HB-4447, As Passed House, May 27, 2015

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

HOUSE BILL NO. 4447

 

 

 

 

 

 

 

 

 

 

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending sections 6237, 6238, 20104, 20106, 20145, 20155,

 

20161, 20501, 20521, and 20551 (MCL 333.6237, 333.6238,

 

333.20104, 333.20106, 333.20145, 333.20155, 333.20161, 333.20501,

 

333.20521, and 333.20551), sections 6237 and 6238 as amended by

 

2012 PA 501, section 20104 as amended by 2010 PA 381, section

 

20106 as amended by 2014 PA 449, section 20145 as amended by 2004

 

PA 469, section 20155 as amended by 2012 PA 322, and section

 

20161 as amended by 2013 PA 137; and to repeal acts and parts of

 

acts.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 6237. The Until October 1, 2019, the department shall

 

 2  issue a license assess a $500.00 fee for licenses on an annual

 


 1  basis upon determining that the applicant has complied with this

 

 2  part and rules promulgated under this part. A licensee shall

 

 3  prominently display the license while it is in effect.

 

 4        Sec. 6238. (1) A standard license issued under this part is

 

 5  effective for no longer than 1 year after the date of issuance.

 

 6  The department may issue a provisional license to an applicant

 

 7  temporarily unable to comply with this part or the rules

 

 8  promulgated under this part. The department may renew or extend a

 

 9  provisional license issued under this section for not more than 1

 

10  year. The department may issue a temporary, nonrenewable permit

 

11  for not more than 90 days if additional time is needed for the

 

12  department to properly investigate or for the applicant to

 

13  undertake remedial action.

 

14        (2) The department shall make at least 1 visit to each

 

15  licensed substance use disorder program every 3 years for survey

 

16  and evaluation for the purpose of licensure.

 

17        (3) The department may waive the visit required by

 

18  subsection (2) if the licensed program requests a waiver and

 

19  submits the following:

 

20        (a) Evidence that it is currently fully accredited by an

 

21  accrediting body with expertise in the health facility type and

 

22  the accrediting organization is accepted by the department.

 

23        (b) A copy of the most recent accreditation executive

 

24  summary submitted to the department at least 30 days from

 

25  licensure renewal. Submission of an executive summary does not

 

26  prevent or prohibit the department from requesting the entire

 

27  accreditation report if the department considers it necessary.

 


 1        (4) Accreditation information provided to the department

 

 2  under subsection (3) is confidential, is not a public record, and

 

 3  is not subject to court subpoena. The department shall use the

 

 4  accreditation information only as provided in this section. The

 

 5  department shall properly destroy the documentation after a

 

 6  decision on the waiver request is made.

 

 7        (5) The department shall grant a waiver under subsection (3)

 

 8  if the accreditation report submitted is less than 3 years old

 

 9  and there is no indication of substantial noncompliance with

 

10  licensure standards or of deficiencies that represent a threat to

 

11  public safety or patient care in the accreditation report.

 

12        (6) Denial of waiver request by the department is not

 

13  subject to appeal.

 

14        (7) This section does not prohibit the department from

 

15  conducting an inspection or citing a violation of this part

 

16  related to a complaint.

 

17        Sec. 20104. (1) "Certification" means the issuance of a

 

18  document by the department to a health facility or agency

 

19  attesting to the fact that the health facility or agency meets

 

20  both of the following:

 

21        (a) It complies with applicable statutory and regulatory

 

22  requirements and standards.

 

23        (b) It is eligible to participate as a provider of care and

 

24  services in a specific federal or state health program.

 

25        (2) "Clinical laboratory" means a facility patronized by, or

 

26  at the direction of, a physician, health officer, or other person

 

27  authorized by law to obtain information for the diagnosis,

 


 1  prevention, or treatment of disease or the assessment of a

 

 2  medical condition by the microbiological, serological,

 

 3  histological, hematological, immunohematological, biophysical,

 

 4  cytological, pathological, or biochemical examination of

 

 5  materials derived from the human body, except as provided in

 

 6  section 20507.

 

 7        (2) (3) "Consumer" means a person who is not a provider of

 

 8  health care as defined in section 1531(3) of title 15 of the

 

 9  public health service act, 42 USC 300n.

 

10        (3) (4) "County medical care facility" means a nursing care

 

11  facility, other than a hospital long-term care unit, which that

 

12  provides organized nursing care and medical treatment to 7 or

 

13  more unrelated individuals who are suffering or recovering from

 

14  illness, injury, or infirmity and which that is owned by a county

 

15  or counties.

 

16        (4) (5) "Direct access" means access to a patient or

 

17  resident or to a patient's or resident's property, financial

 

18  information, medical records, treatment information, or any other

 

19  identifying information.

 

20        (5) (6) "Freestanding surgical outpatient facility" means a

 

21  facility, other than the office of a physician, dentist,

 

22  podiatrist, or other private practice office, offering a surgical

 

23  procedure and related care that in the opinion of the attending

 

24  physician can be safely performed without requiring overnight

 

25  inpatient hospital care. It Freestanding surgical outpatient

 

26  facility does not include a surgical outpatient facility owned by

 

27  and operated as part of a hospital.

 


 1        (6) (7) "Good moral character" means that term as defined in

 

 2  section 1 of 1974 PA 381, MCL 338.41.

 

 3        Sec. 20106. (1) "Health facility or agency", except as

 

 4  provided in section 20115, means:

 

 5        (a) An ambulance operation, aircraft transport operation,

 

 6  nontransport prehospital life support operation, or medical first

 

 7  response service.

 

 8        (b) A clinical laboratory.

 

 9        (b) (c) A county medical care facility.

 

10        (c) (d) A freestanding surgical outpatient facility.

 

11        (d) (e) A health maintenance organization.

 

12        (e) (f) A home for the aged.

 

13        (f) (g) A hospital.

 

14        (g) (h) A nursing home.

 

15        (h) (i) A hospice.

 

16        (i) (j) A hospice residence.

 

17        (j) (k) A facility or agency listed in subdivisions (a) to

 

18  (h) (g) located in a university, college, or other educational

 

19  institution.

 

20        (2) "Health maintenance organization" means that term as

 

21  defined in section 3501 of the insurance code of 1956, 1956 PA

 

22  218, MCL 500.3501.

 

23        (3) "Home for the aged" means a supervised personal care

 

24  facility, other than a hotel, adult foster care facility,

 

25  hospital, nursing home, or county medical care facility that

 

26  provides room, board, and supervised personal care to 21 or more

 

27  unrelated, nontransient, individuals 60 years of age or older.

 


 1  Home for the aged includes a supervised personal care facility

 

 2  for 20 or fewer individuals 60 years of age or older if the

 

 3  facility is operated in conjunction with and as a distinct part

 

 4  of a licensed nursing home. Home for the aged does not include an

 

 5  area excluded from this definition by section 17(3) of the

 

 6  continuing care community disclosure act, 2014 PA 448, MCL

 

 7  554.917.

 

 8        (4) "Hospice" means a health care program that provides a

 

 9  coordinated set of services rendered at home or in outpatient or

 

10  institutional settings for individuals suffering from a disease

 

11  or condition with a terminal prognosis.

 

12        (5) "Hospital" means a facility offering inpatient,

 

13  overnight care, and services for observation, diagnosis, and

 

14  active treatment of an individual with a medical, surgical,

 

15  obstetric, chronic, or rehabilitative condition requiring the

 

16  daily direction or supervision of a physician. Hospital does not

 

17  include a mental health hospital licensed or operated by the

 

18  department of community health or a hospital operated by the

 

19  department of corrections.

