
21 of this state. If the application is considered incomplete by the
22 department, the department shall notify the applicant in writing
23 or make the notice electronically available within 30 days after
24 receipt of the incomplete application, describing the deficiency
25 and requesting additional information. If the department
26 identifies a deficiency or requires the fulfillment of a
27 corrective action plan, the 6-month period is tolled until either
1 of the following occurs:
2 (a) Upon notification by the department of a deficiency,
3 until the date the requested information is received by the
4 department.
5 (b) Upon notification by the department that a corrective
6 action plan is required, until the date the department determines
7 the requirements of the corrective action plan have been met.
8 (2) The determination of the completeness of an application
9 does not operate as an approval of the application for the
10 license and does not confer eligibility of an applicant
11 determined otherwise ineligible for issuance of a license.
12 (3) Except as otherwise provided in this subsection, if the
13 department fails to issue or deny a license within the time
14 period required by this section, the department shall return the
15 license fee and shall reduce the license fee for the applicant's
16 next licensure application, if any, by 15%. Failure to issue or
17 deny a license within the time period required under this section
18 does not allow the department to otherwise delay processing an
19 application. The completed application shall be placed in
20 sequence with other completed applications received at that same
21 time. The department shall not discriminate against an applicant
22 in the processing of the application based upon the fact that the
23 application fee was refunded or discounted under this subsection.
24 The department may issue a nonrenewable temporary permit for not
25 more than 6 months if additional time is needed to make a proper
26 investigation or to permit the applicant to undertake remedial
27 action related to operational or procedural deficiencies or items
1 of noncompliance. A temporary permit shall not be issued to cover
2 deficiencies in physical plant requirements.
3 (4) Except as provided in part 32, the department may issue
4 a provisional license for not more than 3 consecutive years to an
5 applicant who temporarily is unable to comply with the rules as
6 to the physical plant owned, maintained, or operated by a long-
7 term care facility except as otherwise provided in this article.
8 A provisional license shall not be issued to a new long-term care
9 facility or a long-term care facility whose ownership is
10 transferred after the effective date of this act, unless the
11 long-term care facility was licensed and operating under this
12 article or a prior law for not less than 5 years. Provisional
13 licensure under acts repealed by this act shall be counted
14 against the 3-year maximum for licensure.
15 (5) The department, in order to protect the people of this
16 state, shall provide a procedure for the orderly closing of a
17 long-term care facility if it is unable to maintain its license
18 under this section.
19 (6) Except as provided in part 32, the department, upon
20 finding that a long-term care facility is not operating in accord
21 with the requirements of its license, may do the following:
22 (a) Issue an order directing the licensee to:
23 (i) Discontinue admissions.
24 (ii) Transfer selected patients out of the facility.
25 (iii) Reduce its licensed capacity.
26 (iv) Comply with specific requirements for licensure or
27 certification as appropriate.
1 (b) Through the office of the attorney general, initiate
2 misdemeanor proceedings against the licensee as provided in
3 section 3143.
4 (7) An order issued under subsection (6) shall be governed
5 by the notice and hearing requirements of section 3119(1) and the
6 status requirements of section 3119(2).
7 (8) As used in this section, "completed application" means
8 an application complete on its face and submitted with any
9 applicable licensing fees as well as any other information,
10 records, approval, security, or similar item required by law or
11 rule from a local unit of government, a federal agency, or a
12 private entity but not from another department or agency of this
13 state.
14 Sec. 3113. (1) A license, certification, provisional
15 license, or limited license is valid for not more than 1 year
16 after the date of issuance. A license or certification is not
17 transferable and shall state the persons, buildings, and
18 properties to which it applies.
19 (2) If ownership is not voluntarily transferred, the
20 department shall be notified immediately and the new owner shall
21 apply for a license and certification not later than 30 days
22 after the transfer.
23 Sec. 3115. (1) Except as otherwise provided in this section,
24 after notice of intent to an applicant or licensee to deny,
25 limit, suspend, or revoke the applicant's or licensee's license
26 or certification and an opportunity for a hearing, the department
27 may deny, limit, suspend, or revoke the license or certification
1 or impose an administrative fine on a licensee if 1 or more of
2 the following exist:
3 (a) Fraud or deceit in obtaining or attempting to obtain a
4 license or certification or in the operation of the licensed
5 long-term care facility.
6 (b) A violation of this article or a rule promulgated under
7 this article.
8 (c) False or misleading advertising.
9 (d) Negligence or failure to exercise due care, including
10 negligent supervision of employees and subordinates.
11 (e) Permitting a license or certificate to be used by an
12 unauthorized long-term care facility.
13 (f) Evidence of abuse regarding a patient's health, welfare,
14 or safety or the denial of a patient's rights.
15 (2) The department may deny an application for a license or
16 certification based on a finding of a condition or practice that
17 would constitute a violation of this article if the applicant
18 were a licensee.
19 Sec. 3117. (1) Notice of intent to deny, limit, suspend, or
20 revoke a license or certification shall be given by certified
21 mail or personal service, shall set forth the particular reasons
22 for the proposed action, and shall fix a date, not less that 30
23 days after the date of service, on which the applicant or
24 licensee shall be given the opportunity for a hearing before the
25 director or the director's authorized representative. The hearing
26 shall be conducted in accordance with the administrative
27 procedures act of 1969 and rules promulgated by the department. A
1 full and complete record shall be kept of the proceeding and
2 shall be transcribed when requested by an interested party, who
3 shall pay the cost of preparing the transcript.
4 (2) On the basis of a hearing or on the default of the
5 applicant or licensee, the department may issue, deny, limit,
6 suspend, or revoke a license or certification. A copy of the
7 determination shall be sent by certified mail or served
8 personally upon the applicant or licensee. The determination
9 becomes final 30 days after it is mailed or served, unless the
10 applicant or licensee within the 30 days appeals the decision to
11 the circuit court in the county of jurisdiction or to the Ingham
12 county circuit court.
13 (3) The department may establish procedures, hold hearings,
14 administer oaths, issue subpoenas, or order testimony to be taken
15 at a hearing or by deposition in a proceeding pending at any
16 stage of the proceeding. A person may be compelled to appear and
17 testify and to produce books, papers, or documents in a
18 proceeding.
19 (4) In case of disobedience of a subpoena, a party to a
20 hearing may invoke the aid of the circuit court of the
21 jurisdiction in which the hearing is held to require the
22 attendance and testimony of witnesses. The circuit court may
23 issue an order requiring an individual to appear and give
24 testimony. Failure to obey the order of the circuit court may be
25 punished by the court as a contempt.
26 (5) The department shall not deny, limit, suspend, or revoke
27 a license on the basis of an applicant's or licensee's failure to
1 show a need for a long-term care facility.
2 Sec. 3119. (1) Upon a finding that a deficiency or violation
3 of this article or the rules promulgated under this article
4 seriously affect the health, safety, and welfare of individuals
5 receiving care or services in or from a licensed long-term care
6 facility, the department may issue an emergency order limiting,
7 suspending, or revoking the license of the long-term care
8 facility. If the department issues an emergency order affecting
9 the license of a nursing home, the department may request the
10 department of human services to limit reimbursements or payments
11 authorized under section 3218. The department shall provide an
12 opportunity for a hearing within 5 working days after issuance of
13 the order.
14 (2) An order shall incorporate the department's findings.
15 The conduct of a hearing under this section shall not suspend the
16 department's order.
17 Sec. 3121. If the department is directed to promulgate rules
18 by this act and rules exist pursuant to former part 213, 214, or
19 217 of the public health code or to the former adult foster care
20 facility licensing act, 1979 PA 218, MCL 400.701 to 400.737, on
21 the date the requirement to promulgate takes effect, then those
22 rules continue in effect and shall apply to the long-term care
23 facilities licensed under this act to the extent that they do not
24 conflict with this act and shall continue to be enforced. The
25 rules may be amended or rescinded by the director.
26 Sec. 3123. If a board, committee, council, task force, or
27 other agency created by or pursuant to this act was preceded by
1 an agency with the same or similar name and functions under the
2 public health code, former parts of the public health code, or
3 the former adult foster care facility licensing act, 1979 PA 218,
4 MCL 400.701 to 400.737, members of the predecessor agency shall
5 continue in office for the duration of the terms of office for
6 which they were appointed and with the new members appointed
7 shall constitute the new agency. Members shall be appointed under
8 this act only as terms of the former members expire or vacancies
9 occur. Members of the predecessor agency may be appointed to the
10 new agency to succeed themselves subject to the limits for the
11 total period of service set forth in this act.
12 Sec. 3125. (1) Except as otherwise provided in subsection
13 (2), a long-term care facility shall not employ, independently
14 contract with, or grant clinical privileges to an individual who
15 regularly has direct access to or provides direct services to
16 patients or residents in the health facility or agency after the
17 effective date of this act if the individual satisfies 1 or more
18 of the following:
19 (a) Has been convicted of a relevant crime described under
20 42 USC 1320a-7.
21 (b) Has been convicted of any of the following felonies, an
22 attempt or conspiracy to commit any of those felonies, or any
23 other state or federal crime that is similar to the felonies
24 described in this subdivision, other than a felony for a relevant
25 crime described under 42 USC 1320a-7, unless 15 years have lapsed
26 since the individual completed all of the terms and conditions of
27 his or her sentencing, parole, and probation for that conviction
1 prior to the date of application for employment or clinical
2 privileges or the date of the execution of the independent
3 contract:
4 (i) A felony that involves the intent to cause death or
5 serious impairment of a body function, that results in death or
6 serious impairment of a body function, that involves the use of
7 force or violence, or that involves the threat of the use of
8 force or violence.
9 (ii) A felony involving cruelty or torture.
10 (iii) A felony under chapter XXA of the Michigan penal code,
11 1931 PA 328, MCL 750.145m to 750.145r.
12 (iv) A felony involving criminal sexual conduct.
13 (v) A felony involving abuse or neglect.
14 (vi) A felony involving the use of a firearm or dangerous
15 weapon.
16 (vii) A felony involving the diversion or adulteration of a
17 prescription drug or other medications.
18 (c) Has been convicted of a felony or an attempt or
19 conspiracy to commit a felony, other than a felony for a relevant
20 crime described under 42 USC 1320a-7 or a felony described under
21 subdivision (b), unless 10 years have lapsed since the individual
22 completed all of the terms and conditions of his or her
23 sentencing, parole, and probation for that conviction prior to
24 the date of application for employment or clinical privileges or
25 the date of the execution of the independent contract.
26 (d) Has been convicted of any of the following misdemeanors,
27 other than a misdemeanor for a relevant crime described under 42
1 USC 1320a-7, or a state or federal crime that is substantially
2 similar to the misdemeanors described in this subdivision, within
3 the 10 years immediately preceding the date of application for
4 employment or clinical privileges or the date of the execution of
5 the independent contract:
6 (i) A misdemeanor involving the use of a firearm or dangerous
7 weapon with the intent to injure, the use of a firearm or
8 dangerous weapon that results in a personal injury, or a
9 misdemeanor involving the use of force or violence or the threat
10 of the use of force or violence.
11 (ii) A misdemeanor under chapter XXA of the Michigan penal
12 code, 1931 PA 328, MCL 750.145m to 750.145r.
13 (iii) A misdemeanor involving criminal sexual conduct.
14 (iv) A misdemeanor involving cruelty or torture unless
15 otherwise provided under subdivision (e).
16 (v) A misdemeanor involving abuse or neglect.
17 (e) Has been convicted of any of the following misdemeanors,
18 other than a misdemeanor for a relevant crime described under 42
19 USC 1320a-7, or a state or federal crime that is substantially
20 similar to the misdemeanors described in this subdivision, within
21 the 5 years immediately preceding the date of application for
22 employment or clinical privileges or the date of the execution of
23 the independent contract:
24 (i) A misdemeanor involving cruelty if committed by an
25 individual who is less than 16 years of age.
26 (ii) A misdemeanor involving home invasion.
27 (iii) A misdemeanor involving embezzlement.
1 (iv) A misdemeanor involving negligent homicide.
2 (v) A misdemeanor involving larceny unless otherwise
3 provided under subdivision (g).
4 (vi) A misdemeanor of retail fraud in the second degree
5 unless otherwise provided under subdivision (g).
6 (vii) Any other misdemeanor involving assault, fraud, theft,
7 or the possession or delivery of a controlled substance unless
8 otherwise provided under subdivision (d), (f), or (g).
9 (f) Has been convicted of any of the following misdemeanors,
10 other than a misdemeanor for a relevant crime described under 42
11 USC 1320a-7, or a state or federal crime that is substantially
12 similar to the misdemeanors described in this subdivision, within
13 the 3 years immediately preceding the date of application for
14 employment or clinical privileges or the date of the execution of
15 the independent contract:
16 (i) A misdemeanor for assault if there was no use of a
17 firearm or dangerous weapon and no intent to commit murder or
18 inflict great bodily injury.
19 (ii) A misdemeanor of retail fraud in the third degree unless
20 otherwise provided under subdivision (g).
21 (iii) A misdemeanor under part 74 unless otherwise provided
22 under subdivision (g).
23 (g) Has been convicted of any of the following misdemeanors,
24 other than a misdemeanor for a relevant crime described under 42
25 USC 1320a-7, or a state or federal crime that is substantially
26 similar to the misdemeanors described in this subdivision, within
27 the year immediately preceding the date of application for
1 employment or clinical privileges or the date of the execution of
2 the independent contract:
3 (i) A misdemeanor under part 74 if the individual, at the
4 time of conviction, is under the age of 18.
5 (ii) A misdemeanor for larceny or retail fraud in the second
6 or third degree if the individual, at the time of conviction, is
7 under the age of 16.
8 (h) Is the subject of an order or disposition under section
9 16b of chapter IX of the code of criminal procedure, 1927 PA 175,
10 MCL 769.16b.
11 (i) Has been the subject of a substantiated finding of
12 neglect, abuse, or misappropriation of property by a state or
13 federal agency pursuant to an investigation conducted in
14 accordance with 42 USC 1395i-3 or 1396r.
15 (2) Except as otherwise provided in subsection (5), a long-
16 term care facility shall not employ, independently contract with,
17 or grant privileges to an individual who regularly has direct
18 access to or provides direct services to patients or residents in
19 the long-term care facility after the effective date of this act
20 until the long-term care facility conducts a criminal history
21 check in compliance with subsection (4). This subsection and
22 subsection (1) do not apply to any of the following:
23 (a) An individual who is employed by, under independent
24 contract to, or granted clinical privileges in a long-term care
25 facility before the effective date of this act. Within 24 months
26 after the effective date of this act, an individual who is exempt
27 under this subdivision shall provide the department of state
1 police with a set of fingerprints and the department of state
2 police shall input those fingerprints into the automated
3 fingerprint identification system database established under
4 subsection (12). An individual who is exempt under this
5 subdivision is not limited to working within the long-term care
6 facility with which he or she is employed by, under independent
7 contract to, or granted clinical privileges on the effective date
8 of this act. That individual may transfer to another long-term
9 care facility that is under the same ownership with which he or
10 she was employed, under contract, or granted privileges. If that
11 individual wishes to transfer to another long-term care facility
12 that is not under the same ownership, he or she may do so
13 provided that a criminal history check is conducted by the new
14 long-term care facility in accordance with subsection (4). If an
15 individual who is exempt under this subdivision is subsequently
16 convicted of a crime described under subsection (1)(a) through
17 (g) or found to be the subject of a substantiated finding
18 described under subsection (1)(i) or an order or disposition
19 described under subsection (1)(h), or is found to have been
20 convicted of a relevant crime described under subsection (1)(a),
21 then he or she is no longer exempt and shall be terminated from
22 employment or denied employment.
23 (b) An individual who is an independent contractor with a
24 long-term care facility if the services for which he or she is
25 contracted is not directly related to the provision of services
26 to a patient or resident or if the services for which he or she
27 is contracted allows for direct access to the patients or
1 residents but is not performed on an ongoing basis. This
2 exception includes, but is not limited to, an individual who
3 independently contracts with the health facility or agency to
4 provide utility, maintenance, construction, or communications
5 services.
6 (3) An individual who applies for employment either as an
7 employee or as an independent contractor or for clinical
8 privileges with a long-term care facility and has received a good
9 faith offer of employment, an independent contract, or clinical
10 privileges from the health facility or agency shall give written
11 consent at the time of application for the department of state
12 police to conduct an initial criminal history check under this
13 section, along with identification acceptable to the department
14 of state police.
15 (4) Upon receipt of the written consent and identification
16 required under subsection (3), a long-term care facility that has
17 made a good faith offer of employment or an independent contract
18 or clinical privileges to the applicant shall make a request to
19 the department of state police to conduct a criminal history
20 check on the applicant, to input the applicant's fingerprints
21 into the automated fingerprint identification system database,
22 and to forward the applicant's fingerprints to the federal bureau
23 of investigation. The department of state police shall request
24 the federal bureau of investigation to make a determination of
25 the existence of any national criminal history pertaining to the
26 applicant. The applicant shall provide the department of state
27 police with a set of fingerprints. The request shall be made in a
1 manner prescribed by the department of state police. The long-
2 term care facility shall make the written consent and
3 identification available to the department of state police. The
4 long-term care facility shall make a request to the relevant
5 licensing or regulatory department to conduct a check of all
6 relevant registries established pursuant to federal and state law
7 and regulations for any substantiated findings of abuse, neglect,
8 or misappropriation of property. If the department of state
9 police or the federal bureau of investigation charges a fee for
10 conducting the initial criminal history check, the charge shall
11 be paid by or reimbursed by the department with federal funds as
12 provided to implement a pilot program for national and state
13 background checks on direct patient access employees of long-term
14 care facilities or providers in accordance with section 307 of
15 the medicare prescription drug, improvement, and modernization
16 act of 2003, Public Law 108-173. The long-term care facility
17 shall not seek reimbursement for a charge imposed by the
18 department of state police or the federal bureau of investigation
19 from the individual who is the subject of the initial criminal
20 history check. A long-term care facility, a prospective employee,
21 or a prospective independent contractor covered under this
22 section may not be charged for the cost of an initial criminal
23 history check required under this section. The department of
24 state police shall conduct a criminal history check on the
25 applicant named in the request. The department of state police
26 shall provide the department with a written report of the
27 criminal history check conducted under this subsection if the
1 criminal history check contains any criminal history record
2 information. The report shall contain any criminal history record
3 information on the applicant maintained by the department of
4 state police. The department of state police shall provide the
5 results of the federal bureau of investigation determination to
6 the department within 30 days after the request is made. If the
7 requesting long-term care facility is not a state department or
8 agency and if a criminal conviction is disclosed on the written
9 report of the criminal history check or the federal bureau of
10 investigation determination, the department shall notify the
11 long-term care facility and the applicant in writing of the type
12 of crime disclosed on the written report of the criminal history
13 check or the federal bureau of investigation determination
14 without disclosing the details of the crime. Any charges imposed
15 by the department of state police or the federal bureau of
16 investigation for conducting an initial criminal history check or
17 making a determination under this subsection shall be paid in the
18 manner required under this subsection. The notice shall include a
19 statement that the applicant has a right to appeal a decision
20 made by the long-term care facility regarding his or her
21 employment eligibility based on the criminal background check.
