SB-0446, As Passed House, May 21, 2014SB-0446, As Passed Senate, February 12, 2014

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SENATE BILL No. 446

 

 

June 20, 2013, Introduced by Senator BOOHER and referred to the Committee on Health Policy.

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 22210 (MCL 333.22210), as amended by 2011 PA

 

51.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 22210. (1) Subject to this section, a hospital that

 

applies to the department for a certificate of need and meets all

 

of the following criteria shall be granted a certificate of need

 

for an extended care services program with up to 10 licensed

 

hospital beds:

 

     (a) Is eligible to apply for certification as a provider of

 

extended care services through the use of swing beds under section

 

1883 of title XVIII, 42 USC 1395tt.

 

     (b) Subject to subsection (2), has fewer than 100 licensed

 


beds not counting beds excluded under section 1883 of title XVIII,

 

42 USC 1395tt.

 

     (c) Does not have uncorrected licensing, certification, or

 

safety deficiencies for which the department or the bureau of fire

 

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

 

207, MCL 29.1b, or both, has not accepted a plan of correction.

 

     (d) Provides evidence satisfactory to the department that the

 

hospital has had difficulty in placing patients in skilled nursing

 

home beds during the 12 months immediately preceding the date of

 

the application.

 

     (2) After October 1, 1990, the criteria set forth in

 

subsection (1)(b) may be modified by the commission, using the

 

procedure set forth in section 22215(3). The department shall not

 

charge a fee for processing a certificate of need application to

 

initiate an extended care services program.

 

     (3) A hospital that is granted a certificate of need for an

 

extended care services program under subsection (1) shall comply

 

with all of the following:

 

     (a) Not charge for or otherwise attempt to recover the cost of

 

a length of stay for a patient in the extended care services

 

program that exceeds the length of time allowed for post-hospital

 

extended care under title XVIII.

 

     (b) Admit patients to the extended care services program only

 

pursuant to an admissions contract approved by the department.

 

     (c) Subject to subdivision (f), not discharge or transfer a

 

patient from a licensed hospital bed other than a hospital long-

 

term care unit bed and admit that patient to the extended care

 


services program unless the discharge or transfer and admission is

 

determined medically appropriate by the attending physician.

 

     (d) Permit access to a representative of an organization

 

approved under section 21764 to patients admitted to the extended

 

care services program, for all of the purposes described in section

 

21763.

 

     (e) Not allow the number of patient days for the extended care

 

services program to exceed the equivalent of 1,825 patient days for

 

a single state fiscal year.

 

     (f) Not provide extended care services in a swing bed if the

 

hospital owns or operates a hospital long-term care unit that has

 

beds available at the time a patient requires admission for

 

extended care services.

 

     (g) Not charge or collect from a patient admitted to the

 

extended care services program, for services rendered as part of

 

the extended care services program, an amount in excess of the

 

reasonable charge for the services as determined by the secretary

 

of the United States department of health and human services under

 

title XVIII.

 

     (h) Assist a patient who has been denied coverage for services

 

received in an extended care services program under title XVIII to

 

file an appeal with the medicare recovery project operated by the

 

office of services to the aging.

 

     (i) Operate the extended care services program pursuant to

 

this section and the provisions of section 1883 of title XVIII, 42

 

USC 1395tt, that are applicable to the extended care services

 

program.

 


     (j) Provide data to the department considered necessary by the

 

department to evaluate the extended care services program. The data

 

shall include, but are not be limited to, all of the following:

 

     (i) The total number of patients admitted to the hospital's

 

extended care services program during the period specified by the

 

department.

 

     (ii) The total number of extended care services patient days

 

for the period specified by the department.

 

     (iii) Information identifying the type of care to which patients

 

in the extended care services program are released.

 

     (k) As part of the hospital's policy describing the rights and

 

responsibilities of patients admitted to the hospital, as required

 

under section 20201, incorporate all of the following additional

 

rights and responsibilities for patients in the extended care

 

services program:

 

     (i) A copy of the hospital's policy shall be provided to each

 

extended care services patient upon admission, and the staff of the

 

hospital shall be trained and involved in the implementation of the

 

policy.

 

     (ii) Each extended care services patient may associate and

 

communicate privately with persons of his or her choice.

