Bill Text: MI SB0064 | 2015-2016 | 98th Legislature | Introduced
Bill Title: Health facilities; nursing homes; patient care policies and compliance procedures; require establishment based on nationally recognized guidelines or best-practice resources and provide other general amendments. Amends secs. 1104, 20104, 20155, 20155a, 21703, 21734 & 21799a of 1978 PA 368 (MCL 333.1104 et seq.).
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2015-10-22 - Assigned Pa 0155'15 With Immediate Effect [SB0064 Detail]
Download: Michigan-2015-SB0064-Introduced.html
SENATE BILL No. 64
January 29, 2015, Introduced by Senator HANSEN and referred to the Committee on Families, Seniors and Human Services.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 20155, 21703, and 21734 (MCL 333.20155,
333.21703, and 333.21734), section 20155 as amended by 2012 PA 322
and section 21734 as added by 2000 PA 437.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 20155. (1) Except as otherwise provided in this section
and section 20155a, the department shall make annual and other
visits to each health facility or agency licensed under this
article
for the purposes of survey, evaluation, and consultation. A
The
department shall make a visit made according
to a complaint
shall
be unannounced. Except for a county
medical care facility, a
home for the aged, a nursing home, or a hospice residence, the
department shall determine whether the visits that are not made
according
to a complaint are announced or unannounced. Beginning
June
20, 2001, the The department shall ensure that each newly
hired nursing home surveyor, as part of his or her basic training,
is assigned full-time to a licensed nursing home for at least 10
days within a 14-day period to observe actual operations outside of
the survey process before the trainee begins oversight
responsibilities.
(2)
The state department shall establish a process that
ensures both of the following:
(a)
A newly hired nursing home surveyor shall does not make
independent compliance decisions during his or her training period.
(b)
A nursing home surveyor shall is
not be assigned as a
member of a survey team for a nursing home in which he or she
received training for 1 standard survey following the training
received in that nursing home.
(3)
Beginning November 1, 2012, the The
department shall
perform a criminal history check on all nursing home surveyors in
the manner provided for in section 20173a.
(4)
A member of a survey team shall must
not be employed by a
licensed nursing home or a nursing home management company doing
business in this state at the time of conducting a survey under
this section. The department shall not assign an individual to be a
member of a survey team for purposes of a survey, evaluation, or
consultation visit at a nursing home in which he or she was an
employee within the preceding 3 years.
(5)
Representatives The
department shall invite
representatives from all nursing home provider organizations and
the
state long-term care ombudsman or his or her designee shall be
invited
to participate in the planning
process for the joint
provider and surveyor training sessions. The department shall
include at least 1 representative from nursing home provider
organizations that do not own or operate a nursing home
representing 30 or more nursing homes statewide in internal
surveyor group quality assurance training provided for the purpose
of general clarification and interpretation of existing or new
regulatory requirements and expectations.
(6) The department shall make available online the general
civil service position description related to the required
qualifications for individual surveyors. The department shall use
the required qualifications to hire, educate, develop, and evaluate
surveyors.
(7) The department shall ensure that each annual survey team
is composed of an interdisciplinary group of professionals, 1 of
whom must be a registered nurse. Other members may include social
workers, therapists, dietitians, pharmacists, administrators,
physicians, sanitarians, and others who may have the expertise
necessary to evaluate specific aspects of nursing home operation.
(8) Except as otherwise provided in this section and section
20155a, the department shall make at least a biennial visit to each
licensed clinical laboratory, each nursing home, and each hospice
residence for the purposes of survey, evaluation, and consultation.
The department shall semiannually provide for joint training with
nursing home surveyors and providers on at least 1 of the 10 most
frequently issued federal citations in this state during the past
calendar year. The department shall develop a protocol for the
review of citation patterns compared to regional outcomes and
standards and complaints regarding the nursing home survey process.
