HB6709 93RD GENERAL ASSEMBLY

LRB093 20160 DRJ 45905 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB6709

Introduced 02/09/04, by William B. Black

SYNOPSIS AS INTRODUCED:

210 ILCS 45/3-212.5 new

Amends the Nursing Home Care Act. Requires the Department of Public Health to implement alternative procedures for the nursing home survey process for purposes that include the more effective and efficient use of Department resources to target problem areas. Provides for a time period of up to 30 months between surveys; provides for annual monitoring visits in the case of nursing homes surveyed at intervals greater than 12 months. Provides for educational activities and an evaluation process.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning health facilities.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Nursing Home Care Act is amended by adding Section 3-212.5 as follows:

(210 ILCS 45/3-212.5 new)

Sec. 3-212.5. Alternative facility survey process.

(a) The Department shall implement alternative procedures for the long-term care facility survey process as authorized under this Section. These alternative survey process procedures seek to do the following:

(1) Use Department resources more effectively and efficiently to target problem areas.

(2) Use other existing or new mechanisms to provide objective assessments of quality and to measure quality improvement.

(3) Provide for frequent collaborative interaction of facility staff and surveyors rather than a punitive approach.

(4) Reward a facility that has performed very well by extending intervals between full surveys.

The Department shall pursue changes in federal law necessary to accomplish this process and shall apply for any necessary federal waivers or approval. If a federal waiver is approved, the Department shall promptly implement the waiver by adopting emergency rules in accordance with Section 5-45 of the Illinois Administrative Procedure Act. For purposes of that Act, the adoption of those rules is deemed to be an emergency and necessary for the public interest, safety, or welfare.

(b) The Department must extend the time period between standard surveys up to 30 months based on the criteria established in subsection (d). In using the alternative survey schedule, the requirement for the statewide average to not exceed 12 months does not apply.

(c) The Department shall develop a process for identifying the survey cycles for nursing facilities based on the compliance history of the facility. This process may use a range of months for survey intervals. At a minimum, the process must be based on information from the last 2 survey cycles and must take into consideration any deficiencies issued as the result of a survey or a complaint investigation during the interval. A nursing facility with a finding of substandard quality of care or a finding of immediate jeopardy is not entitled to a survey interval greater than 12 months. The Department shall alter the survey cycle for a specific skilled nursing facility based on findings identified through the completion of a survey, a monitoring visit, or a complaint investigation. The Department must also take into consideration information other than the facility's compliance history.

(d) The Department shall provide public notice of the classification process and shall identify the selected survey cycles for each nursing facility. The classification system must be based on an analysis of the findings made during the past 2 standard survey intervals, but it only takes one survey or complaint finding to modify the interval. The Department shall also take into consideration information obtained from residents and family members in each nursing facility and from other sources such as employees and ombudsmen in determining the appropriate survey intervals for facilities.

(e) The Department shall conduct at least one monitoring visit on an annual basis for every nursing facility that has been selected for a survey cycle greater than 12 months. The Department shall develop protocols for the monitoring visits; the protocols shall be less extensive than the requirements for a standard survey. The Department shall use the criteria set forth in this subsection to determine whether additional monitoring visits to a facility will be required.

The criteria for determining whether additional monitoring visits will be required shall include, but need not be limited to, the following:

(1) Changes in the ownership or administration of the facility, or changes in the direction of the facility's nursing service.

(2) Changes in the facility's quality indicators that might evidence a decline in the facility's quality of care.

(3) Reductions in staffing or an increase in the utilization of temporary nursing personnel.

(4) Complaint information or other information that identifies potential concerns for the quality of the care and services provided in the facility.

(f) The Department shall establish a process for surveying and monitoring facilities that require a survey interval of less than 15 months. This information shall identify the steps that the Department must take to monitor the facility in addition to the standard survey.

(g) The implementation of an alternative survey process for the State must not result in any reduction of funding that would have been provided to the State survey agency for survey and enforcement activity based on the completion of full standard surveys for each skilled nursing facility in the State.

(h) The Department shall expand the State survey agency's training and educational efforts for skilled nursing facilities, residents and family members, residents and family councils, long-term care ombudsman programs, and the general public.

(i) The Department shall develop a process for the evaluation of the effectiveness of an alternative survey process conducted under this Section.