MISSISSIPPI LEGISLATURE

2011 Regular Session

To: Public Health and Human Services

By: Representative Holland

House Bill 447

(COMMITTEE SUBSTITUTE)

AN ACT TO AMEND SECTION 43-11-1, MISSISSIPPI CODE OF 1972, TO DEFINE "PERSONAL CARE HOME," "ASSISTED LIVING," AND "PSYCHIATRIC SUPERVISED HOUSING FACILITY" FOR THE PURPOSES OF THE LICENSURE LAW FOR INSTITUTIONS FOR THE AGED OR INFIRM; TO DELETE THE REVERTER ON THE PROVISION THAT EXCLUDES FROM LICENSURE CERTAIN PRIVATE RESIDENCES IN WHICH THE OWNER OF THE RESIDENCE PROVIDES PERSONAL CARE SERVICES TO DISABLED OR HOMELESS VETERANS; TO AMEND SECTION 43-11-13, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE RULES, REGULATIONS AND STANDARDS ADOPTED BY THE STATE BOARD OF HEALTH FOR PERSONAL CARE HOMES ARE NOT REQUIRED TO BE UNIFORM FOR EACH OF THE CLASSIFICATIONS OF PERSONAL CARE HOMES, BUT MAY VARY BASED ON THE DIFFERENCES BETWEEN THE TYPES OF FACILITIES IN EACH CLASSIFICATION; TO INCREASE THE LIMITATION ON THE NUMBER OF PERSONS WHO ARE ALLOWED TO CONTINUE TO RESIDE IN A PERSONAL CARE HOME WITH APPROVAL OF A PHYSICIAN, NOTWITHSTANDING A DETERMINATION BY THE DEPARTMENT THAT NURSING SERVICES WOULD BE APPROPRIATE FOR THOSE PERSONS; TO EXTEND THE DATE OF THE REPEALER ON THE PRECEDING PROVISION; TO PROVIDE THAT BEFORE A RESIDENT OF A PERSONAL CARE HOME MAY BE TRANSFERRED FROM THE HOME WHERE HE OR SHE WAS INITIALLY ADMITTED TO ANOTHER FACILITY OR LOCATION, THE OPERATOR OF THE PERSONAL CARE HOME SHALL NOTIFY THE RESIDENT'S RESPONSIBLE PARTY AND SHALL ALLOW THE RESPONSIBLE PARTY TO SEE THE FACILITY OR LOCATION TO WHICH THE RESIDENT IS TO BE TRANSFERRED; TO PROHIBIT FACILITIES LICENSED BY THE STATE DEPARTMENT OF HEALTH FROM REFERRING ANY PERSON TO AN UNLICENSED PERSONAL CARE HOME, AND TO PROHIBIT UNLICENSED PERSONAL CARE HOMES FROM RECEIVING ANY PATIENTS OR RESIDENTS THAT HAVE BEEN REFERRED TO THE HOME BY THOSE FACILITIES; TO REQUIRE ANY PERSON WHO OPERATES A PSYCHIATRIC SUPERVISED HOUSING FACILITY TO REGISTER WITH THE LOCAL REGIONAL MENTAL HEALTH CENTER; TO AUTHORIZE PERSONNEL OF THE LOCAL REGIONAL MENTAL HEALTH CENTER TO ENTER THE FACILITY FOR THE PURPOSES OF CASE MANAGEMENT FOLLOWUP; TO AUTHORIZE THE STATE DEPARTMENT OF HEALTH TO REMOVE THE RESIDENTS FROM ANY INSTITUTION FOR THE AGED OR INFIRM WHOSE FAILURE TO COMPLY WITH THE RULES, REGULATIONS AND LAWS THAT GOVERN ITS OPERATION RESULTS IN AN IMMINENTLY DANGEROUS ENVIRONMENT FOR THE RESIDENTS; TO BRING FORWARD SECTIONS 27-65-23.1, 43-7-55, 43-11-5, 43-11-7, 43-11-8, 43-11-9, 43-11-41 AND 73-17-5, MISSISSIPPI CODE OF 1972, FOR THE PURPOSES OF POSSIBLE AMENDMENT; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  Section 43-11-1, Mississippi Code of 1972, is amended as follows:

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     43-11-1.  When used in this chapter, the following words shall have the following meaning:

