Bill Text: IA SF507 | 2021-2022 | 89th General Assembly | Introduced


Bill Title: A bill for an act relating to long-term care facility and hospital practices including patient visitation and protections, and providing civil penalties.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2021-03-08 - Subcommittee: Edler, Costello, and Mathis. S.J. 551. [SF507 Detail]

Download: Iowa-2021-SF507-Introduced.html
Senate File 507 - Introduced SENATE FILE 507 BY CHAPMAN A BILL FOR An Act relating to long-term care facility and hospital 1 practices including patient visitation and protections, and 2 providing civil penalties. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2329XS (9) 89 pf/rh
S.F. 507 DIVISION I 1 LONG-TERM CARE FACILITIES —— RESIDENT AND TENANT VISITATION 2 Section 1. Section 135C.1, Code 2021, is amended by adding 3 the following new subsections: 4 NEW SUBSECTION . 1A. “Assisted living program” means the 5 same as defined in section 231C.2. 6 NEW SUBSECTION . 3A. “Continuing care retirement community” 7 means the same as defined in section 523D.1. 8 NEW SUBSECTION . 12A. “Long-term care facility” or 9 “facility” means a nursing facility, an assisted living 10 program, a continuing care retirement community, or a senior 11 adult congregate living facility, or any combination of such 12 facilities, programs, or communities. 13 NEW SUBSECTION . 13A. “National public health emergency” 14 means a public health emergency declared by the secretary of 15 the United States department of health and human services 16 pursuant to section 319 of the federal Public Health Service 17 Act, Pub. L. No. 104-321, 42 U.S.C. §247d. 18 NEW SUBSECTION . 18A. “Private pay facility” means a 19 long-term care facility that only accepts payment from privates 20 funding sources. 21 NEW SUBSECTION . 18B. “Public health disaster” means the 22 same as defined in section 135.140. 23 NEW SUBSECTION . 22A. “Senior adult congregate living 24 facility” means the same as defined in section 523D.1. 25 NEW SUBSECTION . 26. “Tenant” includes a tenant of an 26 assisted living program or an independent living tenant of a 27 continuing care retirement community. 28 Sec. 2. Section 135C.1, subsection 21, Code 2021, is amended 29 to read as follows: 30 21. “Resident” means an individual admitted to a health 31 care facility in the manner prescribed by section 135C.23 , and 32 includes a person residing in a nursing facility, a continuing 33 care retirement community, or a senior adult congregate living 34 facility . 35 -1- LSB 2329XS (9) 89 pf/rh 1/ 10
S.F. 507 Sec. 3. NEW SECTION . 135C.24A National public health 1 emergency —— public health disaster —— visitation restrictions in 2 private pay facilities, communities, and programs. 3 1. During a national public health emergency or a public 4 health disaster, a private pay long-term care facility may, at 5 the discretion of the individual facility, implement in-person, 6 indoor visitation policies for residents and tenants of the 7 long-term care facility that are less restrictive than the 8 policies applicable to long-term care facilities accepting 9 public sources of payment, including those issued by the 10 centers for Medicare and Medicaid services of the United States 11 department of health and human services. If a long-term care 12 facility implements such visitation policies, the long-term 13 care facility shall post the policies in a conspicuous place on 14 the premises. 15 2. A facility establishing visitation policies under this 16 section shall provide the facility’s visitation policies to all 17 potential or current residents or tenants and to any individual 18 the potential or current resident or tenant designates to 19 receive information and disclosures relating to the potential 20 or current resident’s or tenant’s care, upon inquiry regarding 21 potential admission to the facility, upon the resident or 22 tenant’s admission to the facility, at any time the policies 23 are amended following the resident’s or tenant’s admission, and 24 upon request of any of these parties. 25 3. Failure to facilitate visitation as provided in this 26 section is prohibited without an adequate and substantiated 27 reason related to clinical necessity or resident safety. 28 DIVISION II 29 HOSPITALS —— PATIENT VISITATION AND PROTECTIONS 30 Sec. 4. Section 135B.1, Code 2021, is amended by adding the 31 following new subsections: 32 NEW SUBSECTION . 1A. “End-of-life status” means a patient 33 with a terminal condition or dementia-related disorder that has 34 become advanced, progressive, or incurable or a patient in the 35 -2- LSB 2329XS (9) 89 pf/rh 2/ 10