 

20        (6) "Hospital long-term care unit" means a nursing care

 

21  facility, owned and operated by and as part of a hospital,

 

22  providing organized nursing care and medical treatment to 7 or

 

23  more unrelated individuals suffering or recovering from illness,

 

24  injury, or infirmity.

 

25        Sec. 20145. (1) Before contracting for and initiating a

 

26  construction project involving new construction, additions,

 

27  modernizations, or conversions of a health facility or agency

 


 1  with a capital expenditure of $1,000,000.00 or more, a person

 

 2  shall obtain a construction permit from the department. The

 

 3  department shall not issue the permit under this subsection

 

 4  unless the applicant holds a valid certificate of need if a

 

 5  certificate of need is required for the project pursuant to under

 

 6  part 222.

 

 7        (2) To protect the public health, safety, and welfare, the

 

 8  department may promulgate rules to require construction permits

 

 9  for projects other than those described in subsection (1) and the

 

10  submission of plans for other construction projects to expand or

 

11  change service areas and services provided.

 

12        (3) If a construction project requires a construction permit

 

13  under subsection (1) or (2), but does not require a certificate

 

14  of need under part 222, the department shall require the

 

15  applicant to submit information considered necessary by the

 

16  department to assure that the capital expenditure for the project

 

17  is not a covered capital expenditure as defined in section

 

18  22203(9).

 

19        (4) If a construction project requires a construction permit

 

20  under subsection (1), but does not require a certificate of need

 

21  under part 222, the department shall require the applicant to

 

22  submit information on a 1-page sheet, along with the application

 

23  for a construction permit, consisting of all of the following:

 

24        (a) A short description of the reason for the project and

 

25  the funding source.

 

26        (b) A contact person for further information, including

 

27  address and phone number.

 


 1        (c) The estimated resulting increase or decrease in annual

 

 2  operating costs.

 

 3        (d) The current governing board membership of the applicant.

 

 4        (e) The entity, if any, that owns the applicant.

 

 5        (5) The information filed under subsection (4) shall be made

 

 6  publicly available by the department by the same methods used to

 

 7  make information about certificate of need applications publicly

 

 8  available.

 

 9        (6) The review and approval of architectural plans and

 

10  narrative shall require that the proposed construction project is

 

11  designed and constructed in accord with applicable statutory and

 

12  other regulatory requirements. In performing a construction

 

13  permit review for a health facility or agency under this section,

 

14  the department shall, at a minimum, apply the standards contained

 

15  in the document entitled "Minimum Design Standards for Health

 

16  Care Facilities in Michigan" published by the department and

 

17  dated March 1998. July 2007. The standards are incorporated by

 

18  reference for purposes of this subsection. The department may

 

19  promulgate rules that are more stringent than the standards if

 

20  necessary to protect the public health, safety, and welfare.

 

21        (7) The department shall promulgate rules to further

 

22  prescribe the scope of construction projects and other

 

23  alterations subject to review under this section.

 

24        (8) The department may waive the applicability of this

 

25  section to a construction project or alteration if the waiver

 

26  will not affect the public health, safety, and welfare.

 

27        (9) Upon request by the person initiating a construction

 


 1  project, the department may review and issue a construction

 

 2  permit to a construction project that is not subject to

 

 3  subsection (1) or (2) if the department determines that the

 

 4  review will promote the public health, safety, and welfare.

 

 5        (10) The department shall assess a fee for each review

 

 6  conducted under this section. The fee is .5% of the first

 

 7  $1,000,000.00 of capital expenditure and .85% of any amount over

 

 8  $1,000,000.00 of capital expenditure, up to a maximum of

 

 9  $60,000.00.

 

10        (11) As used in this section, "capital expenditure" means

 

11  that term as defined in section 22203(2), except that it capital

 

12  expenditure does not include the cost of equipment that is not

 

13  fixed equipment.

 

14        Sec. 20155. (1) Except as otherwise provided in this section

 

15  and section 20155a, the department shall make annual and other

 

16  visits to each health facility or agency licensed under this

 

17  article for the purposes of survey, evaluation, and consultation.

 

18  at least 1 visit to each licensed health facility or agency every

 

19  3 years for survey and evaluation for the purpose of licensure. A

 

20  visit made according to a complaint shall be unannounced. Except

 

21  for a county medical care facility, a home for the aged, a

 

22  nursing home, or a hospice residence, the department shall

 

23  determine whether the visits that are not made according to a

 

24  complaint are announced or unannounced. Beginning June 20, 2001,

 

25  the The department shall ensure that each newly hired nursing

 

26  home surveyor, as part of his or her basic training, is assigned

 

27  full-time to a licensed nursing home for at least 10 days within

 


 1  a 14-day period to observe actual operations outside of the

 

 2  survey process before the trainee begins oversight

 

 3  responsibilities.

 

 4        (2) The state shall establish a process that ensures both of

 

 5  the following:

 

 6        (a) A newly hired nursing home surveyor shall not make

 

 7  independent compliance decisions during his or her training

 

 8  period.

 

 9        (b) A nursing home surveyor shall not be assigned as a

 

10  member of a survey team for a nursing home in which he or she

 

11  received training for 1 standard survey following the training

 

12  received in that nursing home.

 

13        (3) Beginning November 1, 2012, the The department shall

 

14  perform a criminal history check on all nursing home surveyors in

 

15  the manner provided for in section 20173a.

 

16        (4) A member of a survey team shall not be employed by a

 

17  licensed nursing home or a nursing home management company doing

 

18  business in this state at the time of conducting a survey under

 

19  this section. The department shall not assign an individual to be

 

20  a member of a survey team for purposes of a survey, evaluation,

 

21  or consultation visit at a nursing home in which he or she was an

 

22  employee within the preceding 3 years.

 

23        (5) Representatives from all nursing home provider

 

24  organizations and the state long-term care ombudsman or his or

 

25  her designee shall be invited to participate in the planning

 

26  process for the joint provider and surveyor training sessions.

 

27  The department shall include at least 1 representative from

 


 1  nursing home provider organizations that do not own or operate a

 

 2  nursing home representing 30 or more nursing homes statewide in

 

 3  internal surveyor group quality assurance training provided for

 

 4  the purpose of general clarification and interpretation of

 

 5  existing or new regulatory requirements and expectations.

 

 6        (6) The department shall make available online the general

 

 7  civil service position description related to the required

 

 8  qualifications for individual surveyors. The department shall use

 

 9  the required qualifications to hire, educate, develop, and

 

10  evaluate surveyors.

 

11        (7) The department shall ensure that each annual survey team

 

12  is composed of an interdisciplinary group of professionals, 1 of

 

13  whom must be a registered nurse. Other members may include social

 

14  workers, therapists, dietitians, pharmacists, administrators,

 

15  physicians, sanitarians, and others who may have the expertise

 

16  necessary to evaluate specific aspects of nursing home operation.