          (a)  "Institutions for the aged or infirm" means a place either governmental or private that provides group living arrangements for four (4) or more persons who are unrelated to the operator and who are being provided food, shelter and personal care services, whether any such place is organized or operated for profit or not.  The term "institution for aged or infirm" includes nursing homes, pediatric skilled nursing facilities, psychiatric residential treatment facilities, personal care homes, convalescent homes, homes for the aged and adult foster care facilities, provided that these institutions fall within the scope of the definitions set forth above.  The term "institution for the aged or infirm" does not include hospitals, clinics or mental institutions devoted primarily to providing medical service, and does not include any private residence in which the owner of the residence is providing personal care services to disabled or homeless veterans under an agreement with, and in compliance with the standards prescribed by, the United States Department of Veterans Affairs, if the owner of the residence also provided personal care services to disabled or homeless veterans at any time during calendar year 2008.

          (b)  "Person" means any individual, firm, partnership, corporation, company, association or joint-stock association, or any licensee herein or the legal successor thereof.

          (c)  "Personal care services" means assistance rendered by personnel of the home to aged or infirm residents in performing one or more of the activities of daily living, which includes, but is not limited to, the bathing, walking, excretory functions, feeding, personal grooming and dressing of those residents.

          (d)  "Personal care home" means a facility that provides personal care services to the residents of the facility.  There are three (3) classifications of personal care homes, based upon the level of services provided:  assisted living facilities, residential living facilities and psychiatric supervised housing facilities.

          (e)  "Assisted living" means a special combination of housing, supportive services, supervision, personalized assistance, and health care designed to respond to the individual needs of those who need help with activities of daily living and/or instrumental activities of daily living.

          (f)  "Psychiatric supervised housing facility" means a facility that serves persons with a psychiatric diagnosis or persons with intellectual or developmental disabilities and only provides personal care services to the residents of the facility.

          (g)  "Psychiatric residential treatment facility" means any nonhospital establishment with permanent facilities which provides a twenty-four-hour program of care by qualified therapists, including, but not limited to, duly licensed mental health professionals, psychiatrists, psychologists, psychotherapists and licensed certified social workers, for emotionally disturbed children and adolescents referred to that facility by a court, local school district or by the Department of Human Services, who are not in an acute phase of illness requiring the services of a psychiatric hospital, and are in need of those restorative treatment services.  For purposes of this paragraph, the term "emotionally disturbed" means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree, which adversely affects educational performance:

              1.  An inability to learn which cannot be explained by intellectual, sensory or health factors;

              2.  An inability to build or maintain satisfactory relationships with peers and teachers;

              3.  Inappropriate types of behavior or feelings under normal circumstances;

              4.  A general pervasive mood of unhappiness or depression; or

              5.  A tendency to develop physical symptoms or fears associated with personal or school problems.  An establishment furnishing primarily domiciliary care is not within this definition.

          (h)  "Pediatric skilled nursing facility" means an institution or a distinct part of an institution that is primarily engaged in providing to inpatients skilled nursing care and related services for persons under twenty-one (21) years of age who require medical or nursing care or rehabilitation services for the rehabilitation of injured, disabled or sick persons.

          (i)  "Licensing agency" means the State Department of Health, or the State Board of Health when pertaining to the adoption and promulgations of rules, regulations or standards.

          (j)  "Medical records" mean, without restriction, those medical histories, records, reports, summaries, diagnoses and prognoses, records of treatment and medication ordered and given, notes, entries, x-rays and other written or graphic data prepared, kept, made or maintained in institutions for the aged or infirm that pertain to residency in, or services rendered to residents of, an institution for the aged or infirm.

          (k)  "Adult foster care facility" means a home setting for vulnerable adults in the community who are unable to live independently due to physical, emotional, developmental or mental impairments, or in need of emergency and continuing protective social services for purposes of preventing further abuse or neglect and for safeguarding and enhancing the welfare of the abused or neglected vulnerable adult.  Adult foster care programs shall be designed to meet the needs of vulnerable adults with impairments through individual plans of care, which provide a variety of health, social and related support services in a protective setting, enabling participants to live in the community.  Adult foster care programs may be (i) traditional, where the foster care provider lives in the residence and is the primary caregiver to clients in the home; (ii) corporate, where the foster care home is operated by a corporation with shift staff delivery services to clients; or (iii) shelter, where the foster care home accepts clients on an emergency short-term basis for up to thirty (30) days.