22 The notice shall also include information regarding where to file
23 and describing the appellate procedures established under section
24 20173b.
25 (5) If a long-term care facility determines it necessary to
26 employ or grant clinical privileges to an applicant before
27 receiving the results of the applicant's criminal history check
1 under this section, the health facility or agency may
2 conditionally employ or grant conditional clinical privileges to
3 the individual if all of the following apply:
4 (a) The long-term care facility requests the criminal
5 history check under this section upon conditionally employing or
6 conditionally granting clinical privileges to the individual.
7 (b) The individual signs a statement in writing that
8 indicates all of the following:
9 (i) That he or she has not been convicted of 1 or more of the
10 crimes that are described in subsection (1)(a) through (g) within
11 the applicable time period prescribed by each subdivision
12 respectively.
13 (ii) That he or she is not the subject of an order or
14 disposition described in subsection (1)(h).
15 (iii) That he or she has not been the subject of a
16 substantiated finding as described in subsection (1)(i).
17 (iv) The individual agrees that, if the information in the
18 criminal history check conducted under this section does not
19 confirm the individual's statements under subparagraphs (i)
20 through (iii), his or her employment or clinical privileges will be
21 terminated by the long-term care facility as required under
22 subsection (1) unless and until the individual appeals and can
23 prove that the information is incorrect.
24 (v) That he or she understands the conditions described in
25 subparagraphs (i) through (iv) that result in the termination of
26 his or her employment or clinical privileges and that those
27 conditions are good cause for termination.
1 (6) The department shall develop and distribute a model form
2 for the statement required under subsection (5)(b). The
3 department shall make the model form available to long-term care
4 facilities subject to this section upon request at no charge.
5 (7) If an individual is employed as a conditional employee
6 or is granted conditional clinical privileges under subsection
7 (5), and the report described in subsection (4) does not confirm
8 the individual's statement under subsection (5)(b)(i) through
9 (iii), the long-term care facility shall terminate the individual's
10 employment or clinical privileges as required by subsection (1).
11 (8) An individual who knowingly provides false information
12 regarding his or her identity, criminal convictions, or
13 substantiated findings on a statement described in subsection
14 (5)(b)(i) through (iii) is guilty of a misdemeanor punishable by
15 imprisonment for not more than 93 days or a fine of not more than
16 $500.00, or both.
17 (9) A long-term care facility shall use criminal history
18 record information obtained under subsection (4) only for the
19 purpose of evaluating an applicant's qualifications for
20 employment, an independent contract, or clinical privileges in
21 the position for which he or she has applied and for the purposes
22 of subsections (5) and (7). A long-term care facility or an
23 employee of the long-term care facility shall not disclose
24 criminal history record information obtained under subsection (4)
25 to a person who is not directly involved in evaluating the
26 applicant's qualifications for employment, an independent
27 contract, or clinical privileges. An individual who knowingly
1 uses or disseminates the criminal history record information
2 obtained under subsection (4) in violation of this subsection is
3 guilty of a misdemeanor punishable by imprisonment for not more
4 than 93 days or a fine of not more than $1,000.00, or both. Upon
5 written request from another long-term care facility, health
6 facility or agency, psychiatric facility or intermediate care
7 facility for people with mental retardation, or adult foster care
8 facility that is considering employing, independently contracting
9 with, or granting clinical privileges to an individual, a long-
10 term care facility that has obtained criminal history record
11 information under this section on that individual shall, with the
12 consent of the applicant, share the information with the
13 requesting long-term care facility, health facility or agency,
14 psychiatric facility or intermediate care facility for people
15 with mental retardation, or adult foster care facility. Except
16 for a knowing or intentional release of false information, a
17 health facility or agency has no liability in connection with a
18 criminal background check conducted under this section or the
19 release of criminal history record information under this
20 subsection.
21 (10) As a condition of continued employment, each employee,
22 independent contractor, or individual granted clinical privileges
23 shall do each of the following:
24 (a) Agree in writing to report to the long-term care
25 facility immediately upon being arraigned for 1 or more of the
26 criminal offenses listed in subsection (1)(a) through (g), upon
27 being convicted of 1 or more of the criminal offenses listed in
1 subsection (1)(a) through (g), upon becoming the subject of an
2 order or disposition described under subsection (1)(h), and upon
3 being the subject of a substantiated finding of neglect, abuse,
4 or misappropriation of property as described in subsection
5 (1)(i). Reporting of an arraignment under this subdivision is not
6 cause for termination or denial of employment.
7 (b) If a set of fingerprints is not already on file with the
8 department of state police, provide the department of state
9 police with a set of fingerprints.
10 (11) In addition to sanctions set forth in section 20165, a
11 licensee, owner, administrator, or operator of a long-term care
12 facility who knowingly and willfully fails to conduct the
13 criminal history checks as required under this section is guilty
14 of a misdemeanor punishable by imprisonment for not more than 1
15 year or a fine of not more than $5,000.00, or both.
16 (12) In collaboration with the department of state police,
17 the department of information technology shall establish an
18 automated fingerprint identification system database that would
19 allow the department of state police to store and maintain all
20 fingerprints submitted under this section and would provide for
21 an automatic notification if and when a subsequent criminal
22 arrest fingerprint card submitted into the system matches a set
23 of fingerprints previously submitted in accordance with this
24 section. Upon such notification, the department of state police
25 shall immediately notify the department and the department shall
26 immediately contact the respective health facility or agency with
27 which that individual is associated. Information in the database
1 established under this subsection is confidential, is not subject
2 to disclosure under the freedom of information act, 1976 PA 442,
3 MCL 15.231 to 15.246, and shall not be disclosed to any person
4 except for purposes of this act or for law enforcement purposes.
5 (13) By March 1, 2007, the department and the department of
6 state police shall develop and implement an electronic web-based
7 system to assist those long-term care facilities required to
8 check relevant registries and conduct criminal history checks of
9 its employees and independent contractors and to provide for an
10 automated notice to those long-term care facilities for those
11 individuals inputted in the system who, since the initial check,
12 have been convicted of a disqualifying offense or have been the
13 subject of a substantiated finding of abuse, neglect, or
14 misappropriation of property.
15 (14) As used in this section:
16 (a) "Adult foster care facility" means an adult foster care
17 facility licensed under the adult foster care facility licensing
18 act, 1979 PA 218, MCL 400.701 to 400.737.
19 (b) "Direct access" means access to a patient or resident or
20 to a patient's or resident's property, financial information,
21 medical records, treatment information, or any other identifying
22 information.
23 (c) "Independent contract" means a contract entered into by
24 a health facility or agency with an individual who provides the
25 contracted services independently or a contract entered into by a
26 health facility or agency with an organization or agency that
27 employs or contracts with an individual after complying with the
1 requirements of this section to provide the contracted services
2 to the health facility or agency on behalf of the organization or
3 agency.
4 (d) "Medicare" means benefits under the federal medicare
5 program established under title XVIII of the social security act,
6 42 USC 1395 to 1395ggg.
7 Sec. 3125a. (1) An individual who has been disqualified from
8 or denied employment by a long-term care facility based on a
9 criminal history check conducted pursuant to section 3125 may
10 appeal to the department if he or she believes that the criminal
11 history report is inaccurate, and the appeal shall be conducted
12 as a contested case hearing pursuant to the administrative
13 procedures act of 1969. The individual shall file the appeal with
14 the director of the department within 15 business days after
15 receiving the written report of the criminal history check unless
16 the conviction contained in the criminal history report is one
17 that may be expunged or set aside. If an individual has been
18 disqualified or denied employment based on a conviction that may
19 be expunged or set aside, then he or she shall file the appeal on
20 a form provided by the department within 15 business days after a
21 court order granting or denying his or her application to expunge
22 or set aside that conviction is granted. If the order is granted
23 and the conviction is expunged or set aside, then the individual
24 shall not be disqualified or denied employment based solely on
25 that conviction. The director shall review the appeal and issue a
26 written decision within 30 business days after receiving the
27 appeal. The decision of the director is final.
1 (2) As used in this section, "business day" means a day
2 other than a Saturday, Sunday, or any legal holiday.
3 Sec. 3127. (1) A long-term care facility shall keep and
4 maintain a record for each patient including a full and complete
5 record of observations made and treatments provided. Departmental
6 officers and employees shall respect the confidentiality of
7 patient clinical records and shall not divulge or disclose the
8 contents of records in a manner that identifies an individual
9 except pursuant to court order.
10 (2) A long-term care facility that employs, contracts with,
11 or grants privileges to a health professional licensed or
12 registered under article 15 of the public health code shall
13 report the following to the department not more than 30 days
14 after it occurs:
15 (a) Disciplinary action taken by the long-term care facility
16 against a health professional licensed or registered under
17 article 15 of the public health code based on the licensee's or
18 registrant's professional competence, disciplinary action that
19 results in a change of employment status, or disciplinary action
20 based on conduct that adversely affects the licensee's or
21 registrant's clinical privileges for a period of more than 15
22 days. As used in this subdivision, "adversely affects" means the
23 reduction, restriction, suspension, revocation, denial, or
24 failure to renew the clinical privileges of a licensee or
25 registrant by a long-term care facility.
26 (b) Restriction or acceptance of the surrender of the
27 clinical privileges of a health professional licensed or
1 registered under article 15 of the public health code under
2 either of the following circumstances:
3 (i) The licensee or registrant is under investigation by the
4 long-term care facility.
5 (ii) There is an agreement in which the long-term care
6 facility agrees not to conduct an investigation into the
7 licensee's or registrant's alleged professional incompetence or
8 improper professional conduct.
9 (c) A case in which a health professional resigns or
10 terminates a contract or whose contract is not renewed instead of
11 the long-term care facility taking disciplinary action against
12 the health professional.
13 (3) Upon request by another long-term care facility seeking
14 a reference for purposes of changing or granting staff
15 privileges, credentials, or employment, a long-term care facility
16 that employs, contracts with, or grants privileges to health
17 professionals licensed or registered under article 15 of the
18 public health code shall notify the requesting long-term care
19 facility of any disciplinary or other action reportable under
20 subsection (2) that it has taken against a health professional
21 licensed or registered under article 15 of the public health code
22 and employed by, under contract to, or granted privileges by the
23 long-term care facility.
24 (4) For the purpose of reporting disciplinary actions under
25 this section, a long-term care facility shall include only the
26 following in the information provided:
27 (a) The name of the health professional licensed or
1 registered under article 15 of the public health code against
2 whom disciplinary action has been taken.
3 (b) A description of the disciplinary action taken.
4 (c) The specific grounds for the disciplinary action taken.
5 (d) The date of the incident that is the basis for the
6 disciplinary action.
7 Sec. 3129. (1) A person may notify the department of a
8 violation of this article or of a rule promulgated under this
9 article that the person believes exists. The department shall
10 investigate each written complaint received and shall notify the
11 complainant in writing of the results of a review or
12 investigation of the complaint and any action proposed to be
13 taken. Except as otherwise provided in sections 3135, 3243(1)(d),
14 and 3299a, the name of the complainant and the charges contained
15 in the complaint are a matter of public record.
16 (2) Except as otherwise provided in section 3299a, a
17 complainant who is aggrieved by the decision of the department
18 under this section may appeal to the director. After review of an
19 appeal under this subsection, the director may order the
20 department to reinvestigate the complaint.
21 Sec. 3129a. (1) A long-term care facility shall not
22 discharge or discipline, threaten to discharge or discipline, or
23 otherwise discriminate against an employee regarding the
24 employee's compensation, terms, conditions, location, or
25 privileges of employment because the employee or an individual
26 acting on behalf of the employee does either or both of the
27 following:
1 (a) In good faith reports or intends to report, verbally or
2 in writing, the malpractice of a health professional or a
3 violation of this article, article 7, or article 15 of the public
4 health code or a rule promulgated under this act or the public
5 health code.
6 (b) Acts as an expert witness in a civil action involving
7 medical malpractice or in an administrative action.
8 (2) In addition to the sanctions set forth in section 3115,
9 a long-term care facility that violates subsection (1) is subject
10 to an administrative fine of not more than $10,000.00 for each
11 violation.
12 Sec. 3131. Notwithstanding the existence and pursuit of any
13 other remedy, the director, without posting a bond, may request
14 the prosecuting attorney or attorney general to bring an action
15 in the name of the people of this state to restrain, enjoin, or
16 prevent the establishment, maintenance, or operation of a long-
17 term care facility in violation of this article or rules
18 promulgated under this article.
19 Sec. 3133. (1) A long-term care facility that is not a
20 hospice that represents to the public that it provides inpatient
21 care or services or residential care or services, or both, to
22 persons with Alzheimer's disease or a related condition shall
23 provide to each prospective patient, resident, or surrogate
24 decision maker a written description of the services provided by
25 the long-term care facility to patients or residents with
26 Alzheimer's disease or a related condition. A written description
27 shall include, but not be limited to, all of the following:
1 (a) The overall philosophy and mission reflecting the needs
2 of patients or residents with Alzheimer's disease or a related
3 condition.
4 (b) The process and criteria for placement in or transfer or
5 discharge from a program for patients or residents with
6 Alzheimer's disease or a related condition.
7 (c) The process used for assessment and establishment of a
8 plan of care and its implementation.
9 (d) Staff training and continuing education practices.
10 (e) The physical environment and design features appropriate
11 to support the function of patients or residents with Alzheimer's
12 disease or a related condition.
13 (f) The frequency and types of activities for patients or
14 residents with Alzheimer's disease or a related condition.
15 (g) Identification of supplemental fees for services
16 provided to patients or residents with Alzheimer's disease or a
17 related condition.
18 (2) As used in this section, "represents to the public"
19 means advertises or markets the facility as providing specialized
20 Alzheimer's or dementia care services.
21 Sec. 3135. (1) A person employed by or under contract to a
22 long-term care facility or any other person acting in good faith
23 who makes a report or complaint including, but not limited to, a
24 report or complaint of a violation of this article or a rule
25 promulgated under this article; who assists in originating,
26 investigating, or preparing a report or complaint; or who assists
27 the department in carrying out its duties under this article is
1 immune from civil or criminal liability that might otherwise be
2 incurred and is protected under the whistleblowers' protection
3 act, 1980 PA 469, MCL 15.361 to 15.369. A person described in
4 this subsection who makes or assists in making a report or
5 complaint, or who assists the department as described in this
6 subsection, is presumed to have acted in good faith. The immunity
7 from civil or criminal liability granted under this subsection
8 extends only to acts done pursuant to this article.
9 (2) Unless a person described in subsection (1) otherwise
10 agrees in writing, the department shall keep the person's
11 identity confidential until disciplinary proceedings under this
12 article are initiated against the subject of the report or
13 complaint and the person making or assisting in originating,
14 investigating, or preparing the report or complaint is required
15 to testify in the disciplinary proceedings. If disclosure of the
16 person's identity is considered by the department to be essential
17 to the disciplinary proceedings and if the person is the
18 complainant, the department shall give the person an opportunity
19 to withdraw the complaint before disclosure.
20 Sec. 3137. A long-term care facility shall not require the
21 execution of a do-not-resuscitate order under the Michigan do-
22 not-resuscitate procedure act as a condition for admission or
23 receipt of services.
24 Sec. 3139. (1) Subject to subsections (2), (3), and (4), a
25 long-term care facility shall conspicuously display in the
26 patient waiting areas or other common areas of the long-term care
27 facility copies of a pamphlet developed by the department
1 outlining the procedure for filing a complaint against a long-
2 term care facility with the department and the procedure for
3 filing a complaint against an individual who is licensed or
4 registered under article 15 of the public health code and
5 employed by, under contract to, or granted privileges by the
6 long-term care facility. The pamphlet shall be developed and
7 distributed by the department after consultation with appropriate
8 professional associations.
9 (2) The department shall develop the pamphlets required
10 under subsection (1) in languages that are appropriate to the
11 ethnic composition of the patient population where the pamphlet
12 will be displayed. The department shall use large, easily
13 readable type and nontechnical, easily understood language in the
14 pamphlet. The department shall periodically distribute copies of
15 the pamphlet to each long-term care facility.
16 (3) The department shall include a model standardized
17 complaint form in the pamphlet described in subsection (1). The
18 department may develop a separate model standardized complaint
19 form that is specific to a particular long-term care facility or
20 category of long-term care facilities. The department shall
21 develop a model standardized complaint form that is specific to
22 nursing homes. The department shall include on the model
23 standardized complaint form, at a minimum, simple instructions on
24 how to file a complaint, including with the nursing home as
25 required under section 3223, the department, the state long-term
26 care ombudsman, the Michigan protection and advocacy service,
27 inc., and the health care fraud unit of the department of
1 attorney general. The department shall distribute copies of the
2 model standardized complaint form simultaneously with copies of
3 the pamphlet as required under subsection (2). The nursing home
4 shall conspicuously display and make available multiple copies of
5 the pamphlet and model standardized complaint form with the
6 complaint information required to be posted under section 3223 in
7 the patient waiting areas or other common areas of the nursing
8 home that are easily accessible to nursing home patients and
9 their visitors, as described in subsection (1), and shall provide
10 a copy of the pamphlet and complaint form to each nursing home
11 resident or the resident's surrogate decision maker upon
12 admission to the nursing home. The department shall include on
13 the model standardized complaint form a telephone number for the
14 receipt of oral complaints.
15 (4) The department may continue to distribute the complaint
16 pamphlets within its possession on the effective date of this act
17 until the department's stock is exhausted or until 6 months after
18 the effective date of this act, whichever is sooner. Beginning 6
19 months after the effective date of this act, the department shall
20 only distribute the complaint pamphlets and model standardized
21 complaint forms that are in compliance with subsections (2) and
22 (3).
23 (5) The department shall make the complaint pamphlet and the
24 model standardized complaint form available to the public on the
25 department's internet website. The department shall take
26 affirmative action toward the development and implementation of
27 an electronic filing system that would allow an individual to
1 file a complaint through the website.
2 Sec. 3141. (1) Subject to subsection (3), an individual
3 shall not enter upon the premises of a long-term care facility
4 that is a residential facility for the purpose of engaging in an
5 activity that would cause a reasonable person to feel terrorized,
6 frightened, intimidated, threatened, harassed, or molested and
7 that actually causes a long-term care facility employee, patient,
8 resident, or visitor to feel terrorized, frightened, intimidated,
9 threatened, harassed, or molested. This subsection does not
10 prohibit constitutionally protected activity or conduct that
11 serves a legitimate purpose.
12 (2) An individual who violates subsection (1) is guilty of a
13 misdemeanor punishable by imprisonment for not more than 1 year
14 or a fine of not less than $1,000.00 or more than $10,000.00, or
15 both.
16 (3) Subsections (1) and (2) do not apply to a nursing home
17 covered under sections 3263(5) and 3299c(1)(c).
18 Sec. 3143. Except as otherwise provided in section 3105, a
19 person who violates this article or a rule promulgated or an
20 order issued under this article is guilty of a misdemeanor
21 punishable by fine of not more than $1,000.00 for each day the
22 violation continues.
