Analysis

Topic: Nursing Homes
Sponsor: House Bill: Senator Bennett, Sentate Bill: Representative Richardville
Committee:
Senate Economic Development, International Trade and Regulatory Affairs (referred 3/9/00)
House Senior Health, Security and Retirement (referred 4/27/00)
Date of Analysis: May 1, 2000

Position: The Department of Consumer and Industry Services supports the bill.

Background: In 1998 the Department of Consumer and Industry Services initiated major reforms in nursing home enforcement. A major component of these reforms was the use of state approved facility managers and advisors, at facility expense, when homes have serious compliance problems. Temporary managers and advisors are professionals from the private sector who are appointed with the approval of the state to assist homes to achieve and maintain compliance and, if necessary, protect residents if a facility closes.

The use of temporary managers and advisors is recognized in rules promulgated by the Department of Community Health 1999 and has been recognized by the federal government as a valid remedy for problem nursing homes. However, questions, have been raised as to the authority of the Department of Consumer and Industry Services to impose temporary managers and advisors under the Public Health Code. The bill addresses this problem by specifically including temporary managers and advisors in the list of remedies available to the department under the Public Health Code.

Description of the Bill: The bill amends Sections 20162 and 21799 of the Public Health Code to specifically authorize the appointment of temporary mangers and advisors.

Arguments:

Pro: The use of temporary mangers and advisors has been endorsed by consumers and providers and is accepted by the federal government. It is an effective means of restoring a problem nursing home to compliance and assuring that deficiencies stay corrected over time. A temporary manger may be the only remaining alternative to closure of a nursing home and has proven effective in practice in preventing the ultimate closure of nursing homes. Temporary managers are also essential to protect residents and assure stability in the rare cases where the department must oversee the closure of a facility.

Con: A facility may object to the temporary loss of its independent management authority when temporary mangers or advisors are used. A facility may also object to the requirement that it pay the cost of temporary mangers or advisors.

Supporters/Opponents: No information is available at this time.

Fiscal Information: The costs of temporary facility mangers and advisors are paid by the facility. A portion of these costs may be passed on to the Medicaid or Medicare programs.

Economic Impact: The use of facility mangers and advisors can be a key part of efforts to correct care problems so that a facility can avoid closure with the corresponding loss of employment and the necessity to move residents to other homes.

Administrative Rules Impact: These amendments reflect the use of temporary mangers and advisors as alternative remedies in the enforcement rules promulgated by the Medical Services Administration of the Department of Community Health in 1999.