 

17        (8) Except as otherwise provided in this section and section

 

18  20155a, the department shall make at least a biennial visit to

 

19  each licensed clinical laboratory, each nursing home, and each

 

20  hospice residence for the purposes of survey, evaluation, and

 

21  consultation. The department shall semiannually provide for joint

 

22  training with nursing home surveyors and providers on at least 1

 

23  of the 10 most frequently issued federal citations in this state

 

24  during the past calendar year. The department shall develop a

 

25  protocol for the review of citation patterns compared to regional

 

26  outcomes and standards and complaints regarding the nursing home

 

27  survey process. The review will be included in the report

 


House Bill No. 4447 as amended May 27, 2015

 1  required under subsection (20). Except as otherwise provided in

 

 2  this subsection, beginning with his or her first full relicensure

 

 3  period after June 20, 2000, each member of a department nursing

 

 4  home survey team who is a health professional licensee under

 

 5  article 15 shall earn not less than 50% of his or her required

 

 6  continuing education credits, if any, in geriatric care. If a

 

 7  member of a nursing home survey team is a pharmacist licensed

 

 8  under article 15, he or she shall earn not less than 30% of his

 

 9  or her required continuing education credits in geriatric care.

 

10        (9) The department shall make a biennial visit to each

 

11  hospital for survey and evaluation for the purpose of licensure.

 

12  Subject to subsection (12), the department may waive the biennial

 

13  visit required by this subsection (1) if a hospital, as part of a

 

14  timely application for license renewal, health facility or

 

15  agency, requests a waiver and submits both of the following as

 

16  applicable and if all of the requirements of subsection (11) are

 

17  met:

 

18        (a) Evidence that it is currently fully accredited by a body

 

19  with expertise in hospital accreditation whose hospital

 

20  accreditations are the health facility or agency type and the

 

21  accrediting organization is accepted by the United States

 

22  department of health and human services Department of Health and

 

23  Human Services for purposes of section 1865 of part [C E] of title

 

24  XVIII of the social security act, 42 USC 1395bb.

 

25        (b) A copy of the most recent accreditation report, for the

 

26  hospital or executive summary, issued by a body described in

 

27  subdivision (a), and the hospital's health facility's or agency's

 


 1  responses to the accreditation report is submitted to the

 

 2  department at least 30 days from license renewal. Submission of

 

 3  an executive summary does not prevent or prohibit the department

 

 4  from requesting the entire accreditation report if the department

 

 5  considers it necessary.

 

 6        (c) For a nursing home, a standard federal certification

 

 7  survey conducted within the immediately preceding 9 to 15 months

 

 8  that shows substantial compliance or has an accepted plan of

 

 9  correction, if applicable.

 

10        (10) Except as provided in subsection (14), accreditation

 

11  information provided to the department under subsection (9) is

 

12  confidential, is not a public record, and is not subject to court

 

13  subpoena. The department shall use the accreditation information

 

14  only as provided in this section and shall return the

 

15  accreditation information to the hospital within a reasonable

 

16  time properly destroy the documentation after a decision on the

 

17  waiver request is made.

 

18        (11) The department shall grant a waiver under subsection

 

19  (9) if the accreditation report submitted under subsection (9)(b)

 

20  is less than 2 3 years old or the standard federal survey

 

21  submitted under subsection (9)(c) is less than 15 months old and

 

22  there is no indication of substantial noncompliance with

 

23  licensure standards or of deficiencies that represent a threat to

 

24  public safety or patient care. in the report, in complaints

 

25  involving the hospital, or in any other information available to

 

26  the department. If the accreditation report or standard federal

 

27  survey is 2 or more years too old, the department may do 1 of the

 


 1  following:

 

 2        (a) Grant an extension of the hospital's current license

 

 3  until the next accreditation survey is completed by the body

 

 4  described in subsection (9)(a).

 

 5        (b) Grant a waiver under subsection (9) based on the

 

 6  accreditation report that is 2 or more years old, on condition

 

 7  that the hospital promptly submit the next accreditation report

 

 8  to the department.

 

 9        (c) Deny deny the waiver request and conduct the visits

 

10  required under subsection (9). Denial of a waiver request by the

 

11  department is not subject to appeal.

 

12        (12) This section does not prohibit the department from

 

13  citing a violation of this part during a survey, conducting

 

14  investigations or inspections according to section 20156, or

 

15  conducting surveys of health facilities or agencies for the

 

16  purpose of complaint investigations or federal certification.

 

17  This section does not prohibit the bureau of fire services

 

18  created in section 1b of the fire prevention code, 1941 PA 207,

 

19  MCL 29.1b, from conducting annual surveys of hospitals, nursing

 

20  homes, and county medical care facilities.

 

21        (13) At the request of a health facility or agency, the

 

22  department may conduct a consultation engineering survey of a

 

23  health facility and provide professional advice and consultation

 

24  regarding health facility construction and design. A health

 

25  facility or agency may request a voluntary consultation survey

 

26  under this subsection at any time between licensure surveys. The

 

27  fees for a consultation engineering survey are the same as the

 


 1  fees established for waivers under section 20161(10).20161(8).

 

 2        (14) If the department determines that substantial

 

 3  noncompliance with licensure standards exists or that

 

 4  deficiencies that represent a threat to public safety or patient

 

 5  care exist based on a review of an accreditation report submitted

 

 6  under subsection (9)(b), the department shall prepare a written

 

 7  summary of the substantial noncompliance or deficiencies and the

 

 8  hospital's health facility's or agency's response to the

 

 9  department's determination. The department's written summary and

 

10  the hospital's health facility's or agency's response are public

 

11  documents.

 

12        (15) The department or a local health department shall

 

13  conduct investigations or inspections, other than inspections of

 

14  financial records, of a county medical care facility, home for

 

15  the aged, nursing home, or hospice residence without prior notice

 

16  to the health facility or agency. An employee of a state agency

 

17  charged with investigating or inspecting the health facility or

 

18  agency or an employee of a local health department who directly

 

19  or indirectly gives prior notice regarding an investigation or an

 

20  inspection, other than an inspection of the financial records, to

 

21  the health facility or agency or to an employee of the health

 

22  facility or agency, is guilty of a misdemeanor. Consultation

 

23  visits that are not for the purpose of annual or follow-up

 

24  inspection or survey may be announced.

 

25        (16) The department shall maintain a record indicating

 

26  whether a visit and inspection is announced or unannounced.

 

27  Survey findings gathered at each health facility or agency during

 


 1  each visit and inspection, whether announced or unannounced,

 

 2  shall be taken into account in licensure decisions.

 

 3        (17) The department shall require periodic reports and a

 

 4  health facility or agency shall give the department access to

 

 5  books, records, and other documents maintained by a health

 

 6  facility or agency to the extent necessary to carry out the

 

 7  purpose of this article and the rules promulgated under this

 

 8  article. The department shall not divulge or disclose the

 

 9  contents of the patient's clinical records in a manner that

 

10  identifies an individual except under court order. The department

 

11  may copy health facility or agency records as required to

 

12  document findings. Surveyors shall use electronic resident

 

13  information, whenever available, as a source of survey-related

 

14  data and shall request facility assistance to access the system

 

15  to maximize data export.

 

16        (18) The department may delegate survey, evaluation, or

 

17  consultation functions to another state agency or to a local

 

18  health department qualified to perform those functions. However,

 

19  the The department shall not delegate survey, evaluation, or

 

20  consultation functions to a local health department that owns or

 

21  operates a hospice or hospice residence licensed under this

 

22  article. The delegation shall be by cost reimbursement contract

 

23  between the department and the state agency or local health

 

24  department. Survey, evaluation, or consultation functions shall

 

25  not be delegated to nongovernmental agencies, except as provided

 

26  in this section. The department may accept voluntary inspections

 

27  performed by an accrediting body with expertise in clinical

 


 1  laboratory accreditation under part 205 if the accrediting body

 

 2  utilizes forms acceptable to the department, applies the same

 

 3  licensing standards as applied to other clinical laboratories,

 

 4  and provides the same information and data usually filed by the

 

 5  department's own employees when engaged in similar inspections or

 

 6  surveys. The voluntary inspection described in this subsection

 

 7  shall be agreed upon by both the licensee and the department.