23 Sec. 3145. (1) A long-term care facility that provides
24 services directly to patients or residents and is licensed under
25 this article shall adopt a policy describing the rights and
26 responsibilities of patients or residents admitted to the long-
27 term care facility. The policy shall be posted at a public place
1 in the long-term care facility and shall be provided to each
2 member of the long-term care facility staff. Patients or
3 residents shall be treated in accordance with the policy.
4 (2) The policy describing the rights and responsibilities of
5 patients or residents required under subsection (1) shall
6 include, as a minimum, all of the following:
7 (a) A patient or resident shall not be denied appropriate
8 care on the basis of race, religion, color, national origin, sex,
9 age, disability, marital status, sexual preference, or source of
10 payment.
11 (b) An individual who is or has been a patient or resident
12 is entitled to inspect, or receive for a reasonable fee, a copy
13 of his or her medical record upon request. A third party shall
14 not be given a copy of the patient's or resident's medical record
15 without prior authorization of the patient or resident.
16 (c) A patient or resident is entitled to confidential
17 treatment of personal and medical records and may refuse their
18 release to a person outside the long-term care facility except as
19 required because of a transfer to another long-term care facility
20 or as required by law or third party payment contract.
21 (d) A patient or resident is entitled to privacy, to the
22 extent feasible, in treatment and in caring for personal needs
23 with consideration, respect, and full recognition of his or her
24 dignity and individuality.
25 (e) A patient or resident is entitled to receive adequate
26 and appropriate care, and to receive, from the appropriate
27 individual within the long-term care facility, information about
1 his or her medical condition, proposed course of treatment, and
2 prospects for recovery, in terms that the patient or resident can
3 understand, unless medically contraindicated as documented by the
4 attending physician in the medical record.
5 (f) A patient or resident is entitled to refuse treatment to
6 the extent provided by law and to be informed of the consequences
7 of that refusal. If a refusal of treatment prevents a long-term
8 care facility or its staff from providing appropriate care
9 according to ethical and professional standards, the relationship
10 with the patient or resident may be terminated upon reasonable
11 notice.
12 (g) A patient or resident is entitled to exercise his or her
13 rights as a patient or resident and as a citizen, and to this end
14 may present grievances or recommend changes in policies and
15 services on behalf of himself or herself or others to the long-
16 term care facility staff, to governmental officials, or to
17 another person of his or her choice within or outside the long-
18 term care facility, free from restraint, interference, coercion,
19 discrimination, or reprisal. A patient or resident is entitled to
20 information about the long-term care facility's policies and
21 procedures for initiation, review, and resolution of patient or
22 resident complaints.
23 (h) A patient or resident is entitled to information
24 concerning an experimental procedure proposed as a part of his or
25 her care and has the right to refuse to participate in the
26 experimental procedure without jeopardizing his or her continuing
27 care.
1 (i) A patient or resident is entitled to receive and examine
2 an explanation of his or her bill regardless of the source of
3 payment and to receive, upon request, information relating to
4 financial assistance available through the long-term care
5 facility.
6 (j) A patient or resident is entitled to know who is
7 responsible for and who is providing his or her direct care, is
8 entitled to receive information concerning his or her continuing
9 health needs and alternatives for meeting those needs, and is
10 entitled to be involved in his or her discharge planning, if
11 appropriate.
12 (k) A patient or resident is entitled to associate and have
13 private communications and consultations with his or her
14 physician, attorney, or any other person of his or her choice and
15 to send and receive personal mail unopened on the same day it is
16 received at the long-term care facility, unless medically
17 contraindicated as documented by the attending physician in the
18 medical record. A patient's or resident's civil and religious
19 liberties, including the right to independent personal decisions
20 and the right to knowledge of available choices, shall not be
21 infringed and the long-term care facility shall encourage and
22 assist in the fullest possible exercise of these rights. A
23 patient or resident may meet with, and participate in, the
24 activities of social, religious, and community groups at his or
25 her discretion, unless medically contraindicated as documented by
26 the attending physician in the medical record.
27 (l) A patient or resident is entitled to be free from mental
1 and physical abuse and from physical and chemical restraints,
2 except those restraints authorized in writing by the attending
3 physician for a specified and limited time or as are necessitated
4 by an emergency to protect the patient or resident from injury to
5 self or others, in which case the restraint may only be applied
6 by a qualified professional who shall set forth in writing the
7 circumstances requiring the use of restraints and who shall
8 promptly report the action to the attending physician. In case of
9 a chemical restraint, a physician shall be consulted within 24
10 hours after the commencement of the chemical restraint.
11 (m) A patient or resident is entitled to be free from
12 performing services for the long-term care facility that are not
13 included for therapeutic purposes in the plan of care.
14 (n) A patient or resident is entitled to information about
15 the long-term care facility rules and regulations affecting
16 patient or resident care and conduct.
17 (o) A patient or resident is entitled to adequate and
18 appropriate pain and symptom management as a basic and essential
19 element of his or her medical treatment.
20 (3) The following additional requirements for the policy
21 described in subsection (2) apply to licensees under parts 32 and
22 33:
23 (a) The policy shall be provided to each nursing home
24 patient or home for the aged resident upon admission, and the
25 staff of the facility shall be trained and involved in the
26 implementation of the policy.
27 (b) Each nursing home patient may associate and communicate
1 privately with persons of his or her choice. Reasonable, regular
2 visiting hours, which shall be not less than 8 hours per day, and
3 which shall take into consideration the special circumstances of
4 each visitor, shall be established for patients to receive
5 visitors. A patient may be visited by the patient's attorney or
6 by representatives of the departments named in section 3109,
7 during other than established visiting hours. Reasonable privacy
8 shall be afforded for visitation of a patient who shares a room
9 with another patient. Each patient shall have reasonable access
10 to a telephone. A married nursing home patient or home for the
11 aged resident is entitled to meet privately with his or her
12 spouse in a room that assures privacy. If both spouses are
13 residents in the same facility, they are entitled to share a room
14 unless medically contraindicated and documented by the attending
15 physician in the medical record.
16 (c) A nursing home patient or home for the aged resident is
17 entitled to retain and use personal clothing and possessions as
18 space permits, unless to do so would infringe upon the rights of
19 other patients or residents, or unless medically contraindicated
20 as documented by the attending physician in the medical record.
21 Each nursing home patient or home for the aged resident shall be
22 provided with reasonable space. At the request of a patient, a
23 nursing home shall provide for the safekeeping of personal
24 effects, funds, and other property of a patient in accordance
25 with section 3267, except that a nursing home is not required to
26 provide for the safekeeping of a property that would impose an
27 unreasonable burden on the nursing home.
1 (d) A nursing home patient or home for the aged resident is
2 entitled to the opportunity to participate in the planning of his
3 or her medical treatment. A nursing home patient shall be fully
4 informed by the attending physician of the patient's medical
5 condition unless medically contraindicated as documented by a
6 physician in the medical record. Each nursing home patient shall
7 be afforded the opportunity to discharge himself or herself from
8 the nursing home.
9 (e) A home for the aged resident may be transferred or
10 discharged only for medical reasons, for his or her welfare or
11 that of other residents, or for nonpayment of his or her stay,
12 except as provided by title XVIII or title XIX. A nursing home
13 patient may be transferred or discharged only as provided in
14 sections 3273 to 3277. A nursing home patient or home for the
15 aged resident is entitled to be given reasonable advance notice
16 to ensure orderly transfer or discharge. Those actions shall be
17 documented in the medical record.
18 (f) A nursing home patient or home for the aged resident is
19 entitled to be fully informed before or at the time of admission
20 and during stay of services available in the facility, and of the
21 related charges including any charges for services not covered
22 under title XVIII, or not covered by the facility's basic per
23 diem rate. The statement of services provided by the facility
24 shall be in writing and shall include those required to be
25 offered on an as-needed basis.
26 (g) A nursing home patient or home for the aged resident is
27 entitled to manage his or her own financial affairs, or to have
1 at least a quarterly accounting of personal financial
2 transactions undertaken in his or her behalf by the facility
3 during a period of time the patient or resident has delegated
4 those responsibilities to the facility. In addition, a patient or
5 resident is entitled to receive each month from the facility an
6 itemized statement setting forth the services paid for by or on
7 behalf of the patient and the services rendered by the facility.
8 The admission of a patient to a nursing home does not confer on
9 the nursing home or its owner, administrator, employees, or
10 representatives the authority to manage, use, or dispose of a
11 patient's property.
12 (h) A nursing home patient or a person authorized by the
13 patient in writing may inspect and copy the patient's personal
14 and medical records. The records shall be made available for
15 inspection and copying by the nursing home within a reasonable
16 time, not exceeding 1 week, after the receipt of a written
17 request.
18 (i) If a nursing home patient desires treatment by a
19 licensed member of the healing arts, the treatment shall be made
20 available unless it is medically contraindicated, and the medical
21 contraindication is justified in the patient's medical record by
22 the attending physician.
23 (j) A nursing home patient has the right to have his or her
24 parents, if a minor, or his or her spouse, next of kin, or
25 patient's representative, if an adult, stay at the facility 24
26 hours a day if the patient is considered terminally ill by the
27 physician responsible for the patient's care.
1 (k) Each nursing home patient shall be provided with meals
2 that meet the recommended dietary allowances for that patient's
3 age and sex and that may be modified according to special dietary
4 needs or ability to chew.
5 (l) Each nursing home patient has the right to receive
6 representatives of approved organizations as provided in section
7 21763.
8 (4) A nursing home, its owner, administrator, employee, or
9 representative shall not discharge, harass, or retaliate or
10 discriminate against a patient because the patient has exercised
11 a right protected under this section.
12 (5) In the case of a nursing home patient, the rights
13 enumerated in subsection (2)(c), (g), and (k) and subsection
14 (3)(d), (g), and (h) may be exercised by the patient's
15 representative.
16 (6) A nursing home patient or home for the aged resident is
17 entitled to be fully informed, as evidenced by the patient's or
18 resident's written acknowledgment, before or at the time of
19 admission and during stay, of the policy required by this
20 section. The policy shall provide that if a patient or resident
21 is adjudicated incompetent and not restored to legal capacity,
22 the rights and responsibilities set forth in this section shall
23 be exercised by a person designated by the patient or resident.
24 The long-term care facility shall provide proper forms for the
25 patient or resident to provide for the designation of this person
26 at the time of admission.
27 (7) This section does not prohibit a long-term care facility
1 from establishing and recognizing additional patients' rights.
2 (8) As used in this section, "patient's representative"
3 means that term as defined in section 3203.
4 Sec. 3147. (1) A patient or resident is responsible for
5 following the long-term care facility rules and regulations
6 affecting patient or resident care and conduct.
7 (2) A patient or resident is responsible for providing a
8 complete and accurate medical history.
9 (3) A patient or resident is responsible for making it known
10 whether he or she clearly comprehends a contemplated course of
11 action and the things he or she is expected to do.
12 (4) A patient or resident is responsible for following the
13 recommendations and advice prescribed in a course of treatment by
14 the physician.
15 (5) A patient or resident is responsible for providing
16 information about unexpected complications that arise in an
17 expected course of treatment.
18 (6) A patient or resident is responsible for being
19 considerate of the rights of other patients or residents and
20 long-term care facility personnel and property.
21 (7) A patient or resident is responsible for providing the
22 long-term care facility with accurate and timely information
23 concerning his or her sources of payment and ability to meet
24 financial obligations.
25 Sec. 3149. (1) The rights and responsibilities prescribed in
26 sections 3145 and 3147 are guidelines for long-term care
27 facilities, facility staff, facility employees, patients, and
1 residents. An individual shall not be civilly or criminally
2 liable for failure to comply with those sections.
3 (2) Sections 3145 and 3147 shall not be construed to expand
4 or diminish other remedies at law available to a patient or
5 resident under this act or the statutory and common law of this
6 state.
7 (3) The department shall develop guidelines to assist long-
8 term care facilities in the implementation of sections 3145 and
9 3147.
10 Sec. 3151. (1) Every 6 months, the department shall issue a
11 summary of its activities in relation to licensing and regulation
12 and shall cause the information to be made available to the news
13 media and all persons who make a written request to receive
14 copies of the information.
15 (2) The list and current inspection reports shall be
16 available for inspection and copying.
17 PART 32
18 NURSING HOMES
19 Sec. 3201. (1) For purposes of this part, the words and
20 phrases defined in sections 3202 to 3203 have the meanings
21 ascribed to them in those sections.
22 (2) In addition, article I contains general definitions and
23 principles of construction applicable to all articles in this act
24 and part 31 contains definitions applicable to this part.
25 Sec. 3202. (1) "Discharge" means the voluntary or
26 involuntary movement of a patient out of a nursing home
27 regardless of the individual's destination or reason for the
1 movement.
2 (2) "Full-time" means being usually present in the nursing
3 home or conducting or participating in activities directly
4 related to the nursing home during the normal 40-hour business
5 week.
6 (3) "Involuntary transfer" means a transfer not agreed to in
7 writing by the patient or, in the case of a plenary guardianship,
8 by the patient's legal guardian.
9 (4) "Medicaid" means that term as defined in section 103.
10 (5) "Medical reasons" means a medical justification for
11 either of the following:
12 (a) The transfer or discharge of a patient in accord with
13 the written orders of the attending physician that is written
14 into the patient's clinical record by the physician in the
15 progress notes.
16 (b) The transfer or discharge of a patient who is a medicaid
17 recipient due to a change in level of care required by the
18 patient and the fact that the nursing home or nursing care
19 facility is not certified to provide the needed level of care.
20 (6) "Medicare" means that term as defined in section 103.
21 (7) "Modification of a license" means an action by the
22 department to alter the number of beds, the levels of care, or
23 the portions of the physical plant that may be operated or
24 maintained by a licensee in a particular nursing home, or to
25 restrict the nursing home from engaging in activity that violates
26 this article or a rule promulgated under this article.
27 (8) "Negative case action" means an action taken by the
1 department of human services to deny an application for medical
2 assistance, cancel medical assistance, or reduce medical
3 assistance coverage.
4 (9) "Nonpayment" means:
5 (a) Failure to collect from the patient or any other source
6 the full amount of the facility charges to a nonmedicaid patient
7 based on a written contract signed on or after that patient's
8 admission to the facility.
9 (b) Failure to collect a medicaid patient's stipulated
10 contribution toward his or her care.
11 (10) "Private pay rate" means the amount charged by a
12 nursing home for the care of a patient who is not entitled to
13 state or federal benefits for that patient's nursing home care.
14 Sec. 3203. (1) "Patient" means a person who receives care or
15 services at a nursing home.
16 (2) "Patient's representative" means a person, other than
17 the licensee or an employee or person having a direct or indirect
18 ownership interest in the nursing home, designated in writing by
19 a patient or a patient's guardian for a specific, limited purpose
20 or for general purposes, or, if a written designation of a
21 representative is not made, the guardian of the patient.
22 (3) "Relocation" means the movement of a patient from 1 bed
23 to another or from 1 room to another within the same nursing home
24 or within a certified distinct part of a nursing home.
25 (4) "Transfer" means the movement of a patient from 1
26 nursing home to another nursing home or from 1 certified distinct
27 part of a nursing home to another certified distinct part of the
1 same nursing home.
2 (5) "Welfare" means, with reference to a patient, the
3 physical, emotional, or social well-being of a patient in a
4 nursing home, including a patient awaiting transfer or discharge,
5 as documented in the patient's clinical record by a licensed or
6 certified health care professional.
7 Sec. 3207. (1) The course of medical treatment provided to a
8 patient in a nursing home shall be prescribed by the patient's
9 physician.
10 (2) This part does not do the following:
11 (a) Authorize the supervision, regulation, or control of the
12 practice of any method of healing.
13 (b) Authorize the medical supervision, regulation, or
14 control of the remedial care or nonmedical nursing care of
15 patients in a nursing home operated for the adherents of a bona
16 fide church or religious denomination who rely upon treatment by
17 prayer or spiritual means only in accordance with the creed or
18 tenets of that church or denomination. The residents, patients,
19 personnel, or employees, other than food handlers, of the home
20 are not required to submit to a medical or physical examination.
21 However, the nursing home shall be inspected and licensed under
22 laws pertaining to fire, safety, sanitation, and building
23 construction.
24 Sec. 3211. (1) A nursing home shall be licensed under this
25 article.
26 (2) "Nursing home", "nursing center", "convalescent center",
27 "extended care facility", or a similar term or abbreviation shall
1 not be used to describe or refer to a long-term care facility
2 unless the long-term care facility is licensed as a nursing home
3 by the department under this article.
4 (3) A person shall not purport to provide formal or informal
5 nursing care services of the kind normally provided in a nursing
6 home without obtaining a license as provided in this article.
7 This subsection does not apply to a hospital or a facility
8 created by 1885 PA 152, MCL 36.1 to 36.12.
9 Sec. 3212. (1) A nursing home shall use the name that
10 appears on the license for its premises. A nursing home shall not
11 change its name without the approval of the department.
12 (2) A nursing home shall not use the terms "hospital" or
13 "sanitarium" or a term conveying a meaning that is substantially
14 similar to those terms in the name of the nursing home. However,
15 a nursing home may use the term "health center" or "health care
16 center" or "rehabilitation center" or a term conveying a meaning
17 substantially similar to those terms as long as those terms do
18 not conflict with the terms prohibited by this subsection.
19 (3) If a nursing home uses the term "rehabilitation center"
20 in its name as allowed under subsection (2), the nursing home
21 shall have the capacity to provide rehabilitation services that
22 include, at a minimum, all of the following:
23 (a) Physical therapy services.
24 (b) Occupational therapy services.
25 (c) Speech therapy services.
26 (4) A nursing home shall not include in its name the name of
27 a religious, fraternal, or charitable corporation, organization,
1 or association unless the corporation, organization, or
2 association is an owner of the nursing home.
3 Sec. 3213. The owner, operator, and governing body of a
4 nursing home licensed under this article:
5 (a) Are responsible for all phases of the operation of the
6 nursing home and quality of care rendered in the home.
7 (b) Shall cooperate with the department in the enforcement
8 of this article and require that the physicians and other
9 personnel working in the nursing home and for whom a license or
10 registration is required be currently licensed or registered.
11 Sec. 3215. (1) A nursing home shall provide a program of
12 planned and continuing medical care under the charge of
13 physicians.
14 (2) Nursing care and medical care shall consist of services
15 given to individuals who are subject to prolonged suffering from
16 illness or injury or who are recovering from illness or injury.
17 The services shall be within the ability of the home to provide
18 and shall include the functions of medical care such as diagnosis
19 and treatment of an illness; nursing care via assessment,
20 planning, and implementation; evaluation of a patient's health
21 care needs; and the carrying out of required treatment prescribed
22 by a physician.
23 Sec. 3216. A nursing home shall offer each resident, or
24 shall provide each resident with information and assistance in
25 obtaining, an annual vaccination against influenza in accordance
26 with the most recent recommendations of the advisory committee on
27 immunization practices of the federal centers for disease control
1 and prevention, as approved by the department of community
2 health.
3 Sec. 3217. An individual shall not be admitted or retained
4 for care in a nursing home who requires special medical or
5 surgical treatment, or treatment for acute mental illness, mental
6 retardation, communicable tuberculosis, or a communicable
7 disease, unless the home is able to provide an area and a program
8 for the care. The department shall approve both the area and the
9 program, including the programs providing treatment for mental
10 illness and mental retardation.
