Analysis

Topic: Nursing Homes
Sponsor: Representative Patterson
Date Introduced: February 13, 2001
Date Enrolled: February 12, 2002
Date of Analysis: February 12, 2002

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

Background: Michigan Administrative Code R 325.20113 requires a nursing home to have established policies and procedures to implement resident rights and responsibilities, including complaint procedures. This rule details the content of the procedures, specifically, R 325.20113(c), "The name, title, location, and telephone number of the individual in the home who is responsible for receiving complaints and conducting complaint investigations and a procedure for communicating with that individual."

Bill Content: This bill enhances the aforementioned Michigan Administrative Code Rule by requiring a nursing home to have an individual responsible for receiving complaints and conducting complaint investigations in a nursing home. This person will be on duty and on site not less than 24 hours per day, 7 days a week and will respond using the nursing home's established procedures pursuant to R 325.20113. The bill includes posting requirements congruent with R 325.20113(c).

To assist this individual, the Department will post the following items on its Internet website.
- Links to federal and state regulations and rules governing the nursing home industry.
- The scheduling of any training or joint training sessions concerning nursing home or elderly care issues being put on by the Department.
- A list of long-term care contact phone numbers including, but not limited to, the Department's Complaint Hotline and Nursing Home Licensing Division, any commonly known nursing home provider groups, the State Long-Term Care Ombudsman, and any commonly known nursing home patient care advocacy groups.
- When it becomes available, information on the availability of electronic mail access to file a complaint concerning nursing home violations directly with the Department.
- Any other information that the Department believes is helpful in responding to complaints, requests, and inquiries of a nursing home resident or his or her surrogate decision maker.

The bill also includes language that a nursing home receiving reimbursement from the Medicaid program will designate one or more current employees as the person(s) responsible for receiving complaints and that this designation does not constitute a basis for increasing nursing home staffing levels.

Arguments For: This bill provides a consistent mechanism to nursing homes for fulfilling the intent of R 325.20113. There have been concerns voiced that residents, their guardians, family members, etc., often do not know who to go to for help with questions or concerns they may have about the nursing home. Designating a nursing home employee to respond to such questions/concerns 24 hours a day, 7 days a week, will help to solve this problem. It will also help to address concerns at the nursing home level, rather than being referred into the regulatory system. The bill also requires the Department to post resources on its website which will help the nursing home-designated employee to handle internal questions/concerns and help the nursing home residents, their guardians, family members, etc.

The bill is consistent with a new initiative of the Department in which nursing homes are being encouraged to address issues involving family, residents, and staff in the facility.

Arguments Against: There was some concern among nursing home provider groups that the complaint process would be confusing if the Department posted long-term care contact information on their website.

The Department of Community Health had a concern that the original bill might unnecessarily increase staffing levels because nursing homes receive reimbursement pursuant to the Medicaid program. This was addressed by including language in the bill that by designating an employee to respond to resident questions/concerns, does not constitute a basis for increasing nursing home staffing levels.

Supporters/Opponents: The Michigan Department of Consumer and Industry Services, the Health Care Association of Michigan, and the Michigan Association of Homes and Services for the Aging support the bill.

Fiscal Impact: The bill would have no fiscal impact on the Department of Consumer and Industry Services.

Administrative Rules Impact: No new or revised administrative rules would be required as a result of this bill.