 

 8        (19) If, upon investigation, the department or a state

 

 9  agency determines that an individual licensed to practice a

 

10  profession in this state has violated the applicable licensure

 

11  statute or the rules promulgated under that statute, the

 

12  department, state agency, or local health department shall

 

13  forward the evidence it has to the appropriate licensing agency.

 

14        (20) The department may consolidate all information provided

 

15  for any report required under this section and section 20155a

 

16  into a single report. The department shall report to the

 

17  appropriations subcommittees, the senate and house of

 

18  representatives standing committees having jurisdiction over

 

19  issues involving senior citizens, and the fiscal agencies on

 

20  March 1 of each year on the initial and follow-up surveys

 

21  conducted on all nursing homes in this state. The report shall

 

22  include all of the following information:

 

23        (a) The number of surveys conducted.

 

24        (b) The number requiring follow-up surveys.

 

25        (c) The average number of citations per nursing home for the

 

26  most recent calendar year.

 

27        (d) The number of night and weekend complaints filed.

 


 1        (e) The number of night and weekend responses to complaints

 

 2  conducted by the department.

 

 3        (f) The average length of time for the department to respond

 

 4  to a complaint filed against a nursing home.

 

 5        (g) The number and percentage of citations disputed through

 

 6  informal dispute resolution and independent informal dispute

 

 7  resolution.

 

 8        (h) The number and percentage of citations overturned or

 

 9  modified, or both.

 

10        (i) The review of citation patterns developed under

 

11  subsection (8).

 

12        (j) Implementation of the clinical process guidelines and

 

13  the impact of the guidelines on resident care.

 

14        (k) Information regarding the progress made on implementing

 

15  the administrative and electronic support structure to

 

16  efficiently coordinate all nursing home licensing and

 

17  certification functions.

 

18        (l) The number of annual standard surveys of nursing homes

 

19  that were conducted during a period of open survey or enforcement

 

20  cycle.

 

21        (m) The number of abbreviated complaint surveys that were

 

22  not conducted on consecutive surveyor workdays.

 

23        (n) The percent of all form CMS-2567 reports of findings

 

24  that were released to the nursing home within the 10-working-day

 

25  requirement.

 

26        (o) The percent of provider notifications of acceptance or

 

27  rejection of a plan of correction that were released to the

 


 1  nursing home within the 10-working-day requirement.

 

 2        (p) The percent of first revisits that were completed within

 

 3  60 days from the date of survey completion.

 

 4        (q) The percent of second revisits that were completed

 

 5  within 85 days from the date of survey completion.

 

 6        (r) The percent of letters of compliance notification to the

 

 7  nursing home that were released within 10 working days of the

 

 8  date of the completion of the revisit.

 

 9        (s) A summary of the discussions from the meetings required

 

10  in subsection (24).

 

11        (t) The number of nursing homes that participated in a

 

12  recognized quality improvement program as described under section

 

13  20155a(3).

 

14        (21) The department shall report March 1 of each year to the

 

15  standing committees on appropriations and the standing committees

 

16  having jurisdiction over issues involving senior citizens in the

 

17  senate and the house of representatives on all of the following:

 

18        (a) The percentage of nursing home citations that are

 

19  appealed through the informal dispute resolution process.

 

20        (b) The number and percentage of nursing home citations that

 

21  are appealed and supported, amended, or deleted through the

 

22  informal dispute resolution process.

 

23        (c) A summary of the quality assurance review of the amended

 

24  citations and related survey retraining efforts to improve

 

25  consistency among surveyors and across the survey administrative

 

26  unit that occurred in the year being reported.

 

27        (22) Subject to subsection (23), a clarification work group

 


 1  comprised of the department in consultation with a nursing home

 

 2  resident or a member of a nursing home resident's family, nursing

 

 3  home provider groups, the American medical directors association,

 

 4  Medical Directors Association, the state long-term care

 

 5  ombudsman, and the federal centers for medicare and medicaid

 

 6  services Centers for Medicare and Medicaid Services shall clarify

 

 7  the following terms as those terms are used in title XVIII and

 

 8  title XIX and applied by the department to provide more

 

 9  consistent regulation of nursing homes in this state:

 

10        (a) Immediate jeopardy.

 

11        (b) Harm.

 

12        (c) Potential harm.

 

13        (d) Avoidable.

 

14        (e) Unavoidable.

 

15        (23) All of the following clarifications developed under

 

16  subsection (22) apply for purposes of subsection (22):

 

17        (a) Specifically, the term "immediate jeopardy" means a

 

18  situation in which immediate corrective action is necessary

 

19  because the nursing home's noncompliance with 1 or more

 

20  requirements of participation has caused or is likely to cause

 

21  serious injury, harm, impairment, or death to a resident

 

22  receiving care in a nursing home.

 

23        (b) The likelihood of immediate jeopardy is reasonably

 

24  higher if there is evidence of a flagrant failure by the nursing

 

25  home to comply with a clinical process guideline adopted under

 

26  subsection (25) than if the nursing home has substantially and

 

27  continuously complied with those guidelines. If federal

 


 1  regulations and guidelines are not clear, and if the clinical

 

 2  process guidelines have been recognized, a process failure giving

 

 3  rise to an immediate jeopardy may involve an egregious widespread

 

 4  or repeated process failure and the absence of reasonable efforts

 

 5  to detect and prevent the process failure.

 

 6        (c) In determining whether or not there is immediate

 

 7  jeopardy, the survey agency should consider at least all of the

 

 8  following:

 

 9        (i) Whether the nursing home could reasonably have been

 

10  expected to know about the deficient practice and to stop it, but

 

11  did not stop the deficient practice.

 

12        (ii) Whether the nursing home could reasonably have been

 

13  expected to identify the deficient practice and to correct it,

 

14  but did not correct the deficient practice.

 

15        (iii) Whether the nursing home could reasonably have been

 

16  expected to anticipate that serious injury, serious harm,

 

17  impairment, or death might result from continuing the deficient

 

18  practice, but did not so anticipate.

 

19        (iv) Whether the nursing home could reasonably have been

 

20  expected to know that a widely accepted high-risk practice is or

 

21  could be problematic, but did not know.

 

22        (v) Whether the nursing home could reasonably have been

 

23  expected to detect the process problem in a more timely fashion,

 

24  but did not so detect.

 

25        (d) The existence of 1 or more of the factors described in

 

26  subdivision (c), and especially the existence of 3 or more of

 

27  those factors simultaneously, may lead to a conclusion that the

 


 1  situation is one in which the nursing home's practice makes

 

 2  adverse events likely to occur if immediate intervention is not

 

 3  undertaken, and therefore constitutes immediate jeopardy. If none

 

 4  of the factors described in subdivision (c) is present, the

 

 5  situation may involve harm or potential harm that is not

 

 6  immediate jeopardy.

 

 7        (e) Specifically, "actual harm" means a negative outcome to

 

 8  a resident that has compromised the resident's ability to

 

 9  maintain or reach, or both, his or her highest practicable

 

10  physical, mental, and psychosocial well-being as defined by an

 

11  accurate and comprehensive resident assessment, plan of care, and

 

12  provision of services. Harm does not include a deficient practice

 

13  that only may cause or has caused limited consequences to the

 

14  resident.