The
department shall include the review will be included under this
subsection in the report required under subsection (20). Except as
otherwise
provided in this subsection, beginning with his or her
first
full relicensure period after June 20, 2000, each member of a
department nursing home survey team who is a health professional
licensee under article 15 shall earn not less than 50% of his or
her required continuing education credits, if any, in geriatric
care. If a member of a nursing home survey team is a pharmacist
licensed under article 15, he or she shall earn not less than 30%
of his or her required continuing education credits in geriatric
care.
(9) The department shall make a biennial visit to each
hospital for survey and evaluation for the purpose of licensure.
Subject to subsection (12), the department may waive the biennial
visit required by this subsection if a hospital, as part of a
timely application for license renewal, requests a waiver and
submits both of the following and if all of the requirements of
subsection (11) are met:
(a) Evidence that it is currently fully accredited by a body
with expertise in hospital accreditation whose hospital
accreditations are accepted by the United States department of
health
and human services for purposes of section 1865 of part C of
title
XVIII of the social security act,
42 USC 1395bb.
(b) A copy of the most recent accreditation report for the
hospital issued by a body described in subdivision (a), and the
hospital's responses to the accreditation report.
(10) Except as otherwise provided in subsection (14),
accreditation information provided to the department under
subsection (9) is confidential, is not a public record, and is not
subject to court subpoena. The department shall use the
accreditation information only as provided in this section and
shall return the accreditation information to the hospital within a
reasonable time after a decision on the waiver request is made.
(11) The department shall grant a waiver under subsection (9)
if the accreditation report submitted under subsection (9)(b) is
less than 2 years old and there is no indication of substantial
noncompliance with licensure standards or of deficiencies that
represent a threat to public safety or patient care in the report,
in complaints involving the hospital, or in any other information
available to the department. If the accreditation report is 2 or
more years old, the department may do 1 of the following:
(a) Grant an extension of the hospital's current license until
the next accreditation survey is completed by the body described in
subsection (9)(a).
(b) Grant a waiver under subsection (9) based on the
accreditation report that is 2 or more years old, on condition that
the hospital promptly submit the next accreditation report to the
department.
(c) Deny the waiver request and conduct the visits required
under subsection (9).
(12) This section does not prohibit the department from citing
a violation of this part during a survey, conducting investigations
or inspections according to section 20156, or conducting surveys of
health facilities or agencies for the purpose of complaint
investigations or federal certification. This section does not
prohibit the bureau of fire services created in section 1b of the
fire prevention code, 1941 PA 207, MCL 29.1b, from conducting
annual surveys of hospitals, nursing homes, and county medical care
facilities.
(13) At the request of a health facility or agency, the
department may conduct a consultation engineering survey of a
health facility and provide professional advice and consultation
regarding health facility construction and design. A health
facility or agency may request a voluntary consultation survey
under this subsection at any time between licensure surveys. The
fees for a consultation engineering survey are the same as the fees
established for waivers under section 20161(10).
(14) If the department determines that substantial
noncompliance with licensure standards exists or that deficiencies
that represent a threat to public safety or patient care exist
based on a review of an accreditation report submitted under
subsection (9)(b), the department shall prepare a written summary
of the substantial noncompliance or deficiencies and the hospital's
response to the department's determination. The department's
written summary and the hospital's response are public documents.
(15) The department or a local health department shall conduct
investigations or inspections, other than inspections of financial
records, of a county medical care facility, home for the aged,
nursing home, or hospice residence without prior notice to the
health facility or agency. An employee of a state agency charged
with investigating or inspecting the health facility or agency or
an employee of a local health department who directly or indirectly
gives prior notice regarding an investigation or an inspection,
other than an inspection of the financial records, to the health
facility or agency or to an employee of the health facility or
agency, is guilty of a misdemeanor. Consultation visits that are
not for the purpose of annual or follow-up inspection or survey may
be announced.
(16) The department shall maintain a record indicating whether
a visit and inspection is announced or unannounced. Survey findings
gathered at each health facility or agency during each visit and
inspection, whether announced or unannounced, shall be taken into
account in licensure decisions.