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     SECTION 2.  Section 43-11-13, Mississippi Code of 1972, is amended as follows:

     43-11-13.  (1)  The licensing agency shall adopt, amend, promulgate and enforce such rules, regulations and standards, including classifications, with respect to all institutions for the aged or infirm to be licensed under this chapter as may be designed to further the accomplishment of the purpose of this chapter in promoting adequate care of individuals in those institutions in the interest of public health, safety and welfare. 

The rules, regulations and standards for personal care homes are not required to be uniform for each of the classifications of personal care homes, but may vary based on the differences between the types of facilities in each classification.  Those rules, regulations and standards shall be adopted and promulgated by the licensing agency and shall be recorded and indexed in a book to be maintained by the licensing agency in its main office in the State of Mississippi, entitled "Rules, Regulations and Minimum Standards for Institutions for the Aged or Infirm" and the book shall be open and available to all institutions for the aged or infirm and the public generally at all reasonable times.  Upon the adoption of those rules, regulations and standards, the licensing agency shall mail copies thereof to all those institutions in the state that have filed with the agency their names and addresses for this purpose, but the failure to mail the same or the failure of the institutions to receive the same shall in no way affect the validity thereof.  The rules, regulations and standards may be amended by the licensing agency, from time to time, as necessary to promote the health, safety and welfare of persons living in those institutions.

     (2)  The licensee shall keep posted in a conspicuous place on the licensed premises all current rules, regulations and minimum standards applicable to fire protection measures as adopted by the licensing agency.  The licensee shall furnish to the licensing agency at least once each six (6) months a certificate of approval and inspection by state or local fire authorities.  Failure to comply with state laws and/or municipal ordinances and current rules, regulations and minimum standards as adopted by the licensing agency, relative to fire prevention measures, shall be prima facie evidence for revocation of license.

     (3)  The licensing agency shall promulgate rules and regulations restricting the storage, quantity and classes of drugs allowed in personal care homes and adult foster care facilities.  Residents requiring administration of Schedule II Narcotics as defined in the Uniform Controlled Substances Law may be admitted to a personal care home.  Schedule drugs may only be allowed in a personal care home if they are administered or stored utilizing proper procedures under the direct supervision of a licensed physician or nurse.

     (4)  (a)  Notwithstanding any determination by the licensing agency that skilled nursing services would be appropriate for a resident of a personal care home, that resident, the resident's guardian or the legally recognized responsible party for the resident may consent in writing for the resident to continue to reside in the personal care home, if approved in writing by a licensed physician.  However, no personal care home shall allow more than three (3) residents, or fifteen percent (15%) of the total number of residents in the personal care home, whichever is greater, to remain in the personal care home under the provisions of this subsection (4).  This consent shall be deemed to be appropriately informed consent as described in the regulations promulgated by the licensing agency.  After that written consent has been obtained, the resident shall have the right to continue to reside in the personal care home for as long as the resident meets the other conditions for residing in the personal care home.  A copy of the written consent and the physician's approval shall be forwarded by the personal care home to the licensing agency.

          (b)  The licensing agency shall promulgate rules and regulations restricting the handling of a resident's personal deposits by the director of a personal care home.  Any funds given or provided for the purpose of supplying extra comforts, conveniences or services to any resident in any personal care home, and any funds otherwise received and held from, for or on behalf of any such resident, shall be deposited by the director or other proper officer of the personal care home to the credit of that resident in an account that shall be known as the Resident's Personal Deposit Fund.  No more than one (1) month's charge for the care, support, maintenance and medical attention of the resident shall be applied from the account at any one time.  After the death, discharge or transfer of any resident for whose benefit any such fund has been provided, any unexpended balance remaining in his personal deposit fund shall be applied for the payment of care, cost of support, maintenance and medical attention that is accrued.  If any unexpended balance remains in that resident's personal deposit fund after complete reimbursement has been made for payment of care, support, maintenance and medical attention, and the director or other proper officer of the personal care home has been or shall be unable to locate the person or persons entitled to the unexpended balance, the director or other proper officer may, after the lapse of one (1) year from the date of that death, discharge or transfer, deposit the unexpended balance to the credit of the personal care home's operating fund.

