HOUSE BILL No. 4861 June 3, 1997, Introduced by Reps. Green, Cropsey, Kukuk, Goschka, Hammerstrom, Rhead, Gernaat and Voorhees and referred to the Committee on Health Policy. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20155 (MCL 333.20155), as amended by 1996 PA 267. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 20155. (1) Except as OTHERWISE provided in this sec- 2 tion, the department OF CONSUMER AND INDUSTRY SERVICES shall make 3 annual and other visits to each health facility or agency 4 licensed under this article for the purposes of survey, evalu- 5 ation, and consultation. Except for a health facility or agency 6 described in section 20106(1)(c), (f), (h), or (j), the depart- 7 ment shall determine whether the visits shall be announced or 8 unannounced, except that a complaint investigation shall not be 9 announced and there shall be at least 1 unannounced visit other 10 than a complaint investigation annually to a health facility or 02107'97 ** CPD 2 1 agency described in section 20106(1)(c), (h), or (j). BEGINNING 2 UPON THE EXPIRATION OF 1 YEAR AFTER THE EFFECTIVE DATE OF THE 3 AMENDATORY ACT THAT ADDED THIS SENTENCE, FOR PURPOSES OF A 4 SURVEY, EVALUATION, AND CONSULTATION VISIT, THE DEPARTMENT SHALL 5 ENSURE THAT EACH STANDARD OR ANNUAL SURVEY AND REVISIT SURVEY OF 6 A LICENSED NURSING HOME IS CONDUCTED BY A SURVEY, EVALUATION, AND 7 CONSULTATION TEAM THAT INCLUDES AT LEAST 1 SURVEYOR WHO IS A 8 LICENSED REGISTERED PROFESSIONAL NURSE AND WHO HAS AT LEAST 3 9 YEARS' EXPERIENCE AS A HEALTH PROFESSIONAL EMPLOYEE OF A LICENSED 10 NURSING HOME. THE LICENSED REGISTERED PROFESSIONAL NURSE SUR- 11 VEYOR SHALL BE EMPLOYED BY OR UNDER CONTRACT TO THE DEPARTMENT. 12 A MEMBER OF A SURVEY TEAM SHALL NOT BE EMPLOYED BY A LICENSED 13 NURSING HOME OR A NURSING HOME MANAGEMENT COMPANY DOING BUSINESS 14 IN THIS STATE AT THE TIME OF CONDUCTING A SURVEY UNDER THIS 15 SECTION. THE DEPARTMENT SHALL NOT ALLOW A LICENSED REGISTERED 16 PROFESSIONAL NURSE TO BE A MEMBER OF A SURVEY TEAM FOR PURPOSES 17 OF THIS SUBSECTION IF HE OR SHE HAS BEEN INVOLUNTARILY DISCHARGED 18 FROM EMPLOYMENT WITH A NURSING HOME OR OTHER LONG-TERM CARE 19 FACILITY WITHIN THE 5 YEARS IMMEDIATELY PRECEDING THE DATE THE 20 SURVEY IS TO BE CONDUCTED. 21 (2) The department OF CONSUMER AND INDUSTRY SERVICES shall 22 make at least a biennial visit to each licensed clinical labora- 23 tory, each nursing home, and each hospice residence for the pur- 24 poses of survey, evaluation, and consultation. If a nursing home 25 is only partially certified under title XVIII or title XIX, the 26 department shall include all licensed parts of the nursing home 27 in a certification survey conducted by the department. 02107'97 ** 3 1 (3) The department OF CONSUMER AND INDUSTRY SERVICES shall 2 make a biennial visit to each hospital for survey and evaluation 3 for the purpose of licensure. Subject to subsection (6), the 4 department may waive the biennial visit required by this subsec- 5 tion if a hospital, as part of a timely application for license 6 renewal, requests a waiver and submits both of the following and 7 if all of the requirements of subsection (5) are met: 8 (a) Evidence that it is currently fully accredited by a body 9 with expertise in hospital accreditation whose hospital accredit- 10 ations are accepted by the United States department of health and 11 human services for purposes of section 1865 of PART C OF title 12 XVIII of the social security act,chapter 531, 49 Stat. 620,13 42 U.S.C. 1395bb. 14 (b) A copy of the most recent accreditation report for the 15 hospital issued by a body described in subdivision (a), and the 16 hospital's responses to the accreditation report. 17 (4) Except as provided in subsection (8), accreditation 18 information provided to the department OF CONSUMER AND INDUSTRY 19 SERVICES under subsection (3) is confidential, is not a public 20 record, and is not subject to court subpoena. The department 21 shall use the accreditation information only as provided in this 22 section and shall return the accreditation information to the 23 hospital within a reasonable time after a decision on the waiver 24 request is made. 25 (5) The department OF CONSUMER AND INDUSTRY SERVICES shall 26 grant a waiver under subsection (3) if the accreditation report 27 submitted under subsection (3)(b) is less than 2 years old and 02107'97 ** 4 1 there is no indication of substantial noncompliance with 2 licensure standards or of deficiencies that represent a threat to 3 public safety or patient care in the report, in complaints 4 involving the hospital, or in any other information available to 5 the department. If the accreditation report is 2 or more years 6 old, the department may do 1 of the following: 7 (a) Grant an extension of the hospital's current license 8 until the next accreditation survey is completed by the body 9 described in subsection (3)(a). 10 (b) Grant a waiver under subsection (3) based on the accred- 11 itation report that is 2 or more years old, on condition that the 12 hospital promptly submit the next accreditation report to the 13 department. 14 (c) Deny the waiver request and conduct the visits required 15 under subsection (3). 16 (6) The department OF CONSUMER AND INDUSTRY SERVICES shall 17 not grant more than 2 consecutive waivers under subsection (3). 