(17) The department shall require periodic reports and a
health facility or agency shall give the department access to
books, records, and other documents maintained by a health facility
or agency to the extent necessary to carry out the purpose of this
article and the rules promulgated under this article. The
department shall not divulge or disclose the contents of the
patient's clinical records in a manner that identifies an
individual except under court order. The department may copy health
facility or agency records as required to document findings.
Surveyors shall use electronic resident information, whenever
available, as a source of survey-related data and shall request
facility assistance to access the system to maximize data export.
(18) The department may delegate survey, evaluation, or
consultation functions to another state agency or to a local health
department qualified to perform those functions. However, the
department shall not delegate survey, evaluation, or consultation
functions to a local health department that owns or operates a
hospice or hospice residence licensed under this article. The
delegation
department shall be delegate under this subsection by
cost reimbursement contract between the department and the state
agency
or local health department. Survey, The department shall not
delegate
survey, evaluation, or consultation
functions shall not be
delegated
to nongovernmental agencies, except
as provided in this
section. The department may accept voluntary inspections performed
by an accrediting body with expertise in clinical laboratory
accreditation under part 205 if the accrediting body utilizes forms
acceptable to the department, applies the same licensing standards
as applied to other clinical laboratories, and provides the same
information and data usually filed by the department's own
employees when engaged in similar inspections or surveys. The
voluntary
inspection described in this subsection shall must be
agreed upon by both the licensee and the department.
(19) If, upon investigation, the department or a state agency
determines that an individual licensed to practice a profession in
this state has violated the applicable licensure statute or the
rules promulgated under that statute, the department, state agency,
or local health department shall forward the evidence it has to the
appropriate licensing agency.
(20) The department may consolidate all information provided
for any report required under this section and section 20155a into
a single report. The department shall report to the appropriations
subcommittees, the senate and house of representatives standing
committees having jurisdiction over issues involving senior
citizens, and the fiscal agencies on March 1 of each year on the
initial and follow-up surveys conducted on all nursing homes in
this
state. The report department
shall include all of the
following information in the report:
(a) The number of surveys conducted.
(b) The number requiring follow-up surveys.
(c) The average number of citations per nursing home for the
most recent calendar year.
(d) The number of night and weekend complaints filed.
(e) The number of night and weekend responses to complaints
conducted by the department.
(f) The average length of time for the department to respond
to a complaint filed against a nursing home.
(g) The number and percentage of citations disputed through
informal dispute resolution and independent informal dispute
resolution.
(h) The number and percentage of citations overturned or
modified, or both.
(i) The review of citation patterns developed under subsection
(8).
(j)
Implementation of the clinical process guidelines and the
impact
of the guidelines on resident care.
(j) (k)
Information regarding the progress
made on
implementing the administrative and electronic support structure to
efficiently coordinate all nursing home licensing and certification
functions.
(k) (l) The
number of annual standard surveys of nursing homes
that were conducted during a period of open survey or enforcement
cycle.
(l) (m)
The number of abbreviated complaint
surveys that were
not conducted on consecutive surveyor workdays.
(m) (n)
The percent of all form CMS-2567
reports of findings
that were released to the nursing home within the 10-working-day
requirement.
(n) (o)
The percent of provider
notifications of acceptance or
rejection of a plan of correction that were released to the nursing
home within the 10-working-day requirement.
(o) (p)
The percent of first revisits that
were completed
within 60 days from the date of survey completion.
(p) (q)
The percent of second revisits that
were completed
within 85 days from the date of survey completion.
(q) (r)
The percent of letters of
compliance notification to
the nursing home that were released within 10 working days of the
date of the completion of the revisit.
(r) (s)
A summary of the discussions from
the meetings
required in subsection (24).
(s) (t)
The number of nursing homes that
participated in a
recognized quality improvement program as described under section
20155a(3).