 

15        (f) For purposes of subdivision (e), in determining whether

 

16  a negative outcome is of limited consequence, if the "state

 

17  operations manual" or "the guidance to surveyors" published by

 

18  the federal centers for medicare and medicaid services Centers

 

19  for Medicare and Medicaid Services does not provide specific

 

20  guidance, the department may consider whether most people in

 

21  similar circumstances would feel that the damage was of such

 

22  short duration or impact as to be inconsequential or trivial. In

 

23  such a case, the consequence of a negative outcome may be

 

24  considered more limited if it occurs in the context of overall

 

25  procedural consistency with an accepted clinical process

 

26  guideline adopted under subsection (25), as compared to a

 

27  substantial inconsistency with or variance from the guideline.

 


 1        (g) For purposes of subdivision (e), if the publications

 

 2  described in subdivision (f) do not provide specific guidance,

 

 3  the department may consider the degree of a nursing home's

 

 4  adherence to a clinical process guideline adopted under

 

 5  subsection (25) in considering whether the degree of compromise

 

 6  and future risk to the resident constitutes actual harm. The risk

 

 7  of significant compromise to the resident may be considered

 

 8  greater in the context of substantial deviation from the

 

 9  guidelines than in the case of overall adherence.

 

10        (h) To improve consistency and to avoid disputes over

 

11  avoidable and unavoidable negative outcomes, nursing homes and

 

12  survey agencies must have a common understanding of accepted

 

13  process guidelines and of the circumstances under which it can

 

14  reasonably be said that certain actions or inactions will lead to

 

15  avoidable negative outcomes. If the "state operations manual" or

 

16  "the guidance to surveyors" published by the federal centers for

 

17  medicare and medicaid services Centers for Medicare and Medicaid

 

18  Services is not specific, a nursing home's overall documentation

 

19  of adherence to a clinical process guideline with a process

 

20  indicator adopted under subsection (25) is relevant information

 

21  in considering whether a negative outcome was avoidable or

 

22  unavoidable and may be considered in the application of that

 

23  term.

 

24        (24) The department shall conduct a quarterly meeting and

 

25  invite appropriate stakeholders. Appropriate stakeholders shall

 

26  include at least 1 representative from each nursing home provider

 

27  organization that does not own or operate a nursing home

 


 1  representing 30 or more nursing homes statewide, the state long-

 

 2  term care ombudsman or his or her designee, and any other

 

 3  clinical experts. Individuals who participate in these quarterly

 

 4  meetings, in conjunction with the department, may designate

 

 5  advisory workgroups to develop recommendations on the discussion

 

 6  topics that should include, at a minimum, all of the following:

 

 7        (a) Opportunities for enhanced promotion of nursing home

 

 8  performance, including, but not limited to, programs that

 

 9  encourage and reward providers that strive for excellence.

 

10        (b) Seeking quality improvement to the survey and

 

11  enforcement process, including clarifications to process-related

 

12  policies and protocols that include, but are not limited to, all

 

13  of the following:

 

14        (i) Improving the surveyors' quality and preparedness.

 

15        (ii) Enhanced communication between regulators, surveyors,

 

16  providers, and consumers.

 

17        (iii) Ensuring fair enforcement and dispute resolution by

 

18  identifying methods or strategies that may resolve identified

 

19  problems or concerns.

 

20        (c) Promoting transparency across provider and surveyor

 

21  communities, including, but not limited to, all of the following:

 

22        (i) Applying regulations in a consistent manner and

 

23  evaluating changes that have been implemented to resolve

 

24  identified problems and concerns.

 

25        (ii) Providing consumers with information regarding changes

 

26  in policy and interpretation.

 

27        (iii) Identifying positive and negative trends and factors

 


 1  contributing to those trends in the areas of resident care,

 

 2  deficient practices, and enforcement.

 

 3        (d) Clinical process guidelines.

 

 4        (25) Subject to subsection (27), the department shall

 

 5  develop and adopt clinical process guidelines. The department

 

 6  shall establish and adopt clinical process guidelines and

 

 7  compliance protocols with outcome measures for all of the

 

 8  following areas and for other topics where the department

 

 9  determines that clarification will benefit providers and

 

10  consumers of long-term care:

 

11        (a) Bed rails.

 

12        (b) Adverse drug effects.

 

13        (c) Falls.

 

14        (d) Pressure sores.

 

15        (e) Nutrition and hydration including, but not limited to,

 

16  heat-related stress.

 

17        (f) Pain management.

 

18        (g) Depression and depression pharmacotherapy.

 

19        (h) Heart failure.

 

20        (i) Urinary incontinence.

 

21        (j) Dementia.

 

22        (k) Osteoporosis.

 

23        (l) Altered mental states.

 

24        (m) Physical and chemical restraints.

 

25        (n) Culture-change principles, person-centered caring, and

 

26  self-directed care.

 

27        (26) The department shall biennially review and update all

 


 1  clinical process guidelines as needed and shall continue to

 

 2  develop and implement clinical process guidelines for topics that

 

 3  have not been developed from the list in subsection (25) and

 

 4  other topics identified as a result of the meetings required in

 

 5  subsection (24). The department shall consider recommendations

 

 6  from an advisory workgroup created under subsection (24) on

 

 7  clinical process guidelines. The department shall include

 

 8  training on new and revised clinical process guidelines in the

 

 9  joint provider and surveyor training sessions as those clinical

 

10  process guidelines are developed and revised.

 

11        (27) Beginning November 1, 2012, representatives

 

12  Representatives from each nursing home provider organization that

 

13  does not own or operate a nursing home representing 30 or more

 

14  nursing homes statewide and the state long-term care ombudsman or

 

15  his or her designee shall be permanent members of any clinical

 

16  advisory workgroup created under subsection (24). The department

 

17  shall issue survey certification memorandums to providers to

 

18  announce or clarify changes in the interpretation of regulations.

 

19        (28) The department shall maintain the process by which the

 

20  department director of the division of nursing home monitoring or

 

21  his or her designee or the director of the division of operations

 

22  or his or her designee reviews and authorizes the issuance of a

 

23  citation for immediate jeopardy or substandard quality of care

 

24  before the statement of deficiencies is made final. The review

 

25  shall be to assure that the applicable concepts, clinical process

 

26  guidelines, and other tools contained in subsections (25) to (27)

 

27  are being used consistently, accurately, and effectively. As used

 


 1  in this subsection, "immediate jeopardy" and "substandard quality

 

 2  of care" mean those terms as defined by the federal centers for

 

 3  medicare and medicaid services.Centers for Medicare and Medicaid

 

 4  Services.

 

 5        (29) Upon availability of funds, the department shall give

 

 6  grants, awards, or other recognition to nursing homes to

 

 7  encourage the rapid implementation or maintenance of the clinical

 

 8  process guidelines adopted under subsection (25).

 

 9        (30) The department shall instruct and train the surveyors

 

10  in the clinical process guidelines adopted under subsection (25)

 

11  in citing deficiencies.

 

12        (31) A nursing home shall post the nursing home's survey

 

13  report in a conspicuous place within the nursing home for public

 

14  review.

 

15        (32) Nothing in this amendatory act shall be construed to

 

16  limit section limits the requirements of related state and

 

17  federal law.

 

18        (33) As used in this section:

 

19        (a) "Consecutive days" means calendar days, but does not

 

20  include Saturday, Sunday, or state- or federally-recognized

 

21  holidays.

 

22        (b) "Form CMS-2567" means the federal centers for medicare

 

23  and medicaid services' Centers for Medicare and Medicaid

 

24  Services' form for the statement of deficiencies and plan of

 

25  correction or a successor form serving the same purpose.