S.F. 507 active stages of dying, probably within thirty days. 1 NEW SUBSECTION . 3A. “National public health emergency” 2 means a public health emergency declared by the secretary of 3 the United States department of health and human services 4 pursuant to section 319 of the federal Public Health Service 5 Act, Pub. L. No. 104-321, 42 U.S.C. §247d. 6 NEW SUBSECTION . 5. “Public health disaster” means the same 7 as defined in section 135.140. 8 Sec. 5. NEW SECTION . 135B.36 Patient visitation —— national 9 public health emergency or public health disaster —— personal 10 protective equipment stockpile for patient visitors. 11 1. During a national public health emergency or a public 12 health disaster, all of the following shall apply to a licensed 13 hospital: 14 a. The hospital shall permit a patient admitted to the 15 hospital visitation with at least two visitors who are related 16 to the patient by consanguinity or affinity during at least 17 four days in any Sunday through Saturday period for no less 18 than five hours daily. Any visitation and the four days in any 19 Sunday through Saturday period during which such visitation is 20 scheduled shall be subject to the consent of the patient and at 21 the discretion of the visitors. 22 b. Notwithstanding paragraph “a” , if a hospital’s personal 23 protective equipment stockpile for patient visitors is 24 sufficient to provide personal protective equipment for 25 all patient visitors when the hospital is at full capacity 26 including the provision of personal protective equipment for up 27 to two daily visitors per patient, the hospital shall permit 28 visitation with at least two visitors who are related to the 29 patient by consanguinity or affinity during all seven days in 30 any Sunday through Saturday period for no less than five hours 31 daily. Any visitation shall be subject to the consent of the 32 patient. 33 2. Notwithstanding any provision of law to the contrary, 34 and whether or not a national public health emergency or public 35 -3- LSB 2329XS (9) 89 pf/rh 3/ 10
S.F. 507 health disaster exists, if a patient admitted to the hospital 1 is considered by the hospital to have end-of-life status, is 2 a minor as described in section 599.1, or has a disability 3 including but not limited to a physical, intellectual, or 4 cognitive disability, a communication barrier or behavioral 5 concern, or requires assistance due to the specifics of the 6 person’s disability, the hospital shall permit visitation with 7 individuals living in the same residence as the patient and 8 visitation with at least two individuals living in residences 9 other than the residence of the patient. 10 3. Nothing in this section shall be interpreted to require a 11 hospital to alter historically established visitation policies 12 unrelated to a national public health emergency or public 13 health disaster. 14 4. A licensed hospital shall maintain an onsite personal 15 protective equipment stockpile for patient visitors and shall 16 designate a coordinator to evaluate and maintain the stockpile. 17 The stockpile shall comply with all of the following: 18 a. When a national public health emergency or a public 19 health disaster is not in place, all of the following shall 20 apply to the personal protective equipment stockpile for 21 patient visitors: 22 (1) The stockpile shall include a sufficient supply 23 to provide enough personal protective equipment for up to 24 twenty-one visitors per patient during the patient’s inpatient 25 stay and during which time the hospital is at full capacity. 26 (2) The hospital may count up to three-quarters of the 27 personal protective equipment in the stockpile toward the 28 hospital’s required emergency personal protective equipment 29 stockpile for hospital personnel required under county, 30 state, or federal law, at the discretion of the hospital or as 31 required or permitted by law or the county, state, or federal 32 regulatory authority. 33 (3) The hospital shall routinely monitor the stockpile to 34 ensure that the personal protective equipment in the stockpile 35 -4- LSB 2329XS (9) 89 pf/rh 4/ 10
S.F. 507 is used prior to the expiration date. Hospitals are encouraged 1 to use the personal protective equipment in the stockpile at 2 least one year prior to the expiration date. 3 (4) At any time the remaining stockpile constitutes 4 three-quarters of the maximum required amount, the hospital 5 shall make every reasonable effort to purchase and acquire 6 the personal protective equipment necessary to stockpile the 7 maximum amount of personal protective equipment required. At 8 no point shall the stockpile be reduced to one-half of the 9 maximum amount required. 10 (5) Any unforeseen shortages or difficulties in obtaining 11 the amount of personal protective equipment required under this 12 paragraph shall not constitute a violation of this paragraph. 