 

Reasonable, regular visiting hours, which shall take into

 

consideration the special circumstances of each visitor, shall be

 

established for extended care services patients to receive

 

visitors. An extended care services patient may be visited by the

 

patient's attorney or by representatives of the departments named

 

in section 20156 during other than established visiting hours.

 


Reasonable privacy shall be afforded for visitation of an extended

 

care services patient who shares a room with another extended care

 

services patient. Each extended care services patient shall have

 

reasonable access to a telephone.

 

     (iii) An extended care services patient is entitled to retain

 

and use personal clothing and possessions as space permits, unless

 

medically contraindicated, as documented by the attending physician

 

in the medical record.

 

     (iv) An extended care services patient is entitled to the

 

opportunity to participate in the planning of his or her medical

 

treatment, including the development of the discharge plan under

 

subdivision (m). An extended care services patient shall be fully

 

informed by the attending physician of the extended care services

 

patient's medical condition, unless medically contraindicated, as

 

documented by a physician in the medical record. Each extended care

 

services patient shall be afforded the opportunity to discharge

 

himself or herself from the extended care services program.

 

     (v) An extended care services patient is entitled to be fully

 

informed either before or at the time of admission, and during his

 

or her stay, of services available in the hospital and of the

 

related charges for those services. The statement of services

 

provided by the hospital shall be in writing and shall include

 

those services required to be offered on an as needed basis.

 

     (vi) A patient in an extended care services program or a person

 

authorized in writing by the patient may, upon submission to the

 

hospital of a written request, inspect and copy the patient's

 

personal or medical records. The hospital shall make the records

 


available for inspection and copying within a reasonable time, not

 

exceeding 7 days, after the receipt of the written request.

 

     (vii) An extended care services patient has the right to have

 

his or her parents, if the extended care services patient is a

 

minor, or his or her spouse, next of kin, or patient's

 

representative, if the extended care services patient is an adult,

 

stay at the hospital 24 hours a day if the extended care services

 

patient is considered terminally ill by the physician responsible

 

for the extended care services patient's care.

 

     (viii) Each extended care services patient shall be provided

 

with meals that meet the recommended dietary allowances for that

 

patient's age and sex and that may be modified according to special

 

dietary needs or ability to chew.

 

     (ix) Each extended care services patient has the right to

 

receive a representative of an organization approved under section

 

21764, for all of the purposes described in section 21763.

 

     (l) Achieve and maintain medicare certification under title

 

XVIII.

 

     (m) Establish a discharge plan for each extended care services

 

patient who is admitted to the extended care services program. In

 

the discharge plan, the hospital shall emphasize patient choice in

 

receiving extended care services in the most appropriate and least

 

restrictive setting. The hospital shall provide to the patient or

 

his or her authorized representative a copy of the discharge plan

 

not later than 3 days after the patient is admitted to the extended

 

care services program.

 

     (4) A hospital or the owner, an administrator, an employee, or

 


a representative of the hospital shall not discharge, harass, or

 

retaliate or discriminate against an extended care services patient

 

because the extended care services patient has exercised a right

 

described in subsection (3)(k).

 

     (5) In the case of an extended care services patient, the

 

rights described in subsection (3)(k)(iv) may be exercised by the

 

patient's representative, as defined in section 21703(2).

 

     (6) An extended care services patient shall be fully informed,

 

as evidenced by the extended care services patient's written

 

acknowledgment, before or at the time of admission and during stay,

 

of the rights described in subsection (3)(k). The written

 

acknowledgment shall provide that if an extended care services

 

patient is adjudicated incompetent and not restored to legal

 

capacity, the rights and responsibilities set forth in subsection

 

(3)(k) shall be exercised by a person designated by the extended

 

care services patient. The hospital shall provide proper forms for

 

the extended care services patient to provide for the designation

 

of this person at the time of admission.

 

     (7) Subsection (3)(k) does not prohibit a hospital from

 

establishing and recognizing additional rights for extended care

 

services patients.

 

     (8) A hospital that violates subsection (3) is subject to the

 

penalty provisions of section 20165.

 

     (9) A person shall not initiate an extended care services

 

program without first obtaining a certificate of need under this

 

section.

 

     (10) As used in this section:

 


     (a) "Extended care services program" means a program by a

 

hospital to provide extended care services to a patient through the

 

use of swing beds under section 1883 of title XVIII, 42 USC 1395tt.

 

     (b) "Hospital long-term care unit" means that term as defined

 

in section 20106.