(21) The department shall report March 1 of each year to the
standing committees on appropriations and the standing committees
having jurisdiction over issues involving senior citizens in the
senate and the house of representatives on all of the following:
(a) The percentage of nursing home citations that are appealed
through the informal dispute resolution process.
(b) The number and percentage of nursing home citations that
are appealed and supported, amended, or deleted through the
informal dispute resolution process.
(c) A summary of the quality assurance review of the amended
citations and related survey retraining efforts to improve
consistency among surveyors and across the survey administrative
unit that occurred in the year being reported.
(22) Subject to subsection (23), a clarification work group
comprised of the department in consultation with a nursing home
resident or a member of a nursing home resident's family, nursing
home provider groups, the American medical directors association,
the state long-term care ombudsman, and the federal centers for
medicare and medicaid services shall clarify the following terms as
those terms are used in title XVIII and title XIX and applied by
the department to provide more consistent regulation of nursing
homes in this state:
(a) Immediate jeopardy.
(b) Harm.
(c) Potential harm.
(d) Avoidable.
(e) Unavoidable.
(23) All of the following clarifications developed under
subsection (22) apply for purposes of subsection (22):
(a) Specifically, the term "immediate jeopardy" means a
situation in which immediate corrective action is necessary because
the nursing home's noncompliance with 1 or more requirements of
participation has caused or is likely to cause serious injury,
harm, impairment, or death to a resident receiving care in a
nursing home.
(b) The likelihood of immediate jeopardy is reasonably higher
if there is evidence of a flagrant failure by the nursing home to
comply with a nationally recognized clinical process guideline
adopted
under subsection (25) than if the
nursing home has
substantially
and continuously complied with those nationally
recognized clinical process guidelines. If federal regulations and
guidelines are not clear, and if the clinical process guidelines
have been recognized, a process failure giving rise to an immediate
jeopardy may involve an egregious widespread or repeated process
failure and the absence of reasonable efforts to detect and prevent
the process failure.
(c) In determining whether or not there is immediate jeopardy,
the survey agency should consider at least all of the following:
(i) Whether the nursing home could reasonably have been
expected to know about the deficient practice and to stop it, but
did not stop the deficient practice.
(ii) Whether the nursing home could reasonably have been
expected to identify the deficient practice and to correct it, but
did not correct the deficient practice.
(iii) Whether the nursing home could reasonably have been
expected to anticipate that serious injury, serious harm,
impairment, or death might result from continuing the deficient
practice, but did not so anticipate.
(iv) Whether the nursing home could reasonably have been
expected to know that a widely accepted high-risk practice is or
could be problematic, but did not know.
(v) Whether the nursing home could reasonably have been
expected to detect the process problem in a more timely fashion,
but did not so detect.
(d) The existence of 1 or more of the factors described in
subdivision (c), and especially the existence of 3 or more of those
factors simultaneously, may lead to a conclusion that the situation
is one in which the nursing home's practice makes adverse events
likely to occur if immediate intervention is not undertaken, and
therefore constitutes immediate jeopardy. If none of the factors
described in subdivision (c) is present, the situation may involve
harm or potential harm that is not immediate jeopardy.
(e) Specifically, "actual harm" means a negative outcome to a
resident that has compromised the resident's ability to maintain or
reach, or both, his or her highest practicable physical, mental,
and psychosocial well-being as defined by an accurate and
comprehensive resident assessment, plan of care, and provision of
services. Harm does not include a deficient practice that only may
cause or has caused limited consequences to the resident.
(f) For purposes of subdivision (e), in determining whether a
negative outcome is of limited consequence, if the "state
operations manual" or "the guidance to surveyors" published by the
federal centers for medicare and medicaid services does not provide
specific guidance, the department may consider whether most people
in similar circumstances would feel that the damage was of such
short duration or impact as to be inconsequential or trivial. In
such a case, the consequence of a negative outcome may be
considered more limited if it occurs in the context of overall
procedural
consistency with an accepted a
nationally recognized
clinical
process guideline, adopted under subsection (25), as
compared to a substantial inconsistency with or variance from the
guideline.