          (c)  The licensing agency shall promulgate rules and regulations requiring personal care homes to maintain records relating to health condition, medicine dispensed and administered, and any reaction to that medicine.  The director of the personal care home shall be responsible for explaining the availability of those records to the family of the resident at any time upon reasonable request.

          (d)  Before a resident of a personal care home may be transferred from the home where he or she was initially admitted to another facility or location, the operator of the personal care home shall notify the resident's responsible party and shall allow the responsible party to see the facility or location to which the resident is to be transferred.

          (e)  No facility licensed by the licensing agency shall refer any person to a personal care home that is required to be licensed under this chapter but is not licensed, and no such personal care home shall receive any patients or residents that have been referred to that home by a facility licensed by the licensing agency.

          (f)  This subsection (4) shall stand repealed on June 30, 2014.

     (5)  (a)  For the purposes of this subsection (5):

              (i)  "Licensed entity" means a hospital, nursing home, personal care home, home health agency, hospice or adult foster care facility;

              (ii)  "Covered entity" means a licensed entity or a health care professional staffing agency;

              (iii)  "Employee" means any individual employed by a covered entity, and also includes any individual who by contract provides to the patients, residents or clients being served by the covered entity direct, hands-on, medical patient care in a patient's, resident's or client's room or in treatment or recovery rooms.  The term "employee" does not include health care professional/vocational technical students, as defined in Section 37-29-232, performing clinical training in a licensed entity under contracts between their schools and the licensed entity, and does not include students at high schools located in Mississippi who observe the treatment and care of patients in a licensed entity as part of the requirements of an allied-health course taught in the high school, if:

                   1.  The student is under the supervision of a licensed health care provider; and

                   2.  The student has signed an affidavit that is on file at the student's school stating that he or she has not been convicted of or pleaded guilty or nolo contendere to a felony listed in paragraph (d) of this subsection (5), or that any such conviction or plea was reversed on appeal or a pardon was granted for the conviction or plea.  Before any student may sign such an affidavit, the student's school shall provide information to the student explaining what a felony is and the nature of the felonies listed in paragraph (d) of this subsection (5).

     However, the health care professional/vocational technical academic program in which the student is enrolled may require the student to obtain criminal history record checks under the provisions of Section 37-29-232.

          (b)  Under regulations promulgated by the licensing agency, the licensing agency shall require to be performed a criminal history record check on (i) every new employee of a covered entity who provides direct patient care or services and who is employed on or after July 1, 2003, and (ii) every employee of a covered entity employed before July 1, 2003, who has a documented disciplinary action by his or her present employer.  In addition, the licensing agency shall require the covered entity to perform a disciplinary check with the professional licensing agency of each employee, if any, to determine if any disciplinary action has been taken against the employee by that agency.

     Except as otherwise provided in paragraph (c) of this subsection (5), no such employee hired on or after July 1, 2003, shall be permitted to provide direct patient care until the results of the criminal history record check have revealed no disqualifying record or the employee has been granted a waiver.  In order to determine the employee applicant's suitability for employment, the applicant shall be fingerprinted.  Fingerprints shall be submitted to the licensing agency from scanning, with the results processed through the Department of Public Safety's Criminal Information Center.  If no disqualifying record is identified at the state level, the fingerprints shall be forwarded by the Department of Public Safety to the Federal Bureau of Investigation for a national criminal history record check.  The licensing agency shall notify the covered entity of the results of an employee applicant's criminal history record check.  If the criminal history record check discloses a felony conviction, guilty plea or plea of nolo contendere to a felony of possession or sale of drugs, murder, manslaughter, armed robbery, rape, sexual battery, sex offense listed in Section 45-33-23(g), child abuse, arson, grand larceny, burglary, gratification of lust or aggravated assault, or felonious abuse and/or battery of a vulnerable adult that has not been reversed on appeal or for which a pardon has not been granted, the employee applicant shall not be eligible to be employed by the covered entity.

          (c)  Any such new employee applicant may, however, be employed on a temporary basis pending the results of the criminal history record check, but any employment contract with the new employee shall be voidable if the new employee receives a disqualifying criminal history record check and no waiver is granted as provided in this subsection (5).