11 Sec. 3218. (1) Except as provided in subsections (3) and
12 (4), as a condition of skilled nursing facility certification and
13 participation in the title XIX program, a nursing home shall be
14 concurrently certified for and give evidence of active
15 participation in the title XVIII program. A nursing facility that
16 is not concurrently certified for the title XVIII program on
17 March 30, 1979 shall make application for concurrent
18 certification not later than its next application for licensure
19 and certification. A failure to make application shall result in
20 the skilled nursing facility being decertified or refused
21 certification as a provider in the title XIX program. Nursing
22 home or nursing care facility participation in the title XVIII
23 program under the requirements for concurrent certification shall
24 be effective not later than the beginning of the first accounting
25 year following the home's or facility's title XVIII
26 certification.
27 (2) As a condition of skilled nursing facility
1 certification, a nursing home shall obtain concurrent
2 certification under title XIX, for each bed which is certified to
3 provide skilled care under title XVIII. Skilled care
4 certification shall not be renewed unless the requirements of
5 this subsection are met.
6 (3) An exception may be made from the requirements of
7 subsection (1) for a nursing facility that is currently certified
8 as a skilled nursing facility by the director for title XIX
9 participation but has been determined, after making application,
10 to be ineligible for title XVIII certification by the secretary
11 of the United States department of health, education, and
12 welfare.
13 (4) A home or facility, or a distinct part of a home or
14 facility, certified by the director as a special mental
15 retardation or special mental illness nursing home or nursing
16 care facility shall be exempt from the requirements of subsection
17 (1).
18 Sec. 3219. A nursing home shall not be licensed under this
19 part unless the nursing home has formulated, and is prepared to
20 implement, insofar as possible, a plan to provide immediate
21 access to acute care facilities for the emergency care of
22 patients.
23 Sec. 3220. (1) The department shall not license a nursing
24 home under this part unless that nursing home is under the
25 direction of a nursing home administrator licensed under article
26 5.
27 (2) Each nursing home having 50 beds or more shall have a
1 full-time licensed nursing home administrator. If a nursing home
2 changes nursing home administrators, the nursing home immediately
3 shall notify the department of the change.
4 Sec. 3220a. (1) A nursing home shall not be licensed under
5 this part unless that nursing home has on its staff at least 1
6 registered nurse with specialized training or relevant experience
7 in the area of gerontology, who shall serve as the director of
8 nursing and who shall be responsible for planning and directing
9 nursing care. The nursing home shall have at least 1 licensed
10 nurse on duty at all times and shall employ additional registered
11 and licensed practical nurses in accordance with subsection (2).
12 (2) A nursing home shall employ nursing personnel sufficient
13 to provide continuous 24-hour nursing care and services
14 sufficient to meet the needs of each patient in the nursing home.
15 Nursing personnel employed in the nursing home shall be under the
16 supervision of the director of nursing. A licensee shall maintain
17 a nursing home staff sufficient to provide not less than 2.25
18 hours of nursing care by employed nursing care personnel per
19 patient per day. The ratio of patients to nursing care personnel
20 during a morning shift shall not exceed 8 patients to 1 nursing
21 care personnel; the ratio of patients to nursing care personnel
22 during an afternoon shift shall not exceed 12 patients to 1
23 nursing care personnel; and the ratio of patients to nursing care
24 personnel during a nighttime shift shall not exceed 15 patients
25 to 1 nursing care personnel and there shall be sufficient nursing
26 care personnel available on duty to assure coverage for patients
27 at all times during the shift. An employee designated as a member
1 of the nursing staff shall not be engaged in providing basic
2 services such as food preparation, housekeeping, laundry, or
3 maintenance services, except in an instance of natural disaster
4 or other emergency reported to and concurred in by the
5 department. In a nursing home having 30 or more beds, the
6 director of nursing shall not be included in counting the minimum
7 ratios of nursing personnel required by this subsection.
8 (3) In administering this section, the department shall take
9 into consideration a natural disaster or other emergency.
10 Sec. 3220b. A nursing home shall not be licensed under this
11 part unless that nursing home has entered into an agreement with
12 the county community mental health program, if available, that
13 will service the mental health needs of the patients of the
14 nursing home.
15 Sec. 3221. (1) Before issuance or renewal of a nursing home
16 license under this article, the owner, operator, or governing
17 body of the nursing home shall give a bond and provide evidence
18 of a patient trust fund in an amount consistent with subsection
19 (2) and with the surety the department approves. The bond shall
20 be conditioned that the applicant shall hold separately in the
21 trust fund all patients' funds deposited with the applicant,
22 shall administer the funds on behalf of the patient in the manner
23 directed by the depositor, and shall render a true and complete
24 account to the patient not less than once each 3 months, to the
25 depositor when requested, and to the department and the
26 department of human services, when requested. Upon termination of
27 the deposit, the applicant shall account for all funds received,
1 expended, and held on hand. The bond shall insure the department
2 for the benefit of the patients.
3 (2) The bond shall be in an amount equal to not less than 1-
4 1/4 times the average balance of patient funds held during the
5 previous year. The department may require an additional bond, or
6 permit the filing of a bond in a lower amount, if the department
7 determines a change in the average balance has occurred or may
8 occur. An applicant for a new license shall file a bond in an
9 amount which the department estimates as 1-1/4 times the average
10 amount of patient funds which the applicant, upon the issuance of
11 the license, is likely to hold during the first year of
12 operation.
13 Sec. 3223. (1) A nursing home shall post in an area
14 accessible to residents, employees, and visitors the name, title,
15 location, and telephone number of the individual in the nursing
16 home who is responsible for receiving complaints and conducting
17 complaint investigations and a procedure for communicating with
18 that individual.
19 (2) An individual responsible for receiving complaints and
20 conducting complaint investigations in a nursing home shall be on
21 duty and on site not less than 24 hours per day, 7 days a week.
22 (3) The individual described in subsection (2) who receives
23 a complaint, inquiry, or request from a nursing home resident or
24 the resident's surrogate decision maker shall respond using the
25 nursing home's established procedures pursuant to R 325.20113 of
26 the Michigan administrative code.
27 (4) To assist the individual described in subsection (2) in
1 performing his or her duties, the department shall post on its
2 internet website all of the following information:
3 (a) Links to federal and state regulations and rules
4 governing the nursing home industry.
5 (b) The scheduling of any training or joint training
6 sessions concerning nursing home or elderly care issues being put
7 on by the department.
8 (c) A list of long-term care contact telephone numbers
9 including, but not limited to, the department's complaint
10 hotline, the department's nursing home licensing division, any
11 commonly known nursing home provider groups, the state long-term
12 care ombudsman, and any commonly known nursing home patient care
13 advocacy groups.
14 (d) When it becomes available, information on the
15 availability of electronic mail access to file a complaint
16 concerning nursing home violations directly with the department.
17 (e) Any other information that the department believes is
18 helpful in responding to complaints, requests, and inquiries of a
19 nursing home resident or his or her surrogate decision maker.
20 (5) A nursing home receiving reimbursement pursuant to the
21 medicaid program shall designate 1 or more current employees to
22 fulfill the duties and responsibilities outlined in this section.
23 This section does not constitute a basis for increasing nursing
24 home staffing levels.
25 Sec. 3231. A licensee of a nursing home operated for profit
26 is considered to be the consumer, and not the retailer, of the
27 tangible personal property purchased and used or consumed in the
1 operation of the home.
2 Sec. 3233. (1) A nursing home licensed under this article
3 shall adopt a policy regulating the smoking of tobacco on the
4 nursing home premises.
5 (2) A nursing home policy regulating smoking at a minimum
6 shall provide that:
7 (a) Upon admission each patient or person responsible for
8 the patient's admission shall be asked if there is a preference
9 for placement with smokers or nonsmokers.
10 (b) Smoking by patients shall be restricted to private
11 rooms, rooms shared with other smokers only, or other designated
12 smoking areas.
13 (c) Visitors shall not be permitted to smoke in rooms or
14 wards occupied by patients who do not smoke.
15 (d) Visitors shall be permitted to smoke only in designated
16 areas.
17 (e) Staff shall be permitted to smoke in designated areas
18 only.
19 (f) Staff shall not be permitted to smoke in patients' rooms
20 or while performing their duties in the presence of patients.
21 (g) Eating areas shall have sections for smokers and
22 nonsmokers.
23 (h) Cigarettes, cigars, and pipe tobacco shall not be sold
24 or dispensed within the nursing home except as provided for by
25 the owner or governing board.
26 (i) A sign indicating that smoking is prohibited in the
27 nursing home except in designated areas shall be posted at each
1 entrance to the nursing home. Each designated smoking area shall
2 be posted as such by sign.
3 (3) A nursing home licensed under this article shall retain
4 a copy of the smoking policy which will be available to the
5 public upon request.
6 Sec. 3234. (1) Notwithstanding section 3145(2)(l), a nursing
7 home shall give each resident who uses a hospital-type bed or the
8 resident's legal guardian, patient advocate, or other legal
9 representative the option of having bed rails. A nursing home
10 shall offer the option to new residents upon admission and to
11 other residents upon request. Upon receipt of a request for bed
12 rails, the nursing home shall inform the resident or the
13 resident's legal guardian, patient advocate, or other legal
14 representative of alternatives to and the risks involved in using
15 bed rails. A resident or the resident's legal guardian, patient
16 advocate, or other legal representative has the right to request
17 and consent to bed rails for the resident. A nursing home shall
18 provide bed rails to a resident only upon receipt of a signed
19 consent form authorizing bed rail use and a written order from
20 the resident's attending physician that contains statements and
21 determinations regarding medical symptoms and that specifies the
22 circumstances under which bed rails are to be used. For purposes
23 of this subsection, "medical symptoms" includes the following:
24 (a) A concern for the physical safety of the resident.
25 (b) Physical or psychological need expressed by a resident.
26 A resident's fear of falling may be the basis of a medical
27 symptom.
1 (2) A nursing home that provides bed rails under subsection
2 (1) shall do all of the following:
3 (a) Document that the requirements of subsection (1) have
4 been met.
5 (b) Monitor the resident's use of the bed rails.
6 (c) In consultation with the resident, resident's family,
7 resident's attending physician, and individual who consented to
8 the bed rails, periodically reevaluate the resident's need for
9 the bed rails.
10 (3) The department shall develop clear and uniform
11 guidelines to be used in determining what constitutes each of the
12 following:
13 (a) Acceptable bed rails for use in a nursing home in this
14 state. The department shall consider the recommendations of the
15 hospital bed safety work group established by the United States
16 food and drug administration, if those are available, in
17 determining what constitutes an acceptable bed rail.
18 (b) Proper maintenance of bed rails.
19 (c) Properly fitted mattresses.
20 (d) Other hazards created by improperly positioned bed
21 rails, mattresses, or beds.
22 (4) A nursing home that complies with subsections (1) and
23 (2) and the guidelines developed under this section in providing
24 bed rails to a resident is not subject to administrative
25 penalties imposed by the department based solely on providing the
26 bed rails. Nothing in this subsection precludes the department
27 from citing specific state or federal deficiencies for improperly
1 maintained bed rails, improperly fitted mattresses, or other
2 hazards created by improperly positioned bed rails, mattresses,
3 or beds.
4 Sec. 3235. (1) A nursing home licensed under this article
5 shall have, at a minimum, an emergency generator system that
6 complies with existing state and federal law, including state and
7 federal rules and regulations.
8 (2) A nursing home that fails to comply with this section is
9 subject to a civil penalty as provided under existing state and
10 federal law, including state and federal rules and regulations.
11 Sec. 3241. (1) The department, after seeking advice and
12 consultation from the department of human services, appropriate
13 consumer and professional organizations, and concerned agencies,
14 shall promulgate rules to implement and administer this part.
15 (2) In addition to the rules prescribed under section 20171
16 of the public health code, rules for nursing homes shall include
17 the establishment of standards relating to:
18 (a) Complaint procedures.
19 (b) Discharges and transfers.
20 (c) Emergency procedures.
21 (d) Medical audit procedures.
22 (e) Patients' rights.
23 (f) Standards of patient care to be provided in nursing
24 homes.
25 (g) Training, educational, and competency requirements of
26 nursing home personnel other than licensed personnel.
27 (h) Utilization and quality control review procedures.
1 Sec. 3243. (1) In addition to public records subject to
2 disclosure under section 3127, the following information is
3 subject to disclosure from the department or the department of
4 human services:
5 (a) Ownership of nursing homes, ownership of buildings
6 occupied by nursing homes, and the names and addresses of
7 suppliers and the ownership of suppliers of goods and services to
8 nursing homes required to be reported under section 3105.
9 (b) Records of license and certification inspections,
10 surveys, and evaluations of nursing homes, other reports of
11 inspections, surveys, and evaluations of patient care, and
12 reports concerning a nursing home prepared pursuant to titles
13 XVIII and XIX.
14 (c) Cost and reimbursement reports submitted by a nursing
15 home, reports of audits of nursing homes, and other public
16 records concerning costs incurred by, revenues received by, and
17 reimbursement of nursing homes.
18 (d) Complaints filed against a nursing home and complaint
19 investigation reports. A complaint or complaint investigation
20 report shall not be disclosed to a person other than the
21 complainant or complainant's representative before it is
22 disclosed to a nursing home under section 5299a, and a
23 complainant's or patient's name shall not be disclosed except as
24 provided in section 5299a.
25 (2) The department, the department of human services, and
26 the nursing home shall respect the confidentiality of a patient's
27 clinical record as provided in section 3127 and shall not divulge
1 or disclose the contents of a record in a manner which identifies
2 a patient, except upon a patient's death to a relative or
3 guardian, or under judicial proceedings. This subsection shall
4 not be construed to limit the right of a patient or a patient's
5 representative to inspect or copy the patient's clinical record.
6 (3) Confidential medical, social, personal, or financial
7 information identifying a patient shall not be available for
8 public inspection in a manner which identifies a patient.
9 Sec. 3244. The department shall provide to the applicant or
10 licensee professional advice and consultation related to the
11 quality of institutional or agency aspects of health care and
12 services provided by the applicant or licensee.
13 Sec. 3251. (1) When the department has concluded a
14 proceeding under sections 71 to 106 of the administrative
15 procedures act of 1969, or when the department has suspended or
16 revoked the license of a nursing home, the department, a patient
17 in the facility, or a patient's representative may file an
18 emergency petition with the circuit court to place the nursing
19 home under the control of a receiver if necessary to protect the
20 health or safety of patients in the nursing home. The court may
21 grant the petition upon a finding that the health or safety of
22 the patients in the nursing home would be seriously threatened if
23 a condition existing at the time the petition was filed is
24 permitted to continue.
25 (2) The court shall appoint as receiver the director of the
26 department of human services, the director of the department, or
27 another state agency or person designated by the director of
1 community health. The receiver appointed by the court shall use
2 the income and assets of the nursing home to maintain and operate
3 the home and to attempt to correct the conditions which
4 constitute a threat to the patients. A major structural
5 alteration shall not be made to the nursing home, unless the
6 alteration is necessary to bring the nursing home into compliance
7 with licensing requirements.
8 (3) To assist in the implementation of the mandate of the
9 court, the receiver may request and receive reasonable
10 consultation from the available personnel of the department.
11 (4) The receivership shall be terminated when the receiver
12 and the court certify that the conditions which prompted the
13 appointment have been corrected, when the license is restored,
14 when a new license is issued, or, in the case of a discontinuance
15 of operation, when the patients are safely placed in other
16 facilities, whichever occurs first.
17 (5) Upon the termination of the receivership, the receiver
18 shall render a complete accounting to the court and shall dispose
19 of surplus funds as the court directs.
20 Sec. 3255. The department may refuse to issue a license to
21 establish or maintain and operate, or both, a nursing home to an
22 applicant:
23 (a) Whose occupational, professional, or health agency
24 license has been revoked during the 5 years preceding the date of
25 application.
26 (b) Whom the department finds is not suitable to operate a
27 nursing home because of financial incapacity or a lack of good
1 moral character or appropriate business or professional
2 experience. As used in this subdivision, "good moral character"
3 means that term as defined in 1974 PA 381, MCL 338.41 to 338.47.
4 Sec. 3257. (1) The department may issue a 1-year provisional
5 license, renewable for not more than 1 additional year, to an
6 applicant whose services are needed in the community but who is
7 temporarily unable to comply with the rules related to the
8 physical plant of the facilities, excluding maintenance problems.
9 At the time a provisional license is granted, specific deadlines
10 for the correction of each physical plant violation shall be
11 established.
12 (2) A provisional license shall not be issued for a nursing
13 home constructed, established, or changing corporate ownership or
14 management after March 30, 1979 unless it is shown that unusual
15 hardship would result to the public or to the applicant for the
16 provisional license and the nursing home was licensed and
17 operating under a prior licensing act for not less than 5 years.
18 Sec. 3261. (1) In addition to the requirements of section
19 3106, a licensee shall certify annually to the department, as
20 part of its application for licensure and certification, that all
21 phases of its operation, including its training program, are
22 without discrimination against persons or groups of persons on
23 the basis of race, religion, color, national origin, sex, age,
24 disability, marital status, sexual preference, or the exercise of
25 rights guaranteed by law, including freedom of speech and
26 association. If the department finds a violation of rights
27 enumerated in this section, the department shall direct the
1 administrator of the nursing home to take the necessary action to
2 assure that the nursing home is, in fact, operated in accordance
3 with the rights listed in this section.
4 (2) This section shall not be construed to prevent a nursing
5 home operated, supervised, or controlled by a religious or
6 fraternal institution or organization from giving preference to
7 applicants who are members of that religious or fraternal
8 institution or organization.
9 Sec. 3263. (1) A nursing home shall permit a representative
10 of an approved organization, who is known by the nursing home
11 administration to be authorized to represent the organization or
12 who carries identification showing that the representative is
13 authorized to represent the organization, a family member of a
14 patient, or a legal representative of a patient, to have access
15 to nursing home patients for 1 or more of the following purposes:
16 (a) Visit, talk with, and make personal, social, and legal
17 services available to the patients.
18 (b) Inform patients of their rights and entitlements, and
19 their corresponding obligations, under federal and state laws by
20 means of the distribution of educational materials and discussion
21 in groups and with individual patients.
22 (c) Assist patients in asserting their legal rights
23 regarding claims for public assistance, medical assistance, and
24 social services benefits, as well as in all matters in which
25 patients are aggrieved. Assistance may be provided individually
26 or on a group basis and may include organizational activity and
27 counseling and litigation.
1 (d) Engage in other methods of assisting, advising, and
2 representing patients so as to extend to them the full enjoyment
3 of their rights.
4 (2) Access as prescribed in subsection (1) shall be
5 permitted during regular visiting hours each day. A
6 representative of an approved organization entering a nursing
7 home under this section promptly shall advise the nursing home
8 administrator or the acting administrator or other available
9 agent of the nursing home of the representative's presence. A
10 representative shall not enter the living area of a patient
11 without identifying himself or herself to the patient and without
12 receiving the patient's permission to enter. A representative
13 shall use only patient areas of the home to carry out the
14 activities described in subsection (1).