(g) For purposes of subdivision (e), if the publications
described in subdivision (f) do not provide specific guidance, the
department may consider the degree of a nursing home's adherence to
a
nationally recognized clinical process guideline adopted under
subsection
(25) in considering whether the
degree of compromise and
future risk to the resident constitutes actual harm. The risk of
significant compromise to the resident may be considered greater in
the context of substantial deviation from the guidelines than in
the case of overall adherence.
(h) To improve consistency and to avoid disputes over
avoidable and unavoidable negative outcomes, nursing homes and
survey agencies must have a common understanding of accepted
process guidelines and of the circumstances under which it can
reasonably be said that certain actions or inactions will lead to
avoidable negative outcomes. If the "state operations manual" or
"the guidance to surveyors" published by the federal centers for
medicare and medicaid services is not specific, a nursing home's
overall documentation of adherence to a nationally recognized
clinical
process guideline with a process indicator adopted under
subsection
(25) is relevant information in
considering whether a
negative outcome was avoidable or unavoidable and may be considered
in the application of that term.
(24) The department shall conduct a quarterly meeting and
invite
appropriate stakeholders. Appropriate stakeholders The
department
shall include invite as appropriate stakeholders under
this subsection at least 1 representative from each nursing home
provider organization that does not own or operate a nursing home
representing 30 or more nursing homes statewide, the state long-
term care ombudsman or his or her designee, and any other clinical
experts. Individuals who participate in these quarterly meetings,
in
conjunction jointly with the department, may designate advisory
workgroups to develop recommendations on the discussion topics that
should include, at a minimum, all of the following:
(a) Opportunities for enhanced promotion of nursing home
performance, including, but not limited to, programs that encourage
and reward providers that strive for excellence.
(b) Seeking quality improvement to the survey and enforcement
process, including clarifications to process-related policies and
protocols that include, but are not limited to, all of the
following:
(i) Improving the surveyors' quality and preparedness.
(ii) Enhanced communication between regulators, surveyors,
providers, and consumers.
(iii) Ensuring fair enforcement and dispute resolution by
identifying methods or strategies that may resolve identified
problems or concerns.
(c) Promoting transparency across provider and surveyor
communities, including, but not limited to, all of the following:
(i) Applying regulations in a consistent manner and evaluating
changes that have been implemented to resolve identified problems
and concerns.
(ii) Providing consumers with information regarding changes in
policy and interpretation.
(iii) Identifying positive and negative trends and factors
contributing to those trends in the areas of resident care,
deficient practices, and enforcement.
(d) Clinical process guidelines.
(25)
Subject to subsection (27), the department A nursing home
shall
develop and adopt clinical process guidelines. The department
shall
establish and adopt use
evidence-based, nationally recognized
clinical process guidelines or best-practice resources to develop
and implement resident care policies and compliance protocols with
outcome
measures for all of the following areas and for other
topics
where the department determines that clarification will
benefit
providers and consumers of long-term care:measurable
outcomes specifically in the following clinical practice areas:
(a)
Bed Use of bed rails.
(b) Adverse drug effects.
(c)
Falls.Prevention of falls.
(d)
Pressure sores.Prevention
of pressure ulcers.
(e)
Nutrition and hydration. including, but not limited to,
heat-related
stress.
(f) Pain management.
(g) Depression and depression pharmacotherapy.
(h) Heart failure.
(i) Urinary incontinence.
(j) Dementia care.
(k) Osteoporosis.
(l) Altered mental states.
(m) Physical and chemical restraints.
(n)
Culture-change Person-centered
care principles. ,
person-
centered
caring, and self-directed care.
(26) In an area of clinical practice that is not listed in
subsection (25), a nursing home may use evidence-based, nationally
recognized clinical process guidelines or best-practice resources
to develop and implement resident care policies and compliance
protocols with measurable outcomes to promote performance
excellence.