18 This section does not prohibit the department from citing a vio- 19 lation of this part during a survey, conducting investigations or 20 inspections pursuant to section 20156, or conducting surveys of 21 health facilities or agencies for the purpose of complaint inves- 22 tigations or federal certification. This section does not pro- 23 hibit the state fire marshal from conducting annual surveys of 24 hospitals, nursing homes, and county medical care facilities. 25 (7) At the request of a health facility or agency, the 26 department OF CONSUMER AND INDUSTRY SERVICES may conduct a 27 consultation engineering survey of a health facility and provide 02107'97 ** 5 1 professional advice and consultation regarding health facility 2 construction and design. A health facility or agency may request 3 a voluntary consultation survey under this subsection at any time 4 between licensure surveys. The fees for a consultation engineer- 5 ing survey are the same as the fees established for waivers under 6 section 20161(10). 7 (8) If the department OF CONSUMER AND INDUSTRY SERVICES 8 determines that substantial noncompliance with licensure stan- 9 dards exists or that deficiencies that represent a threat to 10 public safety or patient care exist based on a review of an 11 accreditation report submitted pursuant to subsection (3)(b), the 12 department shall prepare a written summary of the substantial 13 noncompliance or deficiencies and the hospital's response to the 14 department's determination. The department's written summary and 15 the hospital's response are public documents. 16 (9) Investigations or inspections, other than inspections of 17 financial records, of a health facility or agency described in 18 section 20106(1)(c), (f), (h), or (j) shall be conducted without 19 prior notice to the health facility or agency. An employee of a 20 state agency charged with inspecting the health facility or 21 agency or an employee of a local health department who directly 22 or indirectly gives prior notice regarding an inspection, other 23 than an inspection of the financial records, to the health facil- 24 ity or agency or to an employee of the health facility or agency, 25 is guilty of a misdemeanor. Consultation visits that are not for 26 the purpose of annual or follow-up inspection or survey may be 27 announced. 02107'97 ** 6 1 (10) The department OF CONSUMER AND INDUSTRY SERVICES shall 2 maintain a record indicating whether visits are announced or 3 unannounced. Information gathered at all visits, announced or 4 unannounced, shall be taken into account in licensure decisions. 5 (11) The department OF CONSUMER AND INDUSTRY SERVICES shall 6 require periodic reports and a health facility or agency shall 7 give the department access to books, records, and other documents 8 maintained by a health facility or agency to the extent necessary 9 to carry out the purpose of this article and the rules promul- 10 gated under this article. The department shall respect the con- 11 fidentiality of a patient's clinical record and shall not divulge 12 or disclose the contents of the records in a manner that identi- 13 fies an individual except under court order. The department may 14 copy health facility or agency records as required to document 15 findings. 16 (12) The department OF CONSUMER AND INDUSTRY SERVICES may 17 delegate survey, evaluation, or consultation functions to another 18 state agency or to a local health department qualified to perform 19 those functions. However, the department shall not delegate 20 survey, evaluation, or consultation functions to a local health 21 department that owns or operates a hospice or hospice residence 22 licensed under this article. The delegation shall be by cost 23 reimbursement contract between the department and the state 24 agency or local health department. Survey, evaluation, or con- 25 sultation functions shall not be delegated to nongovernmental 26 agencies, except as provided in this section. The department may 27 accept voluntary inspections performed by an accrediting body 02107'97 ** 7 1 with expertise in clinical laboratory accreditation under part 2 205 if the accrediting body utilizes forms acceptable to the 3 department, applies the same licensing standards as applied to 4 other clinical laboratories and provides the same information and 5 data usually filed by the department's own employees when engaged 6 in similar inspections or surveys. The voluntary inspection 7 described in this subsection shall be agreed upon by both the 8 licensee and the department. 9 (13) If, upon investigation, the department OF CONSUMER AND 10 INDUSTRY SERVICES or a state agency determines that an individual 11 licensed to practice a profession in this state has violated the 12 applicable licensure statute or the rules promulgated under that 13 statute, the department, state agency, or local health department 14 shall forward the evidence it has to the appropriate licensing 15 agency. 16 (14) As used in this section: 17 (a) "Title XVIII" means title XVIII of the social security 18 act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 19 1395c to 1395i, 1395i-2 to 1395i-4, 1395j to 1395t, 1395u to 20 1395w-2, 1395w-4 to 1395yy, and 1395bbb to 1395ccc. 21 (b) "Title XIX" means title XIX of the social security act, 22 chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396f AND 1396g-1 23 1396v. 02107'97 ** Final page. CPD