15 (3) A patient may terminate a visit by a representative
16 permitted access under subsection (1). Communications between a
17 patient and the representative are confidential, unless otherwise
18 authorized by the patient.
19 (4) If a nursing home administrator or employee believes
20 that an individual or organization permitted access under this
21 section is acting or has acted in a manner detrimental to the
22 health or safety of patients in the nursing home, the nursing
23 home administrator or employee may file a complaint with the task
24 force established under section 20127 of the public health code.
25 Upon receipt of a complaint, department staff shall investigate
26 the allegations made in the complaint. The task force shall make
27 a determination regarding proper resolution of the complaint
1 based on the results of the investigation. Written notification
2 of the task force determination and of recommendations adopted by
3 the task force shall be given to the complainant and the
4 individual or organization against whom the complaint was made.
5 (5) An individual shall not enter upon the premises of a
6 nursing home for the purpose of engaging in an activity that
7 would cause a reasonable person to feel terrorized, frightened,
8 intimidated, threatened, harassed, or molested and that actually
9 causes a nursing home employee, patient, or visitor to feel
10 terrorized, frightened, intimidated, threatened, harassed, or
11 molested. This subsection does not prohibit constitutionally
12 protected activity or conduct that serves a legitimate purpose
13 including, but not limited to, activities or conduct allowed
14 under subsection (1).
15 Sec. 3264. (1) The director, with the advice of the nursing
16 home task force, shall approve or disapprove a nonprofit
17 corporation which has as 1 of its primary purposes the rendering
18 of assistance, without charge to nursing home patients for the
19 purpose of obtaining access to nursing homes and their patients
20 under section 5263.
21 (2) Upon receipt of a written application for approval under
22 subsection (1), the director shall notify all persons who have
23 made a written request for notice of applications made under this
24 section.
25 (3) The director shall approve the organization making the
26 request if the organization is a bona fide community organization
27 or legal aid program, is capable of providing 1 or more of the
1 services listed in section 5263, and is likely to utilize the
2 access provided under section 5263 to enhance the welfare of
3 nursing home patients. The director shall approve or disapprove
4 the organization within 30 days after receiving the application.
5 (4) A person aggrieved by the decision of the director may
6 appeal the decision to the nursing home task force. A decision of
7 the task force shall be binding on the director.
8 Sec. 3265. (1) A nursing home shall establish written
9 policies and procedures to implement the rights protected under
10 section 3145. The policies shall include a procedure for the
11 investigation and resolution of patient complaints. The policies
12 and procedures shall be subject to approval by the department.
13 The policies and procedures shall be clear and unambiguous, shall
14 be printed in not less than 12-point type, shall be available for
15 inspection by any person, shall be distributed to each patient
16 and representative, and shall be available for public inspection.
17 (2) Each patient shall be given a copy of the rights
18 enumerated in section 3145 at the time of admission to a nursing
19 home. A patient of a nursing home at the time of the
20 implementation of this section shall be given a copy of the
21 rights enumerated in section 3145 as specified by rule.
22 (3) A copy shall be given to a person who executes a
23 contract pursuant to section 3266 and to any other person who
24 requests a copy.
25 (4) If a patient is unable to read the form, it shall be
26 read to the patient in a language the patient understands. In the
27 case of a mentally retarded individual, the rights shall be
1 explained in a manner which that person is able to understand and
2 the explanation witnessed by a third person. In the case of a
3 minor or a person having a legal guardian, both the patient and
4 the parent or legal guardian shall be fully informed of the
5 policies and procedures.
6 (5) A nursing home shall ensure that its staff is familiar
7 with and observes the rights enumerated in section 3145 and the
8 policies and procedures established under this section.
9 Sec. 3265a. (1) A nursing home shall not require an
10 applicant, as a condition of admission, to waive his or her right
11 to benefits under medicare or medicaid, to give oral or written
12 assurance that the applicant is not eligible for medicare or
13 medicaid, or to give oral or written assurance that the applicant
14 will not apply for benefits under medicare or medicaid.
15 (2) A nursing home shall not require any of the following as
16 a condition of an applicant's admission or a patient's continued
17 residency at that nursing home:
18 (a) That an applicant or patient remain a private pay
19 patient for a specified period of time before applying for
20 medicaid.
21 (b) That a person pay on behalf of an applicant or patient
22 the private pay rate for a specified period of time before the
23 applicant or patient applies for medicaid.
24 (c) That an applicant, patient, or other person make a gift
25 or donation on behalf of that applicant or patient.
26 (3) As of April 11, 1994, a contract provision or agreement
27 in conflict with subsection (1) or (2), whether made before, on,
1 or after April 11, 1994, is unenforceable.
2 (4) Not later than 30 days after April 11, 1994, a nursing
3 home that participates in medicaid shall provide written notice
4 to each private pay patient subject to a contract provision or
5 agreement in conflict with subsection (1) or (2) that the
6 contract provision or agreement is no longer a bar to the patient
7 applying for medicaid.
8 Sec. 3266. (1) A nursing home shall execute a written
9 contract solely with an applicant or patient or that applicant's
10 or patient's guardian or legal representative authorized by law
11 to have access to those portions of the patient's or applicant's
12 income or assets available to pay for nursing home care, at each
13 of the following times:
14 (a) At the time an individual is admitted to a nursing home.
15 (b) At the expiration of the term of a previous contract.
16 (c) At the time the source of payment for the patient's care
17 changes.
18 (2) A nursing home shall not discharge or transfer a patient
19 at the expiration of the term of a contract, except as provided
20 in section 3273.
21 (3) A nursing home shall specifically notify in writing an
22 applicant or patient or that applicant's or patient's guardian or
23 legal representative of the availability or lack of availability
24 of hospice care in the nursing home. This written notice shall be
25 by way of a specific paragraph located in the written contract
26 described in subsection (1) and shall require the applicant or
27 patient or that applicant's or patient's guardian or legal
1 representative to sign or initial the paragraph before execution
2 of the written contract. As used in this subsection, "hospice"
3 means that term as defined in section 3101.
4 (4) A nursing home shall provide a copy of the contract to
5 the patient, the patient's representative, or the patient's legal
6 representative or legal guardian at the time the contract is
7 executed.
8 (5) For a patient supported by funds other than the
9 patient's own funds, a nursing home shall make a copy of the
10 contract available to the person providing the funds for the
11 patient's support.
12 (6) For a patient whose care is reimbursed with public funds
13 administered by the department, a nursing home shall maintain a
14 copy of the contract in the patient's file at the nursing home
15 and upon request shall make a copy of the contract available to
16 the department.
17 (7) The nursing home shall ensure that the contract is
18 written in clear and unambiguous language and is printed in not
19 less than 12-point type. The form of the contract shall be
20 prescribed by the department.
21 (8) The contract shall specify all of the following:
22 (a) The term of the contract.
23 (b) The services to be provided under the contract,
24 including the availability of hospice or other special care, and
25 the charges for the services.
26 (c) The services that may be provided to supplement the
27 contract and the charges for the services.
1 (d) The sources liable for payments due under the contract.
2 (e) The amount of deposit paid and the general and
3 foreseeable terms upon which the deposit will be held and
4 refunded.
5 (f) The rights, duties, and obligations of the patient,
6 except that the specification of a patient's rights may be
7 furnished on a separate document that complies with the
8 requirements of section 3145.
9 (9) The nursing home may require a patient's or applicant's
10 guardian or legal representative who is authorized by law to have
11 access to those portions of the patient's or applicant's income
12 or assets available to pay for nursing home care to sign a
13 contract without incurring personal financial liability other
14 than for funds received in his or her legal capacity on behalf of
15 the patient.
16 (10) A nursing home employee may request the appointment of
17 a guardian for an individual applicant or patient only if the
18 nursing home employee reasonably believes that the individual
19 meets the legal requirements for the appointment of a guardian.
20 Sec. 3267. (1) A nursing home, or an owner, administrator,
21 employee, or representative of a nursing home shall not act as
22 guardian, trustee, conservator, patient's representative, or
23 protective payee for a patient, except as provided in subsection
24 (2).
25 (2) Subject to the bonding requirements of section 3221,
26 money or other property belonging or due a patient which is
27 received by a nursing home shall be received as trust funds or
1 property, shall be kept separate from the funds and property of
2 the nursing home and other patients, and shall be disbursed only
3 as directed by the patient. A written receipt shall be given to a
4 patient whose money or other property is received by a nursing
5 home. Upon request, but not less than once every 3 months, the
6 nursing home shall furnish the patient a complete and verified
7 statement of the funds or other property received by the nursing
8 home. The statement shall contain the amounts and items received,
9 the sources, the disposition, and the date of each transaction.
10 The nursing home shall furnish a final statement not later than
11 10 days after the discharge of a patient.
12 Sec. 3271. (1) A licensee, nursing home administrator, or
13 employee of a nursing home shall not physically, mentally, or
14 emotionally abuse, mistreat, or harmfully neglect a patient.
15 (2) A nursing home employee who becomes aware of an act
16 prohibited by this section immediately shall report the matter to
17 the nursing home administrator or nursing director. A nursing
18 home administrator or nursing director who becomes aware of an
19 act prohibited by this section immediately shall report the
20 matter by telephone to the department of community health, which
21 in turn shall notify the department of human services.
22 (3) Any person may report a violation of this section to the
23 department.
24 (4) A physician or other licensed health care personnel of a
25 long-term care facility to which a patient is transferred who
26 becomes aware of an act prohibited by this section shall report
27 the act to the department.
1 (5) Upon receipt of a report made under this section, the
2 department shall make an investigation. The department may
3 require the person making the report to submit a written report
4 or to supply additional information, or both.
5 (6) A licensee or nursing home administrator shall not
6 evict, harass, dismiss, or retaliate against a patient, a
7 patient's representative, or an employee who makes a report under
8 this section.
9 Sec. 3272. The owner, administrator, employee, or
10 representative of a nursing home shall not interfere with the
11 right of a person to bring a civil or criminal action or to file
12 a complaint with the department or other governmental agency with
13 respect to the operation of the nursing home, nor discharge,
14 harass, or retaliate against a person who does so or on whose
15 behalf the action is taken.
16 Sec. 3273. (1) A nursing home shall not involuntarily
17 transfer or discharge a patient except for 1 or more of the
18 following purposes:
19 (a) Medical reasons.
20 (b) The patient's welfare.
21 (c) The welfare of other patients or nursing home employees.
22 (d) Nonpayment for the patient's stay except as prohibited
23 by title XIX.
24 (2) A licensed nursing home shall provide written notice at
25 least 30 days before a patient is involuntarily transferred or
26 discharged. The 30-day requirement of this subsection does not
27 apply in any of the following instances:
1 (a) If an emergency transfer or discharge is mandated by the
2 patient's health care needs and is in accord with the written
3 orders and medical justification of the attending physician.
4 (b) If the transfer or discharge is mandated by the physical
5 safety of other patients and nursing home employees as documented
6 in the clinical record.
7 (c) If the transfer or discharge is subsequently agreed to
8 by the patient or the patient's legal guardian, and notification
9 is given to the next of kin and the person or agency responsible
10 for the patient's placement, maintenance, and care in the nursing
11 home.
12 (3) The notice required by subsection (2) shall be on a form
13 prescribed by the department and shall contain all of the
14 following:
15 (a) The stated reason for the proposed transfer.
16 (b) The effective date of the proposed transfer.
17 (c) A statement in not less than 12-point type that reads:
18 "You have a right to appeal the nursing home's decision to
19 transfer you. If you think you should not have to leave this
20 facility, you may file a request for a hearing with the
21 department of community health within 10 days after receiving
22 this notice. If you request a hearing, it will be held at least 7
23 days after your request, and you will not be transferred during
24 that time. If you lose the hearing, you will not be transferred
25 until at least 30 days after you received the original notice of
26 the discharge or transfer. A form to appeal the nursing home's
27 decision and to request a hearing is attached. If you have any
1 questions, call the department of community health at the number
2 listed below.".
3 (d) A hearing request form, together with a postage paid,
4 preaddressed envelope to the department of community health.
5 (e) The name, address, and telephone number of the
6 responsible official in the department.
7 (4) A request for a hearing made under subsection (3) shall
8 stay a transfer pending a hearing or appeal decision.
9 (5) A copy of the notice required by subsection (3) shall be
10 placed in the patient's clinical record, and a copy shall be
11 transmitted to the department, the patient, the patient's next of
12 kin, patient's representative, or legal guardian, and the person
13 or agency responsible for the patient's placement, maintenance,
14 and care in the nursing home.
15 (6) If the basis for an involuntary transfer or discharge is
16 the result of a negative action by the department with respect to
17 a medicaid client and a hearing request is filed with the
18 department, the 21-day written notice period of subsection (2)
19 does not begin until a final decision in the matter is rendered
20 by the department or a court of competent jurisdiction and notice
21 of that final decision is received by the patient and the nursing
22 home.
23 (7) If nonpayment is the basis for involuntary transfer or
24 discharge, the patient may redeem up to the date that the
25 discharge or transfer is to be made and then may remain in the
26 nursing home.
27 (8) The nursing home administrator or other appropriate
1 nursing home employee designated by the nursing home
2 administrator shall discuss an involuntary transfer or discharge
3 with the patient, the patient's next of kin or legal guardian,
4 and person or agency responsible for the patient's placement,
5 maintenance, and care in the nursing home. The discussion shall
6 include an explanation of the reason for the involuntary transfer
7 or discharge. The content of the discussion and explanation shall
8 be summarized in writing and shall include the names of the
9 individuals involved in the discussions and made a part of the
10 patient's clinical record.
11 (9) The nursing home shall provide the patient with
12 counseling services before the involuntary transfer or discharge,
13 and the department shall assure that counseling services are
14 available after the involuntary transfer or discharge to minimize
15 the possible adverse effect of the involuntary transfer or
16 discharge.
17 (10) If a nursing home voluntarily withdraws from
18 participation in the state plan for medicaid funding, but
19 continues to provide services, the nursing home shall not, except
20 as provided in subsection (1), involuntarily transfer or
21 discharge a patient, whether or not the patient is eligible for
22 medicaid benefits, who resided in the nursing home on the day
23 before the effective date of the nursing home's withdrawal from
24 participation. The prohibition against transfer or discharge
25 imposed by this subsection continues unless the patient falls
26 within 1 or more of the exceptions described in subsection (1).
27 (11) If an individual becomes a patient of a nursing home
1 after the date the nursing home withdraws from participation in
2 the state plan for medicaid funding, the nursing home, on or
3 before the date the individual signs a contract with the nursing
4 home, shall provide to the patient oral and written notice of
5 both of the following:
6 (a) That the nursing home is not participating in the state
7 plan for medicaid funding.
8 (b) That the facility may involuntarily transfer or
9 discharge the patient for nonpayment under subsection (1)(d) even
10 if the patient is eligible for medicaid benefits.
11 Sec. 3274. (1) A patient subject to involuntary transfer or
12 discharge from a licensed nursing home shall have the opportunity
13 to file a request for a hearing with the department within 10
14 days following receipt of the written notice of the involuntary
15 transfer or discharge by the nursing home.
16 (2) The department, when the basis for involuntary transfer
17 or discharge is other than a negative action by the department of
18 human services with respect to a medicaid client, shall hold an
19 informal hearing in the matter at the patient's facility not
20 sooner than 7 days after a hearing request is filed and render a
21 decision in the matter within 14 days after the filing of the
22 hearing request.
23 (3) In a determination as to whether a transfer or discharge
24 is authorized, the burden of proof rests on the party requesting
25 the transfer or discharge. The hearing shall be in accordance
26 with fair hearing procedures prescribed by rule.
27 (4) If the department determines that a transfer or
1 discharge is authorized under section 3273, the patient shall not
2 be required to leave the facility before the thirty-fourth day
3 following receipt of the notice required under section 3273(2),
4 or the tenth day following receipt of the department's decision,
5 whichever is later.
6 Sec. 3275. The department of human services shall continue
7 medicaid funding during the appeal, transfer, or discharge period
8 as provided in section 3274 for those medicaid patients affected
9 by section 3273.
10 Sec. 3276. The licensee, with the approval of the
11 department, shall develop a plan to effectuate the orderly and
12 safe transfer or discharge of a patient. The patient and the
13 patient's family or representative shall be consulted in choosing
14 another facility. The patient shall receive counseling services
15 before the move to minimize the adverse effects of transfer
16 trauma. The department shall assure that counseling will be
17 available if the patient requires counseling after transfer or
18 discharge.
19 Sec. 3277. (1) If a patient is temporarily absent from a
20 nursing home for emergency medical treatment, the nursing home
21 shall hold the bed open for 10 days for that patient in the
22 patient's absence, if there is a reasonable expectation that the
23 patient will return within that period of time and the nursing
24 home receives payment for each day during the absent period.
25 (2) If a patient is temporarily absent from a nursing home
26 for therapeutic reasons as approved by a physician, the nursing
27 home shall hold the bed open for 18 days, if there is a
1 reasonable expectation that the patient will return within that
2 period of time and the nursing home receives payment for each day
3 during the absent period. Temporary absences for therapeutic
4 reasons are limited to 18 days per year.
5 (3) When a patient's absence is longer than specified under
6 subsection (1) or (2), or both, the patient has the option to
7 return to the nursing home for the next available bed.
8 (4) For title XIX patients, the department shall continue
9 funding for the temporary absence as provided under subsections
10 (1) and (2) if the nursing home is at 98% or more occupancy
11 except for any bed being held open under subsection (1) or (2).
12 Sec. 3281. A licensee shall conspicuously post in an area of
13 its offices accessible to patients, employees, and visitors:
14 (a) A current license.
15 (b) A complete copy of the most recent inspection report of
16 the nursing home received from the department.
17 (c) A description, provided by the department, of complaint
18 procedures established under this act and the name, address, and
19 telephone number of a person authorized by the department to
20 receive complaints.
21 (d) A copy of a notice of a pending hearing or order
22 pertaining to the nursing home issued by the department or a
23 court under the authority of this article or rules promulgated
24 under this article.
25 (e) A complete list of materials available for public
26 inspection as required by section 3282.
27 Sec. 3282. A licensee shall retain for public inspection:
1 (a) A complete copy of each inspection report of the nursing
2 home received from the department during the past 5 years.
3 (b) A copy of each notice of a hearing or order pertaining
4 to the nursing home issued by the department or a court under the
5 authority of this article or rules promulgated under this article
6 after March 30, 1979. The copy of the notice or order shall be
7 retained for not less than 3 years after its date of issuance or
8 not less than 3 years after the date of the resolution of the
9 subject matter of the notice or order, whichever is later.
10 (c) A description of the services provided by the nursing
11 home and the rates charged for those services and items for which
12 a patient may be separately charged.
13 (d) A list of the name, address, principal occupation, and
14 official position of each person who, as a stockholder or
15 otherwise, has a proprietary interest in the nursing home as
16 required by section 3105, of each officer and director of a
17 nursing home which is a corporation, and of each trustee or
18 beneficiary of a nursing home which is a trust.
19 (e) A list of licensed personnel employed or retained by the
20 nursing home.
21 (f) A copy of the standard form contract utilized under
22 section 3266.
23 Sec. 3284. If a patient's life is threatened by his or her
24 medical condition, the nursing home shall immediately notify the
25 patient's next of kin, patient's representative, and physician.