 

26        (c) "Title XVIII" means title XVIII of the social security

 

27  act, 42 USC 1395 to 1395kkk.

 


 1        (d) "Title XIX" means title XIX of the social security act,

 

 2  42 USC 1396 to 1396w-5.

 

 3        Sec. 20161. (1) The department shall assess fees and other

 

 4  assessments for health facility and agency licenses and

 

 5  certificates of need on an annual basis as provided in this

 

 6  article. Except Until October 1, 2019, except as otherwise

 

 7  provided in this article, fees and assessments shall be paid as

 

 8  provided in the following schedule:

 

 

     (a) Freestanding surgical

10 outpatient facilities................$238.00 $500.00 per facility

11                                      license.

12      (b) Hospitals...................$8.28 $500.00 per facility

13                                      license and $10.00 per

14                                      licensed bed.

15      (c) Nursing homes, county

16 medical care facilities, and

17 hospital long-term care units........$2.20 $500.00 per facility

18                                      license and $3.00 per

19                                      licensed bed over 100

20                                      licensed beds.

21      (d) Homes for the aged..........$6.27 per licensed bed.

22      (e) Clinical laboratories.......$475.00 per laboratory.

23      (e) Hospice agencies............$500.00 per agency license.

24      (f) Hospice residences..........$200.00 $500.00 per

25                                      facility survey; license

26                                      and $20.00 $5.00 per

27                                      licensed bed.

28      (g) Subject to subsection


(13), (11), quality assurance assessment

for nursing homes and hospital

long-term care units.................an amount resulting

                                     in not more than 6%

                                     of total industry

                                     revenues.

     (h) Subject to subsection

(14), (12), quality assurance assessment

for hospitals........................at a fixed or variable

10                                      rate that generates

11                                      funds not more than the

12                                      maximum allowable under

13                                     the federal matching

14                                      requirements, after

15                                      consideration for the

16                                      amounts in subsection

17                                      (14)(a) (12)(a) and (i).

18      (i) Initial licensure

19 application fee for subdivisions

20 (a), (b), (c), (e), and (f)..........$2,000.00 per initial

21                                      license.

 

 

22        (2) If a hospital requests the department to conduct a

 

23  certification survey for purposes of title XVIII or title XIX of

 

24  the social security act, the hospital shall pay a license fee

 

25  surcharge of $23.00 per bed. As used in this subsection, "title

 

26  XVIII" and "title XIX" mean those terms as defined in section

 

27  20155.

 

28        (3) All of the following apply to the assessment under this


 

 1  section for certificates of need:

 

 2        (a) The base fee for a certificate of need is $3,000.00 for

 

 3  each application. For a project requiring a projected capital

 

 4  expenditure of more than $500,000.00 but less than $4,000,000.00,

 

 5  an additional fee of $5,000.00 is added to the base fee. For a

 

 6  project requiring a projected capital expenditure of

 

 7  $4,000,000.00 or more but less than $10,000,000.00, an additional

 

 8  fee of $8,000.00 is added to the base fee. For a project

 

 9  requiring a projected capital expenditure of $10,000,000.00 or

 

10  more, an additional fee of $12,000.00 is added to the base fee.

 

11        (b) In addition to the fees under subdivision (a), the

 

12  applicant shall pay $3,000.00 for any designated complex project

 

13  including a project scheduled for comparative review or for a

 

14  consolidated licensed health facility application for acquisition

 

15  or replacement.

 

16        (c) If required by the department, the applicant shall pay

 

17  $1,000.00 for a certificate of need application that receives

 

18  expedited processing at the request of the applicant.

 

19        (d) The department shall charge a fee of $500.00 to review

 

20  any letter of intent requesting or resulting in a waiver from

 

21  certificate of need review and any amendment request to an

 

22  approved certificate of need.

 

23        (e) A health facility or agency that offers certificate of

 

24  need covered clinical services shall pay $100.00 for each

 

25  certificate of need approved covered clinical service as part of

 

26  the certificate of need annual survey at the time of submission

 

27  of the survey data.


 

 1        (f) The department of community health shall use the fees

 

 2  collected under this subsection only to fund the certificate of

 

 3  need program. Funds remaining in the certificate of need program

 

 4  at the end of the fiscal year shall not lapse to the general fund

 

 5  but shall remain available to fund the certificate of need

 

 6  program in subsequent years.

 

 7        (4) If licensure is for more than 1 year, the fees described

 

 8  in subsection (1) are multiplied by the number of years for which

 

 9  the license is issued, and the total amount of the fees shall be

 

10  collected in the year in which the license is issued.A license

 

11  issued under this part is effective for no longer than 1 year

 

12  after the date of issuance.

 

13        (5) Fees described in this section are payable to the

 

14  department at the time an application for a license, permit, or

 

15  certificate is submitted. If an application for a license,

 

16  permit, or certificate is denied or if a license, permit, or

 

17  certificate is revoked before its expiration date, the department

 

18  shall not refund fees paid to the department.

 

19        (6) The fee for a provisional license or temporary permit is

 

20  the same as for a license. A license may be issued at the

 

21  expiration date of a temporary permit without an additional fee

 

22  for the balance of the period for which the fee was paid if the

 

23  requirements for licensure are met.

 

24        (7) The department may charge a fee to recover the cost of

 

25  purchase or production and distribution of proficiency evaluation

 

26  samples that are supplied to clinical laboratories under section

 

27  20521(3).


 

 1        (8) In addition to the fees imposed under subsection (1), a

 

 2  clinical laboratory shall submit a fee of $25.00 to the

 

 3  department for each reissuance during the licensure period of the

 

 4  clinical laboratory's license.

 

 5        (7) (9) The cost of licensure activities shall be supported

 

 6  by license fees.

 

 7        (8) (10) The application fee for a waiver under section

 

 8  21564 is $200.00 plus $40.00 per hour for the professional

 

 9  services and travel expenses directly related to processing the

 

10  application. The travel expenses shall be calculated in

 

11  accordance with the state standardized travel regulations of the

 

12  department of technology, management, and budget in effect at the

 

13  time of the travel.

 

14        (9) (11) An applicant for licensure or renewal of licensure

 

15  under part 209 shall pay the applicable fees set forth in part

 

16  209.

 

17        (10) (12) Except as otherwise provided in this section, the

 

18  fees and assessments collected under this section shall be

 

19  deposited in the state treasury, to the credit of the general

 

20  fund. The department may use the unreserved fund balance in fees

 

21  and assessments for the criminal history check program required

 

22  under this article.

 

23        (11) (13) The quality assurance assessment collected under

 

24  subsection (1)(g) and all federal matching funds attributed to

 

25  that assessment shall be used only for the following purposes and

 

26  under the following specific circumstances:

 

27        (a) The quality assurance assessment and all federal


 

 1  matching funds attributed to that assessment shall be used to

 

 2  finance medicaid Medicaid nursing home reimbursement payments.

 

 3  Only licensed nursing homes and hospital long-term care units

 

 4  that are assessed the quality assurance assessment and

 

 5  participate in the medicaid Medicaid program are eligible for

 

 6  increased per diem medicaid Medicaid reimbursement rates under

 

 7  this subdivision. A nursing home or long-term care unit that is

 

 8  assessed the quality assurance assessment and that does not pay

 

 9  the assessment required under subsection (1)(g) in accordance

 

10  with subdivision (c)(i) or in accordance with a written payment

 

11  agreement with the state shall not receive the increased per diem

 

12  medicaid Medicaid reimbursement rates under this subdivision

 

13  until all of its outstanding quality assurance assessments and

 

14  any penalties assessed pursuant to under subdivision (f) have

 

15  been paid in full. Nothing in this This subdivision shall be

 

16  construed to does not authorize or require the department to

 

17  overspend tax revenue in violation of the management and budget

 

18  act, 1984 PA 431, MCL 18.1101 to 18.1594.