13 b. During a national public health emergency or a public 14 health disaster, the stockpile shall only be used for patient 15 visitors unless, through reasonable efforts, the hospital is 16 unable to secure and make available a sufficient amount of 17 personal protective equipment to hospital personnel. 18 Sec. 6. NEW SECTION . 135B.37 Department inspection for 19 compliance —— filing of complaints —— civil penalties —— civil 20 cause of action. 21 1. The department shall ensure compliance with this 22 subchapter by inspecting each licensed hospital at least once 23 every two years. The inspection under this section may be 24 conducted concurrently with any other scheduled or unscheduled 25 inspection during the required time frame. 26 2. The department shall provide a process for a person 27 to file a complaint electronically, in person, or by mail, 28 alleging a violation of this subchapter. The complaint 29 shall state in a reasonably specific manner the basis of the 30 complaint, shall include a statement of the nature of the 31 complaint, and shall be delivered to the hospital involved. 32 The name of the person who files a complaint with the 33 department shall be kept confidential and shall not be subject 34 to discovery, subpoena, or other means of legal compulsion for 35 -5- LSB 2329XS (9) 89 pf/rh 5/ 10
S.F. 507 its release to another person other than departmental employees 1 involved in the investigation of the complaint. 2 3. a. A hospital that violates a provision of this 3 subchapter by failing to maintain the required levels of 4 personal protective equipment in the hospital’s onsite personal 5 protective equipment stockpile for patient visitors is subject 6 to all of the following: 7 (1) For an initial violation, a warning issued by the 8 department. 9 (2) For a second violation, a civil penalty of one thousand 10 dollars. 11 (3) For a third violation, a civil penalty of two thousand 12 dollars. 13 (4) For a fourth or subsequent violation, an additional 14 civil penalty of one thousand dollars per subsequent violation. 15 b. The computation of violations for a hospital shall be 16 cumulative. 17 c. A hospital that violates a provision of this subchapter 18 by failing to comply with the visitation requirements is 19 subject to all of the following: 20 (1) For an initial violation, a civil penalty of one 21 thousand dollars. 22 (2) For a second violation, a civil penalty of two thousand 23 dollars. 24 (3) For a third or subsequent violation, an additional civil 25 penalty of one thousand dollars per subsequent violation. 26 d. The computation of violations for a hospital shall be 27 cumulative. 28 4. This subchapter shall not be construed to prevent a 29 person from bringing a civil cause of action for a hospital’s 30 failure to comply with this subchapter based on any right the 31 person may assert under statute or common law. 32 DIVISION III 33 CODE EDITOR DIRECTIVE 34 Sec. 7. CODE EDITOR DIRECTIVE. The Code editor may 35 -6- LSB 2329XS (9) 89 pf/rh 6/ 10
S.F. 507 designate sections 135B.36 and 135B.37, as enacted in this Act, 1 as a new subchapter within chapter 135B, entitled “HOSPITAL 2 VISITATION AND PATIENT PROTECTIONS”. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill relates to long-term care facility and hospital 7 practices, including those related to patient visitation and 8 protections. The bill is organized into divisions. 9 Division I relates to resident and tenant visitation 10 policies in long-term care facilities. The division provides 11 definitions including those for “long-term care facility”, 12 “national public health emergency”, “private pay facility”, and 13 “public health disaster” for the purposes of the division. 14 The division provides that during a national public health 15 emergency (NPHE) or a public health disaster (PHD), a private 16 pay long-term care facility may, at the discretion of the 17 individual facility, implement in-person, indoor visitation 18 policies for residents and tenants that are less restrictive 19 than the policies applicable to long-term care facilities 20 accepting public sources of payment. If such visitation 21 policies are implemented, the long-term care facility shall 22 post the policies in a conspicuous place on the premises. The 23 division also requires the long-term care facility to provide 24 the facility’s visitation policies to prospective and current 25 residents and tenants and any individual the potential or 26 current resident or tenant designates to receive information 27 and disclosures relating to the potential or current resident’s 28 or tenant’s care, at specific times. 29 Failure to facilitate visitation as provided in the division 30 is prohibited without an adequate and substantiated reason 31 related to clinical necessity or resident safety. 32 Division II relates to hospital practices regarding patient 33 visitation and protections. The division provides that during 34 a NPHE or PHD, a licensed hospital shall permit a patient 35 -7- LSB 2329XS (9) 89 pf/rh 7/ 10