26 The nursing home shall secure emergency medical treatment for the
27 patient when the patient's physician is not available. A nursing
1 home shall take all reasonable measures to ensure the comfort of
2 a patient in the terminal stages of an illness.
3 Sec. 3285. (1) If a nursing home proposes to discontinue
4 operation, the licensee shall notify the department and the
5 department of human services of the impending discontinuance of
6 operation. The licensee shall notify the patient and the
7 patient's next of kin, patient's representative, and the party
8 executing the contract under section 3266 of the proposed date of
9 the discontinuance. The notice shall be sufficient to make
10 suitable arrangements for the transfer and care of the patient.
11 (2) The notices required by this section shall be given not
12 less than 30 days before the discontinuance.
13 (3) The licensee and the department of human services shall
14 be responsible for securing a suitable relocation of a patient
15 who does not have a relative or legal representative to assist in
16 his or her relocation before the discontinuance of operation. The
17 licensee and the department of human services shall keep the
18 department informed of their efforts and activities in carrying
19 out this responsibility. The department of human services shall
20 make available to the licensee and the department assistance
21 necessary to assure the effectiveness of efforts to secure a
22 suitable relocation.
23 Sec. 3286. In the case of an emergency closing of a nursing
24 home, or when it is determined by the department that a nursing
25 home is suddenly no longer able to provide adequate patient care,
26 the department shall do both of the following:
27 (a) Assure that the department of human services has been
1 notified to make arrangements for the orderly and safe discharge
2 and transfer of the patients to another facility.
3 (b) Place a representative of the department in a facility
4 on a daily basis to do each of the following:
5 (i) Monitor the discharge of patients to other facilities or
6 locations.
7 (ii) Ensure that the rights of patients are protected.
8 (iii) Discuss the discharge and relocation with each patient
9 and next of kin or legal guardian, person, or agency responsible
10 for the patient's placement, maintenance, and care in the
11 facility. The content of the explanation and discussion shall be
12 summarized in writing and shall be made a part of the patient's
13 clinical record.
14 Sec. 3287. The department may consult and work with the
15 Michigan public health institute created under section 2611 of
16 the public health code in performing the department's regulatory
17 and disciplinary duties under this article. The department may
18 also contract with the Michigan public health institute for the
19 performance of specific functions required or authorized by this
20 article, if determined necessary by the director of the
21 department.
22 Sec. 3291. A licensee shall not use false or misleading
23 information in the advertising of a nursing home or its name.
24 Sec. 3292. (1) An owner, administrator, employee, or
25 representative of a nursing home shall not pay, or offer to pay,
26 a commission, bonus, fee, or gratuity to a physician, surgeon,
27 organization, agency, or other person for the referral of a
1 patient to a nursing home.
2 (2) A person shall not offer or give a commission, bonus,
3 fee, or gratuity to an owner, administrator, employee, or
4 representative of a nursing home in return for the purchase of a
5 drug, biological, or any other ancillary services provided for a
6 patient of a nursing home.
7 (3) An owner, administrator, employee, or representative of
8 a nursing home shall not accept a commission, bonus, fee, or
9 gratuity in return for the purchase of a drug, biological, or any
10 other ancillary services provided for a patient of a nursing
11 home.
12 (4) A person who violates this section is guilty of a felony
13 punishable by imprisonment for not more than 4 years or a fine of
14 not more than $30,000.00, or both.
15 Sec. 3295. (1) The department, in consultation and with the
16 advice of the Michigan board of nursing and appropriate consumer
17 and professional organizations, shall develop by rule minimum
18 criteria for the education and training for unlicensed nursing
19 personnel in long-term care facilities designated in this part.
20 (2) This section shall not be construed to be a prerequisite
21 for employment of unlicensed nursing personnel in a nursing home.
22 (3) During the annual licensing inspection, the department
23 shall, and during other inspections the department may, conduct
24 random competency examinations to determine whether the
25 requirements of this section are being met. The department shall
26 promulgate rules to administer this subsection.
27 Sec. 3296. The nursing home administrator and licensee shall
1 be responsible for insuring that all licensed personnel employed
2 by the nursing home are properly licensed.
3 Sec. 3299a. (1) A person who believes that this part, a rule
4 promulgated under this part, or a federal certification
5 regulation applying to a nursing home may have been violated may
6 request an investigation of a nursing home. The person may submit
7 the request for investigation to the department as a written
8 complaint, or the department shall assist a person in reducing an
9 oral request made under subsection (2) to a written complaint as
10 provided in subsection (2). A person filing a complaint under
11 this subsection may file the complaint on a model standardized
12 complaint form developed and distributed by the department under
13 section 3139(3) or file the complaint as provided by the
14 department on the internet.
15 (2) The department shall provide a toll-free telephone
16 consumer complaint line. The complaint line shall be accessible
17 24 hours per day and monitored at a level to ensure that each
18 priority complaint is identified and that a response is initiated
19 to each priority complaint within 24 hours after its receipt. The
20 department shall establish a system for the complaint line that
21 includes at least all of the following:
22 (a) An intake form that serves as a written complaint for
23 purposes of subsections (1) and (5).
24 (b) The forwarding of an intake form to an investigator not
25 later than the next business day after the complaint is
26 identified as a priority complaint.
27 (c) Except for an anonymous complaint, the forwarding of a
1 copy of the completed intake form to the complainant not later
2 than 5 business days after it is completed.
3 (3) The substance of a complaint filed under subsection (1)
4 or (2) shall be provided to the licensee no earlier than at the
5 commencement of the on-site inspection of the nursing home that
6 takes place in response to the complaint.
7 (4) A complaint filed under subsection (1) or (2), a copy of
8 the complaint, or a record published, released, or otherwise
9 disclosed to the nursing home shall not disclose the name of the
10 complainant or a patient named in the complaint unless the
11 complainant or patient consents in writing to the disclosure or
12 the investigation results in an administrative hearing or a
13 judicial proceeding, or unless disclosure is considered essential
14 to the investigation by the department. If the department
15 considers disclosure essential to the investigation, the
16 department shall give the complainant the opportunity to withdraw
17 the complaint before disclosure.
18 (5) Upon receipt of a complaint under subsection (1) or (2),
19 the department shall determine, based on the allegations
20 presented, whether this part, a rule promulgated under this part,
21 or a federal certification regulation for nursing homes has been,
22 is, or is in danger of being violated. Subject to subsection (2),
23 the department shall investigate the complaint according to the
24 urgency determined by the department. The initiation of a
25 complaint investigation shall commence within 15 days after
26 receipt of the written complaint by the department.
27 (6) If, at any time, the department determines that this
1 part, a rule promulgated under this part, or a federal
2 certification regulation for nursing homes has been violated, the
3 department shall list the violation and the provisions violated
4 on the state and federal licensure and certification forms for
5 nursing homes. The department shall consider the violations, as
6 evidenced by a written explanation, when it makes a licensure and
7 certification decision or recommendation.
8 (7) In all cases, the department shall inform the
9 complainant of its findings unless otherwise indicated by the
10 complainant. Subject to subsection (2), within 30 days after
11 receipt of the complaint, the department shall provide the
12 complainant a copy, if any, of the written determination, the
13 correction notice, the warning notice, and the state licensure or
14 federal certification form, or both, on which the violation is
15 listed, or a status report indicating when these documents may be
16 expected. The department shall include in the final report a copy
17 of the original complaint. The complainant may request additional
18 copies of the documents described in this subsection and upon
19 receipt shall reimburse the department for the copies in
20 accordance with established policies and procedures.
21 (8) The department shall make a written determination,
22 correction notice, or warning notice concerning a complaint
23 available for public inspection, but the department shall not
24 disclose the name of the complainant or patient without the
25 complainant's or patient's consent.
26 (9) The department shall report a violation discovered as a
27 result of the complaint investigation procedure to persons
1 administering sections 3299c to 3299e. The department shall
2 assess a penalty for a violation, as prescribed by this article.
3 (10) A complainant who is dissatisfied with the
4 determination or investigation by the department may request a
5 hearing. A complainant shall submit a request for a hearing in
6 writing to the director within 30 days after the mailing of the
7 department's findings as described in subsection (7). The
8 department shall send notice of the time and place of the hearing
9 to the complainant and the nursing home.
10 (11) As used in this section, "priority complaint" means a
11 complaint alleging an existing situation that involves physical,
12 mental, or emotional abuse, mistreatment, or harmful neglect of a
13 resident that requires immediate corrective action to prevent
14 serious injury, serious harm, serious impairment, or death of a
15 resident while receiving care in a facility.
16 Sec. 3299b. (1) If, upon investigation, the department finds
17 that a licensee is not in compliance with this part, a rule
18 promulgated under this part, or a federal law or regulation
19 governing nursing home certification under title XVIII or XIX,
20 which noncompliance impairs the ability of the licensee to
21 deliver an acceptable level of care and services, or in the case
22 of a nursing home closure, the department may issue 1 or more of
23 the following correction notices to the licensee:
24 (a) Suspend the admission or readmission of patients to the
25 nursing home.
26 (b) Reduce the licensed capacity of the nursing home.
27 (c) Selectively transfer patients whose care needs are not
1 being met by the licensee.
2 (d) Initiate action to place the home in receivership as
3 prescribed in section 3251.
4 (e) Require appointment at the nursing home's expense of a
5 department approved temporary administrative advisor or a
6 temporary clinical advisor, or both, with authority and duties
7 specified by the department to assist the nursing home management
8 and staff to achieve sustained compliance with required operating
9 standards.
10 (f) Require appointment at the nursing home's expense of a
11 department approved temporary manager with authority and duties
12 specified by the department to oversee the nursing home's
13 achievement of sustained compliance with required operating
14 standards or to oversee the orderly closure of the nursing home.
15 (g) Issue a correction notice to the licensee and the
16 department describing the violation and the statute or rule
17 violated and specifying the corrective action to be taken and the
18 period of time in which the corrective action is to be completed.
19 Upon issuance, the director shall cause to be published in a
20 daily newspaper of general circulation in an area in which the
21 nursing home is located notice of the action taken and the
22 listing of conditions upon which the director's action is
23 predicated.
24 (2) Within 72 hours after receipt of a notice issued under
25 subsection (1), the licensee shall be given an opportunity for a
26 hearing on the matter. The director's notice shall continue in
27 effect during the pendency of the hearing and any subsequent
1 court proceedings. The hearing shall be conducted in compliance
2 with the administrative procedures act of 1969.
3 (3) A licensee who believes that a correction notice has
4 been complied with may request a verification of compliance from
5 the department. Not later than 72 hours after the licensee makes
6 the request, the department shall investigate to determine
7 whether the licensee has taken the corrective action prescribed
8 in the notice under subsection (1)(g). If the department finds
9 that the licensee has taken the corrective action and that the
10 conditions giving rise to the notice have been alleviated, the
11 department may cease taking further action against the licensee
12 or may take other action that the director considers appropriate.
13 (4) The department shall report annually to the house and
14 senate standing committees on senior issues on the number of
15 times the department appointed a temporary administrative
16 advisor, temporary clinical advisor, and temporary manager as
17 described in subsection (1)(e) or (f). The report shall include
18 whether the nursing home closed or remained open. The department
19 may include this report with other reports made to fulfill
20 legislative reporting requirements.
21 (5) If the department determines that a nursing home's
22 patients can be safeguarded and provided with a safe environment,
23 the department shall make its decisions concerning the nursing
24 home's future operation based on a presumption in favor of
25 keeping the nursing home open.
26 Sec. 3299c. (1) A person who violates 1 of the following
27 sections is guilty of a misdemeanor punishable by imprisonment
1 for not more than 1 year or a fine of not less than $1,000.00 or
2 more than $10,000.00, or both:
3 (a) Section 3211.
4 (b) Section 3212.
5 (c) Section 3263(5).
6 (d) Section 3265a(1) or (2).
7 (e) Section 3271(1) or (6).
8 (f) Section 3291.
9 (2) A person who violates section 3265a(1) or (2) is liable
10 to an applicant or patient in a civil action for treble the
11 amount of actual damages or $1,000.00, whichever is greater,
12 together with costs and reasonable attorney fees.
13 (3) For the purpose of computing administrative penalties
14 under this section, the number of patients per day is based on
15 the average number of patients in the nursing home during the 30
16 days immediately preceding the discovery of the violation.
17 (4) If the department finds a violation of section 3145 as
18 to a particular nursing home patient, the department shall issue
19 an order requiring the nursing home to pay to the patient $100.00
20 or to reimburse the patient for costs incurred or injuries
21 sustained as a result of the violation, whichever is greater. The
22 department also shall assess the nursing home an administrative
23 penalty that is the lesser of the following:
24 (a) Not more than $1,500.00.
25 (b) $15.00 per patient bed.
26 (5) The department shall promulgate rules for a quality of
27 care allowance formula that is consistent with the
1 recommendations of the fiscal incentives subcommittee to the
2 committee on nursing home reimbursement established pursuant to
3 1975 PA 241, as described in the November 24, 1975 interim
4 report, in the December 3, 1975 final report, and in the November
5 24, 1976 report of the committee recommending appropriate changes
6 in the procedures utilized.
7 (6) The department shall not assess an administrative
8 penalty under subsection (4) for a violation of this part for
9 which a nursing home's reimbursement is withheld under subsection
10 (5).
11 Sec. 3299d. A civil penalty assessed under this part shall
12 be collected by the department. If the person or nursing home
13 against whom a civil penalty has been assessed does not comply
14 with a written demand for payment within 30 days, the department
15 shall issue an order to do 1 of the following:
16 (a) Direct the department of treasury to deduct the amount
17 of the civil penalty from amounts otherwise due from the state to
18 the nursing home and remit that amount to the department.
19 (b) Add the amount of the civil penalty to the nursing
20 home's licensing fee. If the licensee refuses to make the payment
21 at the time of application for renewal of its license, the
22 license shall not be renewed.
23 (c) Bring an action in circuit court to recover the amount
24 of the civil penalty.
25 Sec. 3299e. (1) The penalties prescribed by this part or a
26 rule promulgated under this part are cumulative and not
27 exclusive. Neither the department nor any other party is limited
1 to the remedies in this part.
2 (2) The remedies provided under section 3107 and sections
3 3299a to 3299d are independent and cumulative. Except as provided
4 in section 3299c(5), the use of 1 remedy by a person shall not be
5 considered a bar to the use of other remedies by that person or
6 to the use of any remedy by another person.
7 PART 33
8 HOMES FOR THE AGED
9 Sec. 3301. Article I contains general definitions and
10 principles of construction applicable to all articles in this
11 act, and part 31 contains definitions applicable to this part.
12 Sec. 3307. This part does not authorize the medical
13 supervision, regulation, or control of the remedial care or
14 treatment of residents in a home for the aged operated for the
15 adherents of a bona fide church or religious denomination who
16 rely on treatment by prayer or spiritual means only in accordance
17 with the creed or tenets of that church or denomination. The
18 residents, personnel, or employees, other than food handlers, of
19 the home are not required to submit to a medical or physical
20 examination.
21 Sec. 3311. (1) A home for the aged shall be licensed under
22 this article.
23 (2) "Home for the aged" or a similar term or abbreviation
24 shall not be used to describe or refer to a long-term care
25 facility unless the long-term care facility is licensed as a home
26 for the aged by the department under this article.
27 (3) Except as otherwise provided in this subsection, a home
1 for the aged shall not admit an individual under 60 years of age.
2 Upon the request of a home for the aged and subject to subsection
3 (4), the director shall waive the age limitation imposed by this
4 subsection if the individual, the individual's guardian or other
5 legal representative, if appointed, and the owner, operator, and
6 governing body of the home for the aged, upon consultation with
7 the individual's physician, agree on each of the following:
8 (a) The home for the aged is capable of meeting all of the
9 individual's medical, social, and other needs as determined in
10 the individual's plan of service.
11 (b) The individual will be compatible with the other
12 residents of that home for the aged.
13 (c) The placement in that home for the aged is in the best
14 interests of the individual.
15 (4) The owner, operator, and governing body of the home for
16 the aged shall submit, with its request for a waiver,
17 documentation to the director that supports each of the points of
18 agreement necessary under subsection (3). Within 5 days after
19 receipt of the information required under this subsection, the
20 director shall determine if that documentation collectively
21 substantiates each of the points of agreement necessary under
22 subsection (3) and approve or deny the waiver. If denied, the
23 director shall send a written notice of the denial and the
24 reasons for denial to the requesting party.
25 Sec. 3313. (1) The owner, operator, and governing body of a
26 home for the aged are responsible for all phases of the operation
27 of the home and shall assure that the home maintains an organized
1 program to provide room and board, protection, supervision,
2 assistance, and supervised personal care for its residents.
3 (2) The owner, operator, and governing body shall assure the
4 availability of emergency medical care required by a resident.
5 Sec. 3321. (1) Before issuance of a license under this
6 article, the owner, operator, or governing body of the applicant
7 shall give a bond with a surety approved by the department. The
8 bond shall insure the department for the benefit of the
9 residents. The bond shall be conditioned to require the applicant
10 to do all of the following:
11 (a) Hold separately and in trust all resident funds
12 deposited with the applicant.
13 (b) Administer the funds on behalf of a resident in the
14 manner directed by the depositor.
15 (c) Render a true and complete account to the resident, the
16 depositor, and the department when requested.
17 (d) Account, on termination of the deposit, for all funds
18 received, expended, and held on hand.
19 (2) The bond shall be in an amount equal to not less than 1-
20 1/4 times the average balance of resident funds held during the
21 prior year. The department may require an additional bond or
22 permit filing of a bond in a lower amount, if the department
23 determines that a change in the average balance has occurred or
24 may occur. An applicant for a new license shall file a bond in an
25 amount which the department estimates as 1-1/4 times the average
26 amount of funds which the applicant, upon issuance of the
27 license, is likely to hold during the first year of operation.
1 Sec. 3325. If a resident of a home for the aged is receiving
2 care in the facility in addition to the room, board, and
3 supervised personal care specified in section 3101(1)(c), as
4 determined by a physician, the department shall not order the
5 removal of the resident from the home for the aged if both of the
6 following conditions are met:
7 (a) The resident, the resident's family, the resident's
8 physician, and the owner, operator, and governing body of the
9 home for the aged consent to the resident's continued stay in the
10 home for the aged.
11 (b) The owner, operator, and governing body of the home for
12 the aged commit to assuring that the resident receives the
13 necessary additional services.
14 Sec. 3331. A licensee of a home for the aged operated for
15 profit is considered to be the consumer, and not the retailer, of
16 tangible personal property purchased and used or consumed in
17 operation of the home.
18 Sec. 3332. A home for the aged shall offer each resident, or
19 shall provide each resident with information and assistance in
20 obtaining, an annual vaccination against influenza in accordance
21 with the most recent recommendations of the advisory committee on
22 immunization practices of the federal centers for disease control
23 and prevention, as approved by the department.
24 Sec. 3333. (1) A home for the aged licensed under this
25 article shall adopt a policy regulating the smoking of tobacco on
26 the home for the aged premises.
27 (2) A home for the aged policy governing smoking shall at a
1 minimum provide that:
2 (a) Upon admission each resident or person responsible for
3 the resident's admission shall be asked if there is a preference
4 for placement with smokers or nonsmokers.
