HB-5537, As Passed House, September 29, 2004

SUBSTITUTE FOR

HOUSE BILL NO. 5537

                 (As amended September 29, 2004)                            

                                                                             A bill to amend 1978 PA 368, entitled                                             

"Public health code,"                                                       

(MCL 333.1101 to 333.25211) by adding section 21735.                        

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1   Sec. 21735.  (1) Except as otherwise provided under                         

2   subsection (3) or (4), in accordance with federal laws, rules,              

3   and regulations, a nursing home initially licensed after                    

4   October 1, 1990 shall maintain a temperature of not less than 71            

5   degrees Fahrenheit or more than 81 degrees Fahrenheit measured 3            

6   feet above the floor at all times in all areas of a building                

7   accessible to residents, employees, and visitors except for the             

8   kitchen or laundry room.                                                    

9   (2) Except as otherwise provided under [subsection (3), (4), or

10  (7)], within 3 years after the effective date of the amendatory             

11  act that added this section, a nursing home licensed prior to               

House Bill No. 5537 (H-4) as amended September 29, 2004

1   October 1, 1990 shall maintain a temperature of not less than 71            

2   degrees Fahrenheit or more than 81 degrees Fahrenheit measured 3            

3   feet above the floor at all times in all areas of a building                

4   accessible to residents, employees, and visitors except for the             

5   kitchen or laundry room.  Upon written request of the nursing               

6   home, the department may grant an extension of the time period              

7   for compliance under this subsection if each of the following is            

8   met:                                                                        

9       (a) Upon review of the nursing home's written policies and                  

10  procedures and existing plans or agreements for emergency                   

11  situations, the department determines that there [are] adequate             

12  protections in place to ensure the continued safety and comfort             

13  of the residents within that nursing home.                                  

14      (b) Building renovations have begun to bring the nursing                    

15  home into compliance with this section or the nursing home has              

16  submitted and the department has approved the nursing home's                

17  plans for renovation, repair, or remodeling of its building to              

18  meet the requirements of this section.                                      

19      (3) If a nursing home is located north of the forty-fifth                   

20  parallel of latitude, the temperatures within that nursing home             

21  may on rare, brief occasions, as a result of rare, brief episodes           

22  of unseasonably hot weather, exceed the upper range of 81 degrees           

23  Fahrenheit.  If the temperature range exceeds 81 degrees                    

24  Fahrenheit, the nursing home shall monitor its residents and take           

25  any appropriate measures to ensure the health, safety, and                  

26  comfort of each resident.                                                   

27      (4) If a nursing home has a separate heating and cooling                    

1   system for resident rooms that allows a resident to control the             

2   temperature in his or her own room, the resident may maintain his           

3   or her room at any level he or she desires unless the temperature           

4   may adversely affect the health, safety, or comfort of the                  

5   resident or any other resident sharing that room, in which case             

6   the nursing home shall intervene and take appropriate action to             

7   keep the resident or residents safe and comfortable.  If a                  

8   resident chooses to maintain the temperature in his or her room             

9   at a temperature level that is outside of the temperature range             

10  required under this section, that resident shall submit                     

11  documentation from his or her physician approving those                     

12  temperature conditions.  This documentation shall be included               

13  with that resident's care plan.                                             

14      (5) Within 30 days after the effective date of the amendatory               

15  act that added this section, the nursing home administrator shall           

16  develop written policies and procedures for maintaining safe and            

17  comfortable temperatures in the nursing home, maintain a copy of            

18  those written policies and procedures on the premises, and submit           

19  a copy of the same to the department for filing with its most               

20  recent license or renewal application.  The written policies and            

21  procedures shall include at least all of the following:                     

22      (a) Measures to be taken to ensure the health, safety, and                  

23  comfort of residents in the nursing home.                                   

24  (b) Identification of circumstances that require notification               

25  of the nursing home administrator or a physician and the                    

26  appropriate time frames for these actions.                                  

27      (c) Identification of available sites within or outside the                 

House Bill No. 5537 (H-4) as amended September 29, 2004

1   nursing home to which residents may be relocated if temperatures            

2   within the nursing home present a threat to the health or safety            

3   of the residents.                                                           

4       (6) A nursing home shall have an existing agreement or plan                 

5   for emergency situations, including, but not limited to, an                 

6   agreement or plan for the provision of emergency services and               

7   repairs in the event of an electrical, heating, ventilation, or             

8   air conditioning failure or malfunction.  The nursing home shall            

9   maintain a copy of these written agreements or plans on the                 

10  premises, and those shall be made available to the department               

11  upon request.  Repair work that is necessary to maintain the                

12  temperature within the range described in subsections (1) and (2)           

13  shall be completed within 48 hours or less.  If, for reasons                

14  beyond the nursing home's control, repairs cannot be completed in           

15  a timely manner, the nursing home shall implement its written               

16  policies and procedures established pursuant to subsection (5).             

17      (7) Within 6 months after the effective date of the                         

18  amendatory act that added this section, the department shall                

19  establish an air conditioning grant program for the purpose of              

20  providing grants to nursing homes that need to replace, update,             

21  or repair their heating and cooling system to maintain the                  

22  temperature standards established under subsection (2).  [Except as

23  otherwise provided under this subsection, if funds are appropriated by the legislature for the air conditioning grant program, the department] shall provide grants to nursing homes                                                         

24  that the department considers eligible within 60 days after the             

25  nursing home submits documentation to the department verifying              

26  [the projected costs of replacing, updating, or repairing its heating and

27  cooling system] to comply with this section.  Any building                  

House Bill No. 5537 (H-4) as amended September 29, 2004

1   maintenance, repair, upkeep, or replacement with similar                    

2   equipment, implemented as a result of this section, is normal               

3   building maintenance and is not a renovation.  In each fiscal               

4   year governed by this subsection, the department shall only                 

5   expend funds under the air conditioning grant program if the                

6   medicaid reimbursement rates are not below the level of rates in            

7   effect on July 1, 2004.  [If funds are not appropriated by the legislature for the air conditioning grant program or if the funds are insufficient, the department is not obligated in any way to make grants to nursing homes under the air conditioning grant program. A nursing home is exempt from the requirements of subsection (2) until full funding is available and granted to that nursing home under the air conditioning grant program.]

8       (8) In accordance with sections 2262, 2263, and 21799d, a                   

9   nursing home that violates this section is subject to a civil               

10  penalty.