(27) (26)
The department shall biennially review and update
all
clinical process guidelines as needed and shall continue to
develop
and implement clinical process guidelines for topics that
have
not been developed from the list in subsection (25) and other
topics
identified as a result of the meetings required in
subsection
(24). The department shall consider
recommendations from
an
advisory workgroup created under subsection (24). on clinical
process
guidelines. The department shall
may include training on
new and revised evidence-based, nationally recognized clinical
process guidelines or best-practice resources, which contain
measurable outcomes, in the joint provider and surveyor training
sessions
as those clinical process guidelines are developed and
revised.to assist provider efforts toward improved
regulatory
compliance and performance excellence and to foster a common
understanding of accepted best-practice standards between providers
and the survey agency. The department shall post on its website all
evidence-based, nationally recognized clinical process guidelines
and best-practice resources used in a training session under this
subsection for provider, surveyor, and public reference.
(28) (27)
Beginning November 1, 2012, representatives
Representatives from each nursing home provider organization that
does not own or operate a nursing home representing 30 or more
nursing homes statewide and the state long-term care ombudsman or
his
or her designee shall be are
permanent members of any a
clinical advisory workgroup created under subsection (24). The
department shall issue survey certification memorandums to
providers to announce or clarify changes in the interpretation of
regulations.
(29) (28)
The department shall maintain the
process by which
the
director of the long-term care division of nursing home
monitoring
or his or her designee or the director
of the division
of
operations or his or her designee reviews
and authorizes the
issuance of a citation for immediate jeopardy or substandard
quality of care before the statement of deficiencies is made final.
The
review shall be to must assure that the applicable concepts,
clinical
process guidelines, and other tools contained in
subsections
(25) to (27) are being used consistently, accurately,
and
effectively. the consistent
and accurate application of federal
and state survey protocols and defined regulatory standards. As
used in this subsection, "immediate jeopardy" and "substandard
quality of care" mean those terms as defined by the federal centers
for medicare and medicaid services.
(30) (29)
Upon availability of funds, the
department shall
give grants, awards, or other recognition to nursing homes to
encourage
the rapid development and implementation or maintenance
of
the resident care policies
and compliance protocols that are
created from evidence-based, nationally recognized clinical process
guidelines
adopted under subsection (25).or
best-practice resources
with measurable outcomes to promote performance excellence.
(31) (30)
The department shall instruct and train the
surveyors
in the Surveyors shall consider
evidence-based,
nationally
recognized clinical process guidelines adopted
under
subsection
(25) in citing deficiencies.or
best-practice resources
with measurable outcomes that are used by a nursing home to develop
and implement resident care policies and compliance protocols when
making compliance decisions under this section.
(32) (31)
A nursing home shall post the
nursing home's survey
report in a conspicuous place within the nursing home for public
review.
(33) (32)
Nothing in this amendatory act shall be construed to
2001 PA 218 does not limit the requirements of related state and
federal law.
(34) (33)
As used in this section:
(a) "Consecutive days" means calendar days, but does not
include Saturday, Sunday, or state- or federally-recognized
holidays.
(b) "Form CMS-2567" means the federal centers for medicare and
medicaid services' form for the statement of deficiencies and plan
of correction or a successor form serving the same purpose.
(c) "Title XVIII" means title XVIII of the social security
act,
42 USC 1395 to 1395kkk.1395lll.
(d) "Title XIX" means title XIX of the social security act, 42
USC 1396 to 1396w-5.
Sec.
21703. (1) "Patient" means a person who receives care or
services
at a nursing home.resident.
(2) "Patient's representative" or "resident's representative"
means a person, other than the licensee or an employee or person
having a direct or indirect ownership interest in the nursing home,
designated
in writing by a patient resident
or a patient's
resident's guardian for a specific, limited purpose or for general
purposes, or, if a written designation of a representative is not
made,
the guardian of the patient.resident.
(3)
"Relocation" means the movement of a patient resident from
1 bed to another or from 1 room to another within the same nursing
home or within a certified distinct part of a nursing home.