5 (b) Smoking by residents shall be restricted to private
6 rooms, rooms shared with other smokers only, or other designated
7 smoking areas.
8 (c) Visitors shall not be permitted to smoke in rooms or
9 wards occupied by residents who do not smoke.
10 (d) Visitors shall be permitted to smoke only in designated
11 areas.
12 (e) Staff shall be permitted to smoke in designated areas
13 only.
14 (f) Staff shall not be permitted to smoke in residents'
15 rooms or while performing their duties in the presence of
16 residents.
17 (g) Eating areas shall have sections for smokers and
18 nonsmokers.
19 (h) Cigarettes, cigars, and pipe tobacco shall not be sold
20 or dispensed within the licensed facility except as provided for
21 by the owner or governing board.
22 (i) A sign indicating that smoking is prohibited in the
23 facility except in designated areas shall be posted at each
24 entrance to the facility. Each designated smoking area shall be
25 posted as such by sign.
26 (3) A home for the aged licensed under this article shall
27 retain a copy of the smoking policy which will be available to
1 the public upon request.
2 PART 34
3 HOSPICES
4 Sec. 3401. (1) As used in this part:
5 (a) "Home care" means a level of care provided to a patient
6 that is consistent with the categories "routine home care" or
7 "continuous home care" described in 42 CFR 418.302(b)(1) and (2).
8 (b) "Hospice residence" means a facility that meets all of
9 the following:
10 (i) Provides 24-hour hospice care to 2 or more patients at a
11 single location.
12 (ii) Either provides inpatient care directly in compliance
13 with this article and with the standards set forth in 42 CFR
14 418.100 or provides home care as described in this article.
15 (iii) Is owned, operated, and governed by a hospice program
16 that is licensed under this article and provides aggregate days
17 of patient care on a biennial basis to not less than 51% of its
18 hospice patients in their own homes. As used in this
19 subparagraph, "home" does not include a residence established by
20 a patient in a long-term care facility licensed under this
21 article or a residence established by a patient in an adult
22 foster care facility licensed under this article.
23 (c) "Inpatient care" means a level of care provided to a
24 patient that is consistent with the categories "inpatient respite
25 care day" and "general inpatient care day" described in 42 CFR
26 418.302(b)(3) and (4).
27 (2) Article I contains general definitions and principles of
1 construction applicable to all articles in this act, and part 31
2 contains definitions applicable to this part.
3 Sec. 3411. (1) Except as provided in subsection (5), a
4 hospice or hospice residence shall be licensed as required under
5 this article.
6 (2) The term "hospice" shall not be used to describe or
7 refer to a long-term care facility unless that program or agency
8 is licensed as a hospice by the department as required under this
9 article or is exempted from licensure as provided in subsection
10 (5).
11 (3) A person shall not represent itself as a hospice
12 residence unless that person is licensed as a hospice residence
13 by the department as required under this article.
14 (4) A hospital, nursing home, home for the aged, county
15 medical care facility, or any other long-term care facility that
16 operates a hospice or hospice residence shall be licensed as a
17 hospice or hospice residence under this article.
18 (5) A hospice is exempt from licensure under this article if
19 the hospice meets all of the following requirements:
20 (a) Provides services to not more than 7 patients per month
21 on a yearly average.
22 (b) Does not charge or receive fees for goods or services
23 provided.
24 (c) Does not receive third party reimbursement for goods or
25 services provided.
26 (6) If a hospice provides inpatient services that meet the
27 definition of a hospital, nursing home, home for the aged, county
1 medical care facility, hospice residence, or other long-term care
2 facility or health facility or agency, the hospice or hospice
3 residence shall obtain a separate license as required under this
4 article for that hospital, nursing home, home for the aged,
5 county medical care facility, hospice residence, or other long-
6 term care facility or health facility or agency.
7 (7) This part does not restrict an activity of a long-term
8 care facility or health facility or agency if the activity is
9 permitted under the license held by that long-term care facility
10 or that health facility or agency.
11 (8) If separate licensure is required under this section,
12 the department may conduct inspections and issue the required
13 licenses concurrently.
14 (9) As used in this section:
15 (a) "Health facility or agency" means that term as defined
16 under section 20106 of the public health code.
17 (b) "Hospital" means that term as defined under section
18 20106 of the public health code and licensed under part 215 of
19 the public health code.
20 Sec. 3413. (1) The owner, operator, and governing body of a
21 hospice or hospice residence licensed under this article:
22 (a) Are responsible for all phases of the operation of the
23 hospice or hospice residence and for the quality of care and
24 services rendered by the hospice or hospice residence.
25 (b) Shall cooperate with the department in the enforcement
26 of this part, and require that the physicians and other personnel
27 working in the hospice or hospice residence and for whom a
1 license or registration is required be currently licensed or
2 registered.
3 (c) Shall not discriminate because of race, religion, color,
4 national origin, or sex, in the operation of the hospice or
5 hospice residence including employment, patient admission and
6 care, and room assignment.
7 (2) As a condition of licensure as a hospice residence, an
8 applicant shall have been licensed under this article as a
9 hospice and in compliance with the standards set forth in 42 CFR
10 part 418 for not less than the 2 years immediately preceding the
11 date of application for licensure. A hospice residence licensed
12 under this article may provide both home care and inpatient care
13 at the same location. A hospice residence providing inpatient
14 care shall comply with the standards in 42 CFR 418.100.
15 (3) In addition to the requirements of subsections (1) and
16 (2) and section 3415, the owner, operator, and governing body of
17 a hospice residence that is licensed under this article and that
18 provides care only at the home care level shall do all of the
19 following:
20 (a) Provide 24-hour nursing services for each patient in
21 accordance with the patient's hospice care plan as required under
22 42 CFR part 418.
23 (b) Have an approved plan for infection control that
24 includes making provisions for isolating each patient with an
25 infectious disease.
26 (c) Obtain fire safety approval pursuant to section 3109.
27 (d) Equip each patient room with a device approved by the
1 department for calling the staff member on duty.
2 (e) Design and equip areas within the hospice residence for
3 the comfort and privacy of each patient and his or her family
4 members.
5 (f) Permit patients to receive visitors at any hour,
6 including young children.
7 (g) Provide individualized meal service plans in accordance
8 with 42 CFR 418.100(j).
9 (h) Provide appropriate methods and procedures for the
10 storage, dispensing, and administering of drugs and biologicals
11 pursuant to 42 CFR 418.100(k).
12 Sec. 3415. (1) A hospice or a hospice residence shall
13 provide a program of planned and continuous hospice care, the
14 medical components of which shall be under the direction of a
15 physician.
16 (2) Hospice care shall consist of a coordinated set of
17 services rendered at home or in hospice residence or other
18 institutional settings on a continuous basis for individuals
19 suffering from a disease or condition with a terminal prognosis.
20 The coordination of services shall assure that the transfer of a
21 patient from 1 setting to another will be accomplished with a
22 minimum disruption and discontinuity of care. Hospice services
23 shall address the physical, psychological, social, and spiritual
24 needs of the individual and shall be designed to meet the related
25 needs of the individual's family through the periods of illness
26 and bereavement. These hospice services shall be provided through
27 a coordinated interdisciplinary team that may also include
1 services provided by trained volunteers.
2 Sec. 3417. An individual shall not be admitted to or
3 retained for care by a hospice or a hospice residence unless the
4 individual is suffering from a disease or condition with a
5 terminal prognosis. An individual shall be considered to have a
6 disease or condition with a terminal prognosis if, in the opinion
7 of a physician, the individual's death is anticipated within 6
8 months after the date of admission to the hospice or hospice
9 residence. If a person lives beyond a 6-month or less prognosis,
10 the person is not disqualified from receiving continued hospice
11 care.
12 Sec. 3419. (1) The department may submit for a public
13 hearing proposed rules necessary to implement and administer this
14 part.
15 (2) The rules promulgated pursuant to subsection (1) shall
16 not establish standards related to the credentials of an
17 individual providing care in a hospice program, whether as an
18 employee of a program or volunteer in a program, unless, with
19 respect to the type of care the individual would provide in the
20 hospice program, a license or other credential is required by law
21 for an individual providing that care.
22 Sec. 3420. Notwithstanding any other provision of this act,
23 all hospices shall be exempt from license fees and certificate of
24 need fees for 3 years after the first hospice is licensed under
25 this article.
26 PART 35
27 ADULT FOSTER CARE FACILITIES
1 Sec. 3501. (1) For the purposes of this part, the words and
2 phrases defined in sections 3503 to 3507 have the meanings
3 ascribed to them in those sections.
4 (2) In addition, article I contains general definitions and
5 principles of construction applicable to all articles in this
6 act.
7 Sec. 3503. (1) "Adult" means:
8 (a) A person 18 years of age or older.
9 (b) A person who is placed in an adult foster care family
10 home or an adult foster care small group home pursuant to section
11 5(6) or (8) of 1973 PA 116, MCL 722.115.
12 (2) "Adult foster care camp" or "adult camp" means an adult
13 foster care facility with the approved capacity to receive more
14 than 4 adults to be provided foster care. An adult foster care
15 camp is a facility located in a natural or rural environment.
16 (3) "Adult foster care congregate facility" means an adult
17 foster care facility with the approved capacity to receive more
18 than 20 adults to be provided with foster care.
19 (4) "Adult foster care facility" means a governmental or
20 nongovernmental establishment that provides foster care to
21 adults. Subject to section 3526a(1), adult foster care facility
22 includes facilities and foster care family homes for adults who
23 are aged, mentally ill, developmentally disabled, or physically
24 disabled who require supervision on an ongoing basis but who do
25 not require continuous nursing care. Adult foster care facility
26 does not include any of the following:
27 (a) A nursing home licensed under part 32 of this act.
1 (b) A home for the aged licensed under part 33 of this act.
2 (c) A hospital licensed under article 17 of the public
3 health code.
4 (d) A hospital for the mentally ill or a facility for the
5 developmentally disabled operated by the department of community
6 health under the mental health code, 1974 PA 258, MCL 330.1001 to
7 330.2106.
8 (e) A county infirmary operated by a county department of
9 social services or family independence agency under section 55 of
10 the social welfare act, 1939 PA 280, MCL 400.55.
11 (f) A child caring institution, children's camp, foster
12 family home, or foster family group home licensed or approved
13 under 1973 PA 116, MCL 722.111 to 722.128, if the number of
14 residents who become 18 years of age while residing in the
15 institution, camp, or home does not exceed the following:
16 (i) Two, if the total number of residents is 10 or fewer.
17 (ii) Three, if the total number of residents is not less than
18 11 and not more than 14.
19 (iii) Four, if the total number of residents is not less than
20 15 and not more than 20.
21 (iv) Five, if the total number of residents is 21 or more.
22 (g) A foster family home licensed or approved under 1973 PA
23 116, MCL 722.111 to 722.128, that has a person who is 18 years of
24 age or older placed in the foster family home under section 5(7)
25 of 1973 PA 116, MCL 722.115.
26 (h) An establishment commonly described as an alcohol or a
27 substance abuse rehabilitation center, a residential facility for
1 persons released from or assigned to adult correctional
2 institutions, a maternity home, or a hotel or rooming house that
3 does not provide or offer to provide foster care.
4 (i) A facility created by 1885 PA 152, MCL 36.1 to 36.12.
5 (5) "Adult foster care family home" means a private
6 residence with the approved capacity to receive 6 or fewer adults
7 to be provided with foster care for 5 or more days a week and for
8 2 or more consecutive weeks. The adult foster care family home
9 licensee shall be a member of the household and an occupant of
10 the residence.
11 (6) "Adult foster care large group home" means an adult
12 foster care facility with the approved capacity to receive at
13 least 13 but not more than 20 adults to be provided with foster
14 care.
15 (7) "Adult foster care small group home" means an adult
16 foster care facility with the approved capacity to receive 12 or
17 fewer adults to be provided with foster care.
18 (8) "Aged" means an adult whose chronological age is 60
19 years of age or older or whose biological age, as determined by a
20 physician, is 60 years of age or older.
21 (9) "Assessment plan" means a written statement prepared in
22 cooperation with a responsible agency or person that identifies
23 the specific care and maintenance, services, and resident
24 activities appropriate for each individual resident's physical
25 and behavioral needs and well-being and the methods of providing
26 the care and services taking into account the preferences and
27 competency of the individual.
1 Sec. 3504. (1) "Council" means the adult foster care
2 licensing advisory council created in section 3508.
3 (2) "Department" means the department of human services.
4 (3) "Developmental disability" means a disability as defined
5 in section 500(h) of 1974 PA 258, MCL 330.1500.
6 (4) "Director" means the director of the department.
7 (5) "Do-not-resuscitate order" means a document executed
8 pursuant to section 3 of the Michigan do-not-resuscitate
9 procedure act, 1996 PA 193, MCL 333.1051 to 333.1067, directing
10 that, in the event a resident suffers cessation of both
11 spontaneous respiration and circulation, no resuscitation will be
12 initiated.
13 (6) "Foster care" means the provision of supervision,
14 personal care, and protection in addition to room and board, for
15 24 hours a day, 5 or more days a week, and for 2 or more
16 consecutive weeks for compensation.
17 Sec. 3505. (1) "Good moral character" means good moral
18 character as defined in 1974 PA 381, MCL 338.41 to 338.47.
19 (2) "Licensed hospice program" means a health care program
20 that provides a coordinated set of services rendered at home or
21 in an outpatient or institutional setting for individuals
22 suffering from a disease or condition with a terminal prognosis
23 and that is licensed under part 34.
24 (3) "Licensee" means the agency, association, corporation,
25 organization, person, or department or agency of the state,
26 county, city, or other political subdivision, that has been
27 issued a license to operate an adult foster care facility.
1 (4) "Mental illness" means a substantial disorder of thought
2 or mood that significantly impairs judgment, behavior, capacity
3 to recognize reality, or ability to cope with the ordinary
4 demands of life.
5 (5) "New construction" means a newly constructed facility or
6 a facility that has been completely renovated for use as an adult
7 foster care facility.
8 Sec. 3506. (1) "Personal care" means personal assistance
9 provided by a licensee or an agent or employee of a licensee to a
10 resident who requires assistance with dressing, personal hygiene,
11 grooming, maintenance of a medication schedule as directed and
12 supervised by the resident's physician, or the development of
13 those personal and social skills required to live in the least
14 restrictive environment.
15 (2) "Physical disability" means a determinable physical
16 characteristic of an individual that may result from disease,
17 injury, congenital condition of birth, or functional disorder.
18 (3) "Physical plant" means the structure in which a facility
19 is located and all physical appurtenances to the facility.
20 (4) "Protection", subject to section 3526a(2), means the
21 continual responsibility of the licensee to take reasonable
22 action to insure the health, safety, and well-being of a
23 resident, including protection from physical harm, humiliation,
24 intimidation, and social, moral, financial, and personal
25 exploitation while on the premises, while under the supervision
26 of the licensee or an agent or employee of the licensee, or when
27 the resident's assessment plan states that the resident needs
1 continuous supervision.
2 (5) "Provisional license" means a license issued to a
3 facility that has previously been licensed under this act or an
4 act repealed by this act but is temporarily unable to conform to
5 the requirements of a regular license prescribed in this act or
6 rules promulgated under this act.
7 (6) "Quality of care" means the foster care of residents of
8 a facility and other similar items not related to the physical
9 plant that address themselves to the general physical and mental
10 health, welfare, and well-being of residents.
11 Sec. 3507. (1) "Regular license" means a license issued to
12 an adult foster care facility which is in compliance with this
13 act and the rules promulgated under this act.
14 (2) "Related" means any of the following relationships by
15 marriage, blood, or adoption: spouse, child, parent, brother,
16 sister, grandparent, aunt, uncle, stepparent, stepbrother,
17 stepsister, or cousin.
18 (3) "Short-term operation" means an adult foster care
19 facility which operates for a period of time less than 6 months
20 within a calendar year.
21 (4) "Special license" means a license issued for the
22 duration of the operation of an adult foster care facility if the
23 licensee is a short-term operation.
24 (5) "Specialized program" means a program of services or
25 treatment provided in an adult foster care facility licensed
26 under this act that is designed to meet the unique programmatic
27 needs of the residents of that home as set forth in the
1 assessment plan for each resident and for which the facility
2 receives special compensation.
3 (6) "Special compensation" means payment to an adult foster
4 care facility to ensure the provision of a specialized program in
5 addition to the basic payment for adult foster care. Special
6 compensation does not include payment received by the adult
7 foster care facility directly from the medicaid program for
8 personal care services for a resident or payment received under
9 the supplemental security income program under title XVI of the
10 social security act, 42 USC 1381 to 1383c.
11 (7) "Supervision" means guidance of a resident in the
12 activities of daily living, including all of the following:
13 (a) Reminding a resident to maintain his or her medication
14 schedule, as directed by the resident's physician.
15 (b) Reminding a resident of important activities to be
16 carried out.
17 (c) Assisting a resident in keeping appointments.
18 (d) Being aware of a resident's general whereabouts even
19 though the resident may travel independently about the community.
20 (8) "Temporary license" means a license issued to a facility
21 which has not previously been licensed pursuant to this act, to
22 the former adult care facility licensing act, or to former 1972
23 PA 287.
24 Sec. 3508. (1) The adult foster care licensing advisory
25 council is created within the department. The council shall
26 consist of 11 members, appointed by the director. The director
27 shall appoint at least 1 member of the council from appropriate
1 state and local agencies, private or public organizations, adult
2 foster care providers, and residents of adult foster care
3 facilities or their representatives. The members of the adult
4 foster care licensing advisory council created under section 8 of
5 the former adult foster care licensing act, MCL 400.708, shall
6 serve as the initial members of the council created in this
7 section until their successors are appointed or until the
8 expiration of their respective terms, whichever occurs first. A
9 vacancy shall be filled for the remainder of the unexpired term
10 in the same manner as original appointments are made.
11 (2) The per diem compensation of the council members and the
12 schedule for reimbursement of travel and other expenses shall be
13 pursuant to the compensation and schedules established by the
14 legislature. The council shall meet not more than once each
15 month. The council shall advise the department on the content of
16 rules and their enforcement.
17 (3) The business which the council may perform shall be
18 conducted at a public meeting of the council held in compliance
19 with the open meetings act, 1976 PA 267, MCL 15.261 to 15.275.
20 Public notice of the time, date, and place of the meeting shall
21 be given in the manner required by the open meetings act, 1976 PA
22 267, MCL 15.261 to 15.275.
23 (4) Except as provided in section 3512, a writing prepared,
24 owned, used, in the possession of, or retained by the council in
25 the performance of an official function shall be made available
26 to the public in compliance with the freedom of information act,
27 1976 PA 442, MCL 15.231 to 15.246.
1 Sec. 3509. (1) The department shall administer this part and
2 shall require reports, establish procedures, make inspections,
3 and conduct investigations pursuant to law to enforce the
4 requirements of this part and the rules promulgated under this
5 part.