          (d)  Under regulations promulgated by the licensing agency, the licensing agency shall require every employee of a covered entity employed before July 1, 2003, to sign an affidavit stating that he or she has not been convicted of or pleaded guilty or nolo contendere to a felony of possession or sale of drugs, murder, manslaughter, armed robbery, rape, sexual battery, any sex offense listed in Section 45-33-23(g), child abuse, arson, grand larceny, burglary, gratification of lust, aggravated assault, or felonious abuse and/or battery of a vulnerable adult, or that any such conviction or plea was reversed on appeal or a pardon was granted for the conviction or plea.  No such employee of a covered entity hired before July 1, 2003, shall be permitted to provide direct patient care until the employee has signed the affidavit required by this paragraph (d).  All such existing employees of covered entities must sign the affidavit required by this paragraph (d) within six (6) months of the final adoption of the regulations promulgated by the licensing agency.  If a person signs the affidavit required by this paragraph (d), and it is later determined that the person actually had been convicted of or pleaded guilty or nolo contendere to any of the offenses listed in this paragraph (d) and the conviction or plea has not been reversed on appeal or a pardon has not been granted for the conviction or plea, the person is guilty of perjury.  If the offense that the person was convicted of or pleaded guilty or nolo contendere to was a violent offense, the person, upon a conviction of perjury under this paragraph, shall be punished as provided in Section 97-9-61.  If the offense that the person was convicted of or pleaded guilty or nolo contendere to was a nonviolent offense, the person, upon a conviction of perjury under this paragraph, shall be punished by a fine of not more than Five Hundred Dollars ($500.00), or by imprisonment in the county jail for not more than six (6) months, or by both such fine and imprisonment.

          (e)  The covered entity may, in its discretion, allow any employee who is unable to sign the affidavit required by paragraph (d) of this subsection (5) or any employee applicant aggrieved by an employment decision under this subsection (5) to appear before the covered entity's hiring officer, or his or her designee, to show mitigating circumstances that may exist and allow the employee or employee applicant to be employed by the covered entity.  The covered entity, upon report and recommendation of the hiring officer, may grant waivers for those mitigating circumstances, which shall include, but not be limited to:  (i) age at which the crime was committed; (ii) circumstances surrounding the crime; (iii) length of time since the conviction and criminal history since the conviction; (iv) work history; (v) current employment and character references; and (vi) other evidence demonstrating the ability of the individual to perform the employment responsibilities competently and that the individual does not pose a threat to the health or safety of the patients of the covered entity.

          (f)  The licensing agency may charge the covered entity submitting the fingerprints a fee not to exceed Fifty Dollars ($50.00), which covered entity may, in its discretion, charge the same fee, or a portion thereof, to the employee applicant.  Any costs incurred by a covered entity implementing this subsection (5) shall be reimbursed as an allowable cost under Section 43-13-116.

          (g)  If the results of an employee applicant's criminal history record check reveals no disqualifying event, then the covered entity shall, within two (2) weeks of the notification of no disqualifying event, provide the employee applicant with a notarized letter signed by the chief executive officer of the covered entity, or his or her authorized designee, confirming the employee applicant's suitability for employment based on his or her criminal history record check.  An employee applicant may use that letter for a period of two (2) years from the date of the letter to seek employment with any covered entity without the necessity of an additional criminal history record check.  Any covered entity presented with the letter may rely on the letter with respect to an employee applicant's criminal background and is not required for a period of two (2) years from the date of the letter to conduct or have conducted a criminal history record check as required in this subsection (5).

          (h)  The licensing agency, the covered entity, and their agents, officers, employees, attorneys and representatives, shall be presumed to be acting in good faith for any employment decision or action taken under this subsection (5).  The presumption of good faith may be overcome by a preponderance of the evidence in any civil action.  No licensing agency, covered entity, nor their agents, officers, employees, attorneys and representatives shall be held liable in any employment decision or action based in whole or in part on compliance with or attempts to comply with the requirements of this subsection (5).

          (i)  The licensing agency shall promulgate regulations to implement this subsection (5).

          (j)  The provisions of this subsection (5) shall not apply to:

              (i)  Applicants and employees of the University of Mississippi Medical Center for whom criminal history record checks and fingerprinting are obtained in accordance with Section 37-115-41; or

              (ii)  Health care professional/vocational technical students for whom criminal history record checks and fingerprinting are obtained in accordance with Section 37-29-232.

     (6)  The State Board of Health shall promulgate rules, regulations and standards regarding the operation of adult foster care facilities.