(4) "Resident" means an individual who receives care or
services at a nursing home.
(5) (4)
"Transfer" means the
movement of a patient resident
from 1 nursing home to another nursing home or from 1 certified
distinct part of a nursing home to another certified distinct part
of the same nursing home.
(6) (5)
"Welfare" means, with
reference to a patient,
resident, the physical, emotional, or social well-being of a
patient
resident in a nursing home, including a patient resident
awaiting
transfer or discharge, as documented in the patient's
resident's clinical record by a licensed or certified health care
professional.
Sec. 21734. (1) Notwithstanding section 20201(2)(l), a nursing
home shall give each resident who uses a hospital-type bed or the
resident's legal guardian, patient advocate, or other legal
representative the option of having bed rails. A nursing home shall
offer the option to new residents upon admission and to other
residents upon request. Upon receipt of a request for bed rails,
the nursing home shall inform the resident or the resident's legal
guardian, patient advocate, or other legal representative of
alternatives to and the risks involved in using bed rails. A
resident or the resident's legal guardian, patient advocate, or
other legal representative has the right to request and consent to
bed rails for the resident. A nursing home shall provide bed rails
to a resident only upon receipt of a signed consent form
authorizing bed rail use and a written order from the resident's
attending physician that contains statements and determinations
regarding medical symptoms and that specifies the circumstances
under which bed rails are to be used. For purposes of this
subsection, "medical symptoms" includes the following:
(a) A concern for the physical safety of the resident.
(b) Physical or psychological need expressed by a resident. A
resident's fear of falling may be the basis of a medical symptom.
(2) A nursing home that provides bed rails under subsection
(1) shall do all of the following:
(a) Document that the requirements of subsection (1) have been
met.
(b) Monitor the resident's use of the bed rails.
(c) In consultation with the resident, resident's family,
resident's attending physician, and individual who consented to the
bed rails, periodically reevaluate the resident's need for the bed
rails.
(3)
The department of consumer and industry services shall
develop
maintain clear and uniform guidelines best-practice
protocols to be used in determining what constitutes each of the
following:
(a) Acceptable bed rails for use in a nursing home in this
state. The department shall consider the recommendations of the
hospital bed safety work group established by the United States
food and drug administration, if those are available, in
determining what constitutes an acceptable bed rail.
(b) Proper maintenance of bed rails.
(c) Properly fitted mattresses.
(d) Other hazards created by improperly positioned bed rails,
mattresses, or beds.
(4)
The department of consumer and industry services shall
develop
the guidelines maintain the
best-practice protocols under
subsection (3) in consultation with the long-term care stakeholders
work
group established under section
20155(24). An individual
representing
manufacturers of bed rails, 2 residents or family
members,
and an individual with expertise in bed rail installation
and
use shall be added to the long-term care work group for
purposes
of this subsection. The department shall consider as part
of
its report to the legislature the recommendations of the
hospital
bed safety work group established by the United States
food
and drug administration, if those recommendations are
available
at the time of the submission of the report. Not later
than
6 months after the effective date of the amendatory act that
added
this section, the department of consumer and industry
services
shall submit its report to the legislature. The department
may
delay submission of its report by up to 3 months so that its
report
may reflect the recommendations of the hospital bed safety
work
group established by the United States food and drug
administration.
(5) A nursing home that complies with subsections (1) and (2)
and
the guidelines developed protocols
maintained under this
section in providing bed rails to a resident is not subject to
administrative penalties imposed by the department based solely on
providing
the bed rails. Nothing in this This
subsection precludes
does not preclude the department from citing specific state or
federal deficiencies for improperly maintained bed rails,
improperly fitted mattresses, or other hazards created by
improperly positioned bed rails, mattresses, or beds.
(6)
The department of consumer and industry services shall
consult
with representatives of the nursing home industry to
expeditiously
develop interim guidelines on bed rail usage that are
to
be used until the department develops the guidelines required
under
subsection (4).