6 (2) The department shall provide advice and technical
7 assistance to facilities covered by this part to assist
8 facilities in meeting the requirements of this part and the rules
9 promulgated under this part. The department shall offer
10 consultation, upon request, in developing methods for the
11 improvement of service. The department shall cooperate with other
12 state departments and agencies and local units of government in
13 administering this part.
14 (3) The department shall provide education to the public
15 regarding the requirements of this part through the ongoing use
16 of mass media and other methods.
17 Sec. 3510. (1) The department shall promulgate rules
18 pursuant to the administrative procedures act of 1969 in the
19 areas provided under subsection (4).
20 (2) The state fire safety board created under the fire
21 prevention code, 1941 PA 207, MCL 29.1 to 29.34, shall promulgate
22 rules providing for adequate fire prevention and safety in an
23 adult foster care facility licensed or proposed to be licensed
24 for more than 6 adults. The rules shall be promulgated in
25 cooperation with the department and shall provide for the
26 protection of the health, safety, and welfare of the adults
27 residing in a facility. The state fire safety board shall
1 promulgate rules pursuant to the administrative procedures act of
2 1969. A person may request a variance from the application of a
3 rule promulgated pursuant to this subsection by application to
4 the state fire marshal. The state fire marshal may make a
5 variance upon a finding that the variance does not result in a
6 hazard to life or property. The finding shall be transmitted to
7 the person requesting the variance and shall be entered into the
8 records of the department of labor and economic growth. If the
9 variance requested concerns a building, the finding shall also be
10 transmitted to the governing body of the city, village, or
11 township in which the building is located. The entire state fire
12 safety board shall act as a hearing body in accordance with the
13 administrative procedures act of 1969 to review and render
14 decisions on a rule promulgated pursuant to this subsection or a
15 ruling of the state fire marshal in the marshal's interpretation
16 or application of these rules. After a hearing, the state fire
17 safety board may vary the application of a rule or may modify the
18 ruling or interpretation of the state fire marshal if the
19 enforcement of the ruling or interpretation would do manifest
20 injustice and would be contrary to the spirit and purpose of the
21 rules or the public interest. A decision of the state fire safety
22 board to vary the application of a rule, or to modify or change a
23 ruling of the state fire marshal, shall specify in what manner
24 the variance, modification, or change is made, the conditions
25 upon which it is made, and the reasons for the variance,
26 modification, or change.
27 (3) The department of community health shall promulgate
1 rules for the certification of specialized programs offered in an
2 adult foster care facility to a mentally ill or developmentally
3 disabled resident. The rules shall include provision for an
4 appeal of a denial or limitation of the terms of certification to
5 the department pursuant to chapter 4 of the administrative
6 procedures act of 1969.
7 (4) The rules promulgated by the department under this part
8 shall be restricted to the following:
9 (a) The operation and conduct of adult foster care
10 facilities.
11 (b) The character, suitability, training, and qualifications
12 of applicants and other persons directly responsible for the care
13 and welfare of adults served.
14 (c) The general financial ability and competence of
15 applicants to provide necessary care for adults and to maintain
16 prescribed standards.
17 (d) The number of individuals or staff required to ensure
18 adequate supervision and care of the adults served.
19 (e) The appropriateness, safety, cleanliness, and general
20 adequacy of the premises, including maintenance of adequate
21 health standards to provide for the physical comfort, care,
22 protection, and well-being of the adults received and maintenance
23 of adequate fire protection for adult foster care facilities
24 licensed to receive 6 or fewer adults. Rules promulgated in the
25 areas provided by this subdivision shall be promulgated in
26 cooperation with the state fire safety board.
27 (f) Provisions for food, clothing, educational
1 opportunities, equipment, and individual supplies to assure the
2 healthy physical, emotional, and mental development of adults
3 served.
4 (g) The type of programs and services necessary to provide
5 appropriate care to each resident admitted.
6 (h) Provisions to safeguard the rights of adults served,
7 including cooperation with rights protection systems established
8 by law.
9 (i) Provisions to prescribe the rights of licensees.
10 (j) Maintenance of records pertaining to admission,
11 progress, health, and discharge of adults. The rules promulgated
12 under this subdivision shall include a method by which a licensee
13 promptly shall notify the appropriate placement agency or
14 responsible agent of any indication that a resident's assessment
15 plan is not appropriate for that resident.
16 (k) Filing of reports with the department.
17 (l) Transportation safety.
18 (5) The rules shall be reviewed by the council not less than
19 once every 5 years.
20 Sec. 3511. (1) The director, the director's agent, or
21 personnel of another department or agency, acting at the request
22 of the director, may enter upon the premises of an applicant or
23 licensee at a reasonable time to make inspections, as permitted
24 by applicable law, to determine whether the applicant or licensee
25 is complying with this part and the rules promulgated under this
26 part. On-site inspections may be conducted without prior notice
27 to the adult foster care facility. A health and sanitation
1 inspection of an adult foster care facility shall be conducted
2 upon the request of the department by 1 of the following:
3 (a) Department staff.
4 (b) The department of community health.
5 (c) A local health department.
6 (2) The department of community health, the fire marshal
7 division of the department of labor and economic growth, or local
8 authorities, in carrying out this act, may visit an adult foster
9 care facility more often than annually to advise in matters
10 affecting health or fire protection. Inspections shall be made as
11 permitted by law.
12 (3) An adult foster care facility shall be inspected for
13 fire safety by 1 of the following:
14 (a) Department staff, if the facility is licensed or
15 proposed to be licensed for 6 or fewer adults. The department may
16 request that a fire safety inspection be completed or caused to
17 be completed by the state fire marshal, for a facility licensed
18 or proposed to be licensed for 6 or fewer adults, when such an
19 inspection would result in the efficient administration of this
20 part.
21 (b) The state fire marshal or the designated representative
22 of the state fire marshal, if the facility is licensed or
23 proposed to be licensed for more than 6 adults. The state fire
24 marshal shall inspect or cause to be inspected for fire safety an
25 adult foster care facility licensed or proposed to be licensed
26 for 6 or fewer adults upon request by the department. The state
27 fire marshal may contract with the fire marshal of a city having
1 a population of not less than 1,000,000 to inspect adult foster
2 care facilities licensed or proposed to be licensed for more than
3 6 adults if the facility is located within that city. The fire
4 marshal of a city shall conduct an inspection in compliance with
5 procedures established and on forms provided by the state fire
6 marshal.
7 (4) Except as provided in subsection (3)(b) and section
8 3510(2), the inspector shall administer and enforce the rules
9 promulgated by the department.
10 (5) Upon receipt of a request from an adult foster care
11 facility for certification of a specialized program for
12 developmentally disabled or mentally ill adults, the department
13 of mental health shall inspect the facility to determine whether
14 the proposed specialized program conforms with the requirements
15 of applicable law and rules. The department of community health
16 shall provide the department with an inspection report and a
17 certification, denial of certification, or certification with
18 limited terms for the proposed specialized program. The
19 department of community health shall reinspect a certified
20 specialized program not less than once biennially and notify the
21 department in the same manner as for the initial certification.
22 In carrying out this subsection, the department of community
23 health may contract with a county community mental health board
24 or any other agency for services.
25 (6) Inspection reports required by this section shall be
26 furnished to the department and shall be used in the evaluation
27 for licensing of an adult foster care facility. The department
1 shall consider the reports carefully and may make special
2 consultations if necessary. The department shall be responsible
3 for the final determination of the issuance, denial, or
4 revocation and the temporary or provisional nature of a license
5 issued to an adult foster care facility. A report of the
6 department's findings shall be furnished to the licensee or
7 applicant.
8 (7) The inspection reports required by this section shall be
9 available for public inspection during reasonable business hours.
10 Sec. 3512. (1) The department may prescribe appropriate
11 records to be kept and maintained regarding each adult received
12 by a licensee and may require reports, upon forms furnished or
13 approved by the department, setting forth facts or circumstances
14 related to the care of adults received by the licensee.
15 (2) The department may examine the books, records, and
16 reports of a facility. Members of the department shall be
17 provided reasonable facilities for the thorough examination and
18 copying of the books, records, and reports of the facility.
19 (3) The records of the residents of a facility which are
20 required to be kept by the facility under this act or rules
21 promulgated under this act shall be confidential and properly
22 safeguarded. These materials shall be open only to the inspection
23 of the director, an agent of the director, another executive
24 department of the state pursuant to a contract between that
25 department and the facility, a party to a contested case
26 involving the facility, or on the order of a court or tribunal of
27 competent jurisdiction. The records of a resident of a facility
1 which are required to be kept by the facility under this act or
2 rules promulgated under this act shall be open to inspection by
3 the resident, unless medically contraindicated, or the guardian
4 of a resident.
5 Sec. 3513. (1) A person, partnership, corporation,
6 association, or a department or agency of the state, county,
7 city, or other political subdivision shall not establish or
8 maintain an adult foster care facility unless licensed by the
9 department.
10 (2) Application for a license shall be made on forms
11 provided and in the manner prescribed by the department. The
12 application shall be accompanied by the fee prescribed in section
13 3513a.
14 (3) Before issuing or renewing a license, the department
15 shall investigate the activities and standards of care of the
16 applicant and shall make an on-site evaluation of the facility.
17 On-site inspections conducted in response to the application may
18 be conducted without prior notice to the applicant. Subject to
19 subsections (9), (10), and (11), the department shall issue or
20 renew a license if satisfied as to all of the following:
21 (a) The financial stability of the facility.
22 (b) The applicant's compliance with this part and rules
23 promulgated under this part.
24 (c) The good moral character of the applicant, or owners,
25 partners, or directors of the facility, if other than an
26 individual. Each of these persons shall be not less than 18 years
27 of age.
1 (d) The physical and emotional ability of the applicant, and
2 the person responsible for the daily operation of the facility to
3 operate an adult foster care facility.
4 (e) The good moral character of the person responsible for
5 the daily operations of the facility and all employees of the
6 facility. The applicant shall be responsible for assessing the
7 good moral character of the employees of the facility. The person
8 responsible for the daily operation of the facility shall be not
9 less than 18 years of age.
10 (4) The department shall require an applicant or a licensee
11 to disclose the names, addresses, and official positions of all
12 persons who have an ownership interest in the adult foster care
13 facility. If the adult foster care facility is located on or in
14 real estate that is leased, the applicant or licensee shall
15 disclose the name of the lessor of the real estate and any direct
16 or indirect interest that the applicant or licensee has in the
17 lease other than as lessee.
18 (5) Each license shall state the maximum number of persons
19 to be received for foster care at 1 time.
20 (6) If applicable, a license shall state the type of
21 specialized program for which certification has been received
22 from the department.
23 (7) A license shall be issued to a specific person for a
24 facility at a specific location, is nontransferable, and remains
25 the property of the department. The prohibition against transfer
26 of a license to another location does not apply if a licensee's
27 adult foster care facility or home is closed as a result of
1 eminent domain proceedings, if the facility or home, as
2 relocated, otherwise meets the requirements of this act and the
3 rules promulgated under this act.
4 (8) An applicant or licensee proposing a sale of an adult
5 foster care facility or home to another owner shall provide the
6 department with advance notice of the proposed sale in writing.
7 The applicant or licensee and other parties to the sale shall
8 arrange to meet with specified department representatives and
9 shall obtain before the sale a determination of the items of
10 noncompliance with applicable law and rules that shall be
11 corrected. The department shall notify the respective parties of
12 the items of noncompliance before the change of ownership, shall
13 indicate that the items of noncompliance shall be corrected as a
14 condition of issuance of a license to the new owner, and shall
15 notify the prospective purchaser of all licensure requirements.
16 (9) The department shall not issue a license to or renew the
17 license of a person who has been convicted of a felony under this
18 part or under chapter XXA of the Michigan penal code, 1931 PA
19 328, MCL 750.145m to 750.145r. The department shall not issue a
20 license to or renew the license of a person who has been
21 convicted of a misdemeanor under this act or under chapter XXA of
22 the Michigan penal code, 1931 PA 328, MCL 750.145m to 750.145r,
23 for a period of 10 years after the conviction.
24 (10) If the department has revoked, suspended, or refused to
25 renew a person's license for an adult foster care facility
26 according to section 3522, the department may refuse to issue a
27 license to or renew a license of that person for a period of 5
1 years after the suspension, revocation, or nonrenewal of the
2 license.
3 (11) The department may refuse to issue a license to or
4 renew the license of an applicant if the department determines
5 that the applicant has a relationship with a former licensee
6 whose license under this act has been suspended, revoked, or
7 nonrenewed under subsection (9) or section 3522 or a convicted
8 person to whom a license has been denied under subsection (9).
9 This subsection applies for 5 years after the suspension,
10 revocation, or nonrenewal of the former licensee's license or the
11 denial of the convicted person's license. For purposes of this
12 subsection, an applicant has a relationship with a former
13 licensee or convicted person if the former licensee or convicted
14 person is involved with the facility in 1 or more of the
15 following ways:
16 (a) Participates in the administration or operation of the
17 facility.
18 (b) Has a financial interest in the operation of the
19 facility.
20 (c) Provides care to residents of the facility.
21 (d) Has contact with residents or staff on the premises of
22 the facility.
23 (e) Is employed by the facility.
24 (f) Resides in the facility.
25 (12) If the department determines that an unlicensed
26 facility is an adult foster care facility, the department shall
27 notify the owner or operator of the facility that it is required
1 to be licensed under this part. A person receiving the
2 notification required under this section who does not apply for a
3 license within 30 days is subject to the penalties described in
4 subsection (13).
5 (13) Subject to subsection (12), a person who violates
6 subsection (1) is guilty of a misdemeanor punishable by
7 imprisonment for not more than 2 years or a fine of not more than
8 $50,000.00, or both. A person who has been convicted of a
9 violation of subsection (1) who commits a second or subsequent
10 violation is guilty of a felony punishable by imprisonment for
11 not more than 5 years or a fine of not more than $75,000.00, or
12 both.
13 (14) The department shall issue an initial or renewal
14 license not later than 6 months after the applicant files a
15 completed application. Receipt of the application is considered
16 the date the application is received by any agency or department
17 of this state. If the application is considered incomplete by the
18 department, the department shall notify the applicant in writing
19 or make notice electronically available within 30 days after
20 receipt of the incomplete application, describing the deficiency
21 and requesting additional information. If the department
22 identifies a deficiency or requires the fulfillment of a
23 corrective action plan, the 6-month period is tolled until either
24 of the following occurs:
25 (a) Upon notification by the department of a deficiency,
26 until the date the requested information is received by the
27 department.
1 (b) Upon notification by the department that a corrective
2 action plan is required, until the date the department determines
3 the requirements of the corrective action plan have been met.
4 (15) The determination of the completeness of an application
5 does not operate as an approval of the application for the
6 license and does not confer eligibility of an applicant
7 determined otherwise ineligible for issuance of a license.
8 (16) If the department fails to issue or deny a license
9 within the time required by this section, the department shall
10 return the license fee and shall reduce the license fee for the
11 applicant's next renewal application, if any, by 15%. Failure to
12 issue or deny a license within the time period required under
13 this section does not allow the department to otherwise delay
14 processing an application. The completed application shall be
15 placed in sequence with other completed applications received at
16 that same time. The department shall not discriminate against an
17 applicant in the processing of an application based on the fact
18 that the application fee was refunded or discounted under this
19 subsection.
20 (17) If, on a continual basis, inspections performed by a
21 local health department delay the department in issuing or
22 denying licenses under this act within the 6-month period, the
23 department may use department staff to complete the inspections
24 instead of the local health department causing the delays.
25 (18) The director of the department shall submit a report by
26 December 1 of each year to the standing committees and
27 appropriations subcommittees of the senate and house of
1 representatives concerned with human services issues. The
2 director shall include all of the following information in the
3 report concerning the preceding fiscal year:
4 (a) The number of initial and renewal applications the
5 department received and completed within the 6-month time period
6 described in subsection (14).
7 (b) The number of applications requiring a request for
8 additional information.
9 (c) The number of applications rejected.
10 (d) The number of licenses not issued within the 6-month
11 period.
12 (e) The average processing time for initial and renewal
13 licenses granted after the 6-month period.
14 (19) As used in this section, "completed application" means
15 an application complete on its face and submitted with any
16 applicable licensing fees as well as any other information,
17 records, approval, security, or similar item required by law or
18 rule from a local unit of government, a federal agency, or a
19 private entity but not from another department or agency of this
20 state. A completed application does not include a health
21 inspection performed by a local health department.
22 Sec. 3513a. (1) Application fees for an individual,
23 partnership, firm, corporation, association, governmental
24 organization, or nongovernmental organization licensed or seeking
25 licensure under this part are as follows:
26 (a) Application fee for a temporary license:
1 (i) Family home $ 65.00
2 (ii) Small group home (1-6) 105.00
3 (iii) Small group home (7-12) 135.00
4 (iv) Large group home 170.00
5 (v) Congregate facility 220.00
6 (vi) Camp 40.00
7 (b) Application fee for subsequent licenses:
8 (i) Family home $ 25.00
9 (ii) Small group home (1-6) 25.00
10 (iii) Small group home (7-12) 60.00
11 (iv) Large group home 100.00
12 (v) Congregate facility 150.00
13 (vi) Camp 25.00
14 (2) Fees collected under this part shall be credited to the
15 general fund of the state to be appropriated by the legislature
16 to the department for the enforcement of this part.
17 Sec. 3513b. An adult foster care facility license issued
18 under the former adult foster care facility licensing act, 1979
19 PA 218, MCL 400.701 to 400.737, is a license issued under this
20 part on the effective date of this act until that license expires
21 and then the adult foster care facility may renew the license
22 pursuant to this part.
23 Sec. 3514. (1) A temporary license shall be issued to an
24 adult foster care facility for the first 6 months of operation if
25 the adult foster care facility has not previously been licensed
26 as an adult foster care facility. At the end of the first 6
1 months of operation, the department shall issue a regular
2 license, issue a provisional license, or refuse to issue a
3 license in the manner provided for in section 3522. A temporary
4 license shall not be renewed.
5 (2) Before issuing a temporary license, the department may
6 require an adult foster care facility to submit to the department
7 an acceptable plan of correction for the adult foster care
8 facility. The adult foster care facility shall implement the plan
9 of correction within the time limitations of the temporary
10 license period.
11 Sec. 3515. The department shall not issue a temporary
12 license to an adult foster care congregate facility, except a
13 facility which is to replace an adult foster care congregate
14 facility licensed on March 27, 1984 and is a new construction;
15 satisfies all applicable state construction code requirements and
16 the fire safety requirements prescribed by section 3520; and the
17 bed capacity does not exceed that of the licensed facility which
18 it replaces.
19 Sec. 3516. (1) Unless the city, village, or township
20 approves a temporary license, a temporary license shall not be
21 granted under this part if the issuance of the license would
22 substantially contribute to an excessive concentration of
23 community residential facilities within a city, village, or
24 township of this state.
25 (2) A temporary license shall not be granted under this part
26 if the proposed adult foster care facility for more than 6 adults
27 has not obtained zoning approval or obtained a special or
1 conditional use permit if required by an ordinance of the city,
2 village, or township in which the proposed facility is located.
3 (3) The department shall not issue a temporary license to an
4 adult foster care facility which does not comply with section 16a
5 of 1943 PA 183, MCL 125.216a, section 16a of 1943 PA 184, MCL