     (7)  Any person who operates a psychiatric supervised housing facility shall register with the local regional mental health center for the county in which the psychiatric supervised housing facility is located.  Personnel of the local regional mental health center for the county in which a psychiatric supervised housing facility is located are authorized to enter the facility for the purposes of case management followup.

     (8)  (a)  For purposes of this subsection (8), an "imminently dangerous environment" is one in which a person has been, or is likely to be, seriously injured or harmed.

          (b)  If the operator or licensee of an institution for the aged or infirm fails to comply with the rules, regulations and laws that govern its operation and that failure of compliance results in an imminently dangerous environment for the residents of the facility, the licensing agency may, without necessity of court order, remove the residents from the facility.  After removal of the residents, the operator or licensee is prohibited from admitting any new residents, and the residents who are removed shall be appropriately placed in a licensed and compliant institution for the aged or infirm.  The licensing agency, upon removal of the residents, shall notify the operator or licensee that it is taking action to revoke the license previously granted to the facility.  The operator or licensee shall be afforded all due process protections granted in Section 43-11-11 in the action to revoke the license of the facility.

     SECTION 3.  Section 27-65-23.1, Mississippi Code of 1972, is brought forward as follows:

     27-65-23.1.  (1)  Subject to the provisions of this section, for any tax levied and collected under the authority of a local and private law of the State of Mississippi ("local and private law"), that is levied or imposed on the gross proceeds or gross income from room rentals of hotels or motels and is collected and paid to the State Tax Commission in the same or similar manner that state sales taxes are collected and paid, the term "hotel" or "motel" also shall include (regardless of how such term is defined in the local and private law) any entity or individual engaged in the business of furnishing or providing one or more rooms intended or designed for dwelling, lodging or sleeping purposes that at any one time will accommodate transient guests and that are known to the trade as such and includes every building or other structure kept, used, maintained or advertised as, or held out to the public to be, a place where sleeping accommodations are supplied for pay or other consideration to transient guests regardless of the number of rooms, units, suites or cabins available, excluding nursing homes or institutions for the aged or infirm as defined in Section 43-11-1 and personal care homes. 

     (2)  If the definition of hotel or motel provided in the local and private law authorizing the tax does not include the entities described in subsection (1) of this section, then the provisions of subsection (1) of this section shall not apply unless the county board of supervisors or municipal governing authorities, as appropriate, authorized to levy the tax under the local and private law, adopts a resolution declaring their intention to include such entities for the purposes of the tax.

If the county board of supervisors or municipal governing authorities, as appropriate, adopts such a resolution, then at least thirty (30) days before the effective date of the levy of the tax upon the entities described in subsection (1) of this section, the county board of supervisors or municipal governing authorities, as appropriate, shall furnish to the State Tax Commission a certified copy of such resolution.

     SECTION 4.  Section 43-7-55, Mississippi Code of 1972, is brought forward as follows:

     43-7-55.  For the purposes of Sections 43-7-51 through 43-7-79, the following words shall have the definitions ascribed herein:

          (a)  "Administrator" means any person charged with the general administration or supervision of a long-term care facility without regard to whether such person has an ownership interest in such facility or to whether such person's functions and duties are shared with one or more other persons;

          (b)  "Community ombudsman" means a person selected by an area agency on aging who is then trained and certified as such by the council pursuant to Section 43-7-59;

          (c)  "Council" means the Mississippi Council on Aging;

          (d)  "Long-term care facility" means any skilled nursing facility, extended care home, intermediate care facility, personal care home or boarding home which is subject to regulation or licensure by the State Department of Health;

          (e)  "Resident" means any resident, prospective resident, prior resident or deceased resident of any long-term care facility;

          (f)  "Sponsor" means an adult relative, friend or guardian who has a responsibility in the resident's welfare;

          (g)  "State Ombudsman" means the State Long-Term Care Facilities Ombudsman;

          (h)  "Ombudsman" means the State Ombudsman or any community ombudsman;

          (i)  "Area agency on aging" means those grantees of the council which are charged with the local administration of the Older Americans Act.

     SECTION 5.  Section 43-11-5, Mississippi Code of 1972, is brought forward as follows:

     43-11-5.  No person, acting severally or jointly with any other person, shall establish, conduct, or maintain an institution for the aged or infirm in this state without a license under this chapter.

