SB-0446, As Passed Senate, February 12, 2014
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.