 

19        (b) Except as otherwise provided under subdivision (c),

 

20  beginning October 1, 2005, the quality assurance assessment is

 

21  based on the total number of patient days of care each nursing

 

22  home and hospital long-term care unit provided to nonmedicare

 

23  non-Medicare patients within the immediately preceding year and

 

24  shall be assessed at a uniform rate on October 1, 2005 and

 

25  subsequently on October 1 of each following year, and is payable

 

26  on a quarterly basis, the first payment due 90 days after the

 

27  date the assessment is assessed.


 

 1        (c) Within 30 days after September 30, 2005, the department

 

 2  shall submit an application to the federal centers for medicare

 

 3  and medicaid services Centers for Medicare and Medicaid Services

 

 4  to request a waiver pursuant according to 42 CFR 433.68(e) to

 

 5  implement this subdivision as follows:

 

 6        (i) If the waiver is approved, the quality assurance

 

 7  assessment rate for a nursing home or hospital long-term care

 

 8  unit with less than 40 licensed beds or with the maximum number,

 

 9  or more than the maximum number, of licensed beds necessary to

 

10  secure federal approval of the application is $2.00 per

 

11  nonmedicare non-Medicare patient day of care provided within the

 

12  immediately preceding year or a rate as otherwise altered on the

 

13  application for the waiver to obtain federal approval. If the

 

14  waiver is approved, for all other nursing homes and long-term

 

15  care units the quality assurance assessment rate is to be

 

16  calculated by dividing the total statewide maximum allowable

 

17  assessment permitted under subsection (1)(g) less the total

 

18  amount to be paid by the nursing homes and long-term care units

 

19  with less than 40 or with the maximum number, or more than the

 

20  maximum number, of licensed beds necessary to secure federal

 

21  approval of the application by the total number of nonmedicare

 

22  non-Medicare patient days of care provided within the immediately

 

23  preceding year by those nursing homes and long-term care units

 

24  with more than 39, but less than the maximum number of licensed

 

25  beds necessary to secure federal approval. The quality assurance

 

26  assessment, as provided under this subparagraph, shall be

 

27  assessed in the first quarter after federal approval of the


 

 1  waiver and shall be subsequently assessed on October 1 of each

 

 2  following year, and is payable on a quarterly basis, the first

 

 3  payment due 90 days after the date the assessment is assessed.

 

 4        (ii) If the waiver is approved, continuing care retirement

 

 5  centers are exempt from the quality assurance assessment if the

 

 6  continuing care retirement center requires each center resident

 

 7  to provide an initial life interest payment of $150,000.00, on

 

 8  average, per resident to ensure payment for that resident's

 

 9  residency and services and the continuing care retirement center

 

10  utilizes all of the initial life interest payment before the

 

11  resident becomes eligible for medical assistance under the

 

12  state's medicaid Medicaid plan. As used in this subparagraph,

 

13  "continuing care retirement center" means a nursing care facility

 

14  that provides independent living services, assisted living

 

15  services, and nursing care and medical treatment services, in a

 

16  campus-like setting that has shared facilities or common areas,

 

17  or both.

 

18        (d) Beginning May 10, 2002, the department of community

 

19  health shall increase the per diem nursing home medicaid Medicaid

 

20  reimbursement rates for the balance of that year. For each

 

21  subsequent year in which the quality assurance assessment is

 

22  assessed and collected, the department of community health shall

 

23  maintain the medicaid Medicaid nursing home reimbursement payment

 

24  increase financed by the quality assurance assessment.

 

25        (e) The department of community health shall implement this

 

26  section in a manner that complies with federal requirements

 

27  necessary to assure ensure that the quality assurance assessment


 

 1  qualifies for federal matching funds.

 

 2        (f) If a nursing home or a hospital long-term care unit

 

 3  fails to pay the assessment required by subsection (1)(g), the

 

 4  department of community health may assess the nursing home or

 

 5  hospital long-term care unit a penalty of 5% of the assessment

 

 6  for each month that the assessment and penalty are not paid up to

 

 7  a maximum of 50% of the assessment. The department of community

 

 8  health may also refer for collection to the department of

 

 9  treasury past due amounts consistent with section 13 of 1941 PA

 

10  122, MCL 205.13.

 

11        (g) The medicaid Medicaid nursing home quality assurance

 

12  assessment fund is established in the state treasury. The

 

13  department of community health shall deposit the revenue raised

 

14  through the quality assurance assessment with the state treasurer

 

15  for deposit in the medicaid Medicaid nursing home quality

 

16  assurance assessment fund.

 

17        (h) The department of community health shall not implement

 

18  this subsection in a manner that conflicts with 42 USC 1396b(w).

 

19        (i) The quality assurance assessment collected under

 

20  subsection (1)(g) shall be prorated on a quarterly basis for any

 

21  licensed beds added to or subtracted from a nursing home or

 

22  hospital long-term care unit since the immediately preceding July

 

23  1. Any adjustments in payments are due on the next quarterly

 

24  installment due date.

 

25        (j) In each fiscal year governed by this subsection,

 

26  medicaid Medicaid reimbursement rates shall not be reduced below

 

27  the medicaid Medicaid reimbursement rates in effect on April 1,


 

 1  2002 as a direct result of the quality assurance assessment

 

 2  collected under subsection (1)(g).

 

 3        (k) The state retention amount of the quality assurance

 

 4  assessment collected pursuant to under subsection (1)(g) shall be

 

 5  equal to 13.2% of the federal funds generated by the nursing

 

 6  homes and hospital long-term care units quality assurance

 

 7  assessment, including the state retention amount. The state

 

 8  retention amount shall be appropriated each fiscal year to the

 

 9  department of community health to support medicaid Medicaid

 

10  expenditures for long-term care services. These funds shall

 

11  offset an identical amount of general fund/general purpose

 

12  revenue originally appropriated for that purpose.

 

13        (l) Beginning October 1, 2015, 2019, the department shall no

 

14  longer assess or collect the quality assurance assessment or

 

15  apply for federal matching funds. The quality assurance

 

16  assessment collected under subsection (1)(g) shall no longer be

 

17  assessed or collected after September 30, 2011, in the event that

 

18  the quality assurance assessment is not eligible for federal

 

19  matching funds. Any portion of the quality assurance assessment

 

20  collected from a nursing home or hospital long-term care unit

 

21  that is not eligible for federal matching funds shall be returned

 

22  to the nursing home or hospital long-term care unit.

 

23        (12) (14) The quality assurance dedication is an earmarked

 

24  assessment collected under subsection (1)(h). That assessment and

 

25  all federal matching funds attributed to that assessment shall be

 

26  used only for the following purpose and under the following

 

27  specific circumstances:


 

 1        (a) To maintain the increased medicaid Medicaid

 

 2  reimbursement rate increases as provided for in subdivision (c).

 

 3        (b) The quality assurance assessment shall be assessed on

 

 4  all net patient revenue, before deduction of expenses, less

 

 5  medicare Medicare net revenue, as reported in the most recently

 

 6  available medicare Medicare cost report and is payable on a

 

 7  quarterly basis, the first payment due 90 days after the date the

 

 8  assessment is assessed. As used in this subdivision, "medicare

 

 9  "Medicare net revenue" includes medicare Medicare payments and

 

10  amounts collected for coinsurance and deductibles.