S.F. 507 admitted to the hospital to have visitation with at least 1 two visitors who are related to the patient by consanguinity 2 or affinity during at least four days in any Sunday through 3 Saturday period for no less than five hours daily. However, 4 if during the NPHE or PHD, the hospital’s personal protective 5 equipment (PPE) stockpile for patient visitors is sufficient 6 to provide PPE for all patient visitors when the hospital is 7 at full capacity including the provision of PPE for up to 8 two daily visitors per patient, the hospital shall permit 9 visitation with at least two visitors who are related to the 10 patient by consanguinity or affinity during all seven days in 11 any Sunday through Saturday period for no less than five hours 12 daily. In all cases, any visitation shall be subject to the 13 consent of the patient. 14 The division provides that notwithstanding any provision 15 of law to the contrary, whether or not during a NPHE or 16 PHD, if a patient admitted to the hospital has end-of-life 17 status, is a minor, or has a disability including but not 18 limited to a physical, intellectual, or cognitive disability, 19 a communication barrier or behavioral concern, or requires 20 assistance due to the specifics of the person’s disability, 21 the hospital shall permit visitation with individuals residing 22 in the same residence as the patient and at least two visitors 23 living in residences other than the patient’s residence. 24 Nothing in the division is to be interpreted to require a 25 hospital to alter historically established visitation policies 26 unrelated to a NPHE or PHD. 27 The division requires each hospital to maintain an onsite 28 personal protective equipment stockpile for patient visitors 29 and to designate a coordinator to evaluate and maintain the 30 stockpile. When a NPHE or PHD is not in place, the stockpile 31 shall include a sufficient supply to provide enough PPE for 32 up to 21 visitors per patient during the patient’s inpatient 33 stay during which time the hospital is at full capacity; the 34 hospital may count up to three-quarters of the PPE in the 35 -8- LSB 2329XS (9) 89 pf/rh 8/ 10
S.F. 507 personal protective equipment stockpile for patient visitors 1 toward the hospital’s required hospital emergency personal 2 protective equipment stockpile for hospital personnel required 3 under county, state, or federal law, at the discretion 4 of the hospital or as required or permitted by law or the 5 county, state, or federal regulatory authority; the hospital 6 shall routinely monitor the stockpile to ensure that the 7 PPE stockpiled is used prior to its expiration date and is 8 encouraged to use the PPE stockpiled at least one year prior 9 to its expiration date; at any time the remaining PPE in the 10 stockpile constitutes three-quarters of the maximum required 11 amount, the hospital shall make every reasonable effort 12 to purchase and acquire the PPE necessary to stockpile the 13 maximum required amount of PPE; at no point shall the stockpile 14 be reduced to one-half of the maximum required amount; and 15 any unforeseen shortages or difficulties in obtaining the 16 amount of PPE required does not constitute a violation. The 17 division also provides that during a NPHE or PHD, the personal 18 protective equipment stockpile for patient visitors shall 19 only be used for patient visitors, unless, through reasonable 20 efforts, the hospital is unable to secure and make available to 21 hospital personnel a sufficient amount of PPE. 22 The department of inspections and appeals (DIA) shall ensure 23 compliance with the division by inspecting each licensed 24 hospital at least once every two years. The inspection 25 may be conducted concurrently with any other scheduled or 26 unscheduled inspection during the required time frame. DIA 27 shall also provide a process for a person to file a complaint 28 electronically, in person, or by mail, alleging a violation of 29 the division. 30 A hospital that violates a provision of the division 31 by failing to maintain the required levels of PPE in the 32 hospital’s onsite personal protective equipment stockpile for 33 patient visitors or by failing to comply with the visitation 34 requirements is subject to civil penalties as specified in the 35 -9- LSB 2329XS (9) 89 pf/rh 9/ 10
S.F. 507 bill. The division is not to be construed to prevent a person 1 from bringing a civil cause of action for a hospital’s failure 2 to comply with the division based on any right the person may 3 assert under statute or common law. 4 -10- LSB 2329XS (9) 89 pf/rh 10/ 10
feedback