     SECTION 6.  Section 43-11-7, Mississippi Code of 1972, is brought forward as follows:

     43-11-7.  Any person, as defined in Section 43-11-1, may

apply for a license as provided in this section.  An application for a license shall be made to the licensing agency upon forms provided by it and shall contain such information as the licensing agency reasonably requires, which may include affirmative evidence of ability to comply with such reasonable standards, rules and regulations as are lawfully prescribed under this chapter.  Each application for a license for an institution for the aged or infirm, except for personal care homes, shall be accompanied by a license fee of Twenty Dollars ($20.00) for each bed in the institution, with a minimum fee per institution of Two Hundred Dollars ($200.00), which shall be paid to the licensing agency.  Each application for a license for a personal care home shall be accompanied by a license fee of Fifteen Dollars ($15.00) for each bed in the institution, with a minimum fee per institution of One Hundred Dollars ($100.00), which shall be paid to the licensing agency.

     No governmental entity or agency shall be required to pay the fee or fees set forth in this section.

     SECTION 7.  Section 43-11-8, Mississippi Code of 1972, is brought forward as follows:

     43-11-8.  (1)  An application for a license for an adult foster care facility shall be made to the licensing agency upon forms provided by it and shall contain such information as the licensing agency reasonably requires, which may include affirmative evidence of ability to comply with such reasonable standards, rules and regulations as are lawfully prescribed hereunder.  Each application for a license for an adult foster care facility shall be accompanied by a license fee of Ten Dollars ($10.00) for each person or bed of licensed capacity, with a minimum fee per home or institution of Fifty Dollars ($50.00), which shall be paid to the licensing agency.

     (2)  A license, unless suspended or revoked, shall be renewable annually upon payment by the licensee of an adult foster care facility, except for personal care homes, of a renewal fee of Ten Dollars ($10.00) for each person or bed of licensed capacity in the institution, with a minimum renewal fee per institution of Fifty Dollars ($50.00), which shall be paid to the licensing agency, and upon filing by the licensee and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency prescribes by regulation.  Each license shall be issued only for the premises and person or persons or other legal entity or entities named in the application and shall not be transferable or assignable except with the written approval of the licensing agency.  Licenses shall be posted in a conspicuous place on the licensed premises.

     SECTION 8.  Section 43-11-9, Mississippi Code of 1972, is brought forward as follows:

     43-11-9.  (1)  Upon receipt of an application for license and the license fee, the licensing agency shall issue a license if the applicant and the institutional facilities meet the requirements established under this chapter and the requirements of Section 41-7-173 et seq., where determined by the licensing agency to be applicable.  A license, unless suspended or revoked, shall be renewable annually upon payment by (a) the licensee of an institution for the aged or infirm, except for personal care homes, of a renewal fee of Twenty Dollars ($20.00) for each bed in the institution, with a minimum fee per institution of Two Hundred Dollars ($200.00), or (b) the licensee of a personal care home of a renewal fee of Fifteen Dollars ($15.00) for each bed in the institution, with a minimum fee per institution of One Hundred Dollars ($100.00), which shall be paid to the licensing agency, and upon filing by the licensee and approval by the licensing agency of an annual report upon such uniform dates and containing such information in such form as the licensing agency prescribes by regulation.  Each license shall be issued only for the premises and person or persons or other legal entity or entities named in the application and shall not be transferable or assignable except with the written approval of the licensing agency.  Licenses shall be posted in a conspicuous place on the licensed premises.

     (2)  A fee known as a "User Fee" shall be applicable and shall be paid to the licensing agency as set out in subsection (1) hereof.  This user fee shall be assessed for the purpose of the required reviewing and inspections of the proposal of any institution in which there are additions, renovations, modernizations, expansion, alterations, conversions, modifications or replacement of the entire facility involved in such proposal.  This fee includes the reviewing of architectural plans in all steps required.  There shall be a minimum user fee of Fifty Dollars ($50.00) and a maximum user fee of Five Thousand Dollars ($5,000.00).

     (3)  No governmental entity or agency shall be required to pay the fee or fees set forth in this section.

     SECTION 9.  Section 43-11-41, Mississippi Code of 1972, is brought forward as follows:

     43-11-41.  (1)  This section shall apply to patients in long-term care facilities, as defined in subsection (2) of this section.  It is the intent of the Legislature that the State of Mississippi shall be a "right-to-choose" state for the purposes of Medicaid and Medicare benefits, excluding Medicare Part A, and that patients of long-term care facilities shall