 

11        (c) Beginning October 1, 2002, the department of community

 

12  health shall increase the hospital medicaid Medicaid

 

13  reimbursement rates for the balance of that year. For each

 

14  subsequent year in which the quality assurance assessment is

 

15  assessed and collected, the department of community health shall

 

16  maintain the hospital medicaid Medicaid reimbursement rate

 

17  increase financed by the quality assurance assessments.

 

18        (d) The department of community health shall implement this

 

19  section in a manner that complies with federal requirements

 

20  necessary to assure ensure that the quality assurance assessment

 

21  qualifies for federal matching funds.

 

22        (e) If a hospital fails to pay the assessment required by

 

23  subsection (1)(h), the department of community health may assess

 

24  the hospital a penalty of 5% of the assessment for each month

 

25  that the assessment and penalty are not paid up to a maximum of

 

26  50% of the assessment. The department of community health may

 

27  also refer for collection to the department of treasury past due


House Bill No. 4447 as amended May 27, 2015

 

 1  amounts consistent with section 13 of 1941 PA 122, MCL 205.13.

 

 2        (f) The hospital quality assurance assessment fund is

 

 3  established in the state treasury. The department of community

 

 4  health shall deposit the revenue raised through the quality

 

 5  assurance assessment with the state treasurer for deposit in the

 

 6  hospital quality assurance assessment fund.

 

 7        (g) In each fiscal year governed by this subsection, the

 

 8  quality assurance assessment shall only be collected and expended

 

 9  if medicaid Medicaid hospital inpatient DRG and outpatient

 

10  reimbursement rates and disproportionate share hospital and

 

11  graduate medical education payments are not below the level of

 

12  rates and payments in effect on April 1, 2002 as a direct result

 

13  of the quality assurance assessment collected under subsection

 

14  (1)(h), except as provided in subdivision (h).

 

15        (h) The quality assurance assessment collected under

 

16  subsection (1)(h) shall no longer be assessed or collected after

 

17  September 30, 2011 in the event that the quality assurance

 

18  assessment is not eligible for federal matching funds. Any

 

19  portion of the quality assurance assessment collected from a

 

20  hospital that is not eligible for federal matching funds shall be

 

21  returned to the hospital.

 

22        (i) The state retention amount of the quality assurance

 

23  assessment collected pursuant to under subsection (1)(h) shall be

 

24  equal to 13.2% of the federal funds generated by the hospital

 

25  quality assurance assessment, including the state retention

 

26  amount. [In the fiscal year ending September 30, 2016, there is a 1-time

    additional retention amount of up to $92,856,100.00.] The state retention

    percentage shall be applied

 

27  proportionately to each hospital quality assurance assessment


House Bill No. 4447 as amended May 27, 2015

 

 1  program to determine the retention amount for each program. The

 

 2  state retention amount shall be appropriated each fiscal year to

 

 3  the department of community health to support medicaid Medicaid

 

 4  expenditures for hospital services and therapy. These funds shall

 

 5  offset an identical amount of general fund/general purpose

 

 6  revenue originally appropriated for that purpose.

           [(13) The department may establish a quality assurance assessment to increase ambulance reimbursement as follows:

           (a) The quality assurance assessment authorized under this subsection shall be used to provide reimbursement to Medicaid ambulance providers. The department may promulgate rules to provide the structure of the quality assurance assessment authorized under this subsection and the level of the assessment.

           (b) The department shall implement this subsection in a manner that complies with federal requirements necessary to ensure that the quality assurance assessment qualifies for federal matching funds.

           (c) The total annual collections by the department under this subsection shall not exceed $6,000,000.00.

           (d) The quality assurance assessment authorized under this subsection shall not be collected after October 1, 2018. The quality assurance assessment authorized under this subsection shall no longer be collected or assessed if the quality assurance assessment authorized under this subsection is not eligible for federal matching funds.]

 7        (14)] (15) The quality assurance assessment provided for

 

 8  under this section is a tax that is levied on a health facility

 

 9  or agency.

 

10        (15)] (16) As used in this section, "medicaid" "Medicaid"

11  means that term as defined in section 22207.

12        Sec. 20501. (1) As used in this part, : "laboratory" means a

13  facility for the biological, microbiological, serological,

14  chemical, immunohematological, hematological, biophysical,

15  cytological, pathological, or other examination of materials

16  derived from the human body for the purpose of providing

17  information for the diagnosis, prevention, or treatment of any

18  disease or impairment of, or the assessment of the health of,

19  human beings.

20        (a) "Laboratory director" means the individual responsible

21  for administration of the technical and scientific operation of a

22  clinical laboratory, including the supervision of procedures and

23  reporting of findings.

24        (b) "Owner" means a person who owns and controls a clinical

25  laboratory.

26        (2) In addition, article 1 contains general definitions and

27  principles of construction applicable to all articles in this


 

 1  code. and part 201 contains definitions applicable to this part.

 

 2        Sec. 20521. (1) The owner, laboratory director, and

 

 3  governing body of a clinical laboratory are responsible for the

 

 4  operation of the clinical laboratory.

 

 5        (2) The laboratory director is responsible for the making

 

 6  and keeping of an accurate record for each specimen examined and

 

 7  procedure followed.

 

 8        (3) A clinical laboratory shall analyze test samples

 

 9  submitted by the department and report to the department on the

 

10  results of the analyses, except that proficiency evaluation

 

11  programs of recognized professional organizations may be

 

12  acceptable to the department in lieu thereof. The analyses and

 

13  reports may be considered by the department in taking action

 

14  under section 20165 or 20525.Only a physician, dentist, or other

 

15  person authorized by law can order a laboratory test that has

 

16  been classified by the Food and Drug Administration as moderate

 

17  or high complexity. A laboratory test that is classified by the

 

18  Food and Drug Administration as waived does not require an order.

 

19        Sec. 20551. (1) A laboratory or other place where live

 

20  bacteria, fungi, mycoplasma, parasites, viruses, or other

 

21  microorganisms of a pathogenic nature are handled, cultivated,

 

22  sold, given away, or shipped from or to or where recombinant

 

23  deoxyribonucleic acid research is done shall be registered with

 

24  the department, and a registration number shall be issued to each

 

25  place registered. An application for a registration number shall

 

26  be made by the person in charge of the laboratory or other place

 

27  where the pathogens are handled or where recombinant


House Bill No. 4447 as amended May 27, 2015

 

 1  deoxyribonucleic acid research is done. The registration number

 

 2  is valid for 1 year and may be renewed upon application to the

 

 3  department.

 

 4        (2) A clinical laboratory licensed in microbiology under

 

 5  sections 20501 to 20525 is registered for purposes of this

 

 6  section and section 20552, and its license number shall be used

 

 7  as its registration number.

 

 8        (2) (3) As used in sections 20551 this section and section

 

 9  20552, "handled", "cultivated", or "shipped" does not include the

 

10  collection of specimens, the initial inoculation of specimens

 

11  into transport media or culture media, or the shipment to

 

12  registered laboratories, but does include any additional work

 

13  performed on cultivated pathogenic microorganisms or any

 

14  recombinant deoxyribonucleic acid research is done.

 

15        Enacting section 1. Sections 20511, 20515, and 20525 of the

 

16  public health code, 1978 PA 368, MCL 333.20511, 333.20515, and

 

17  333.20525, are repealed.

 

18        [Enacting section 2. This amendatory act takes effect October 1,

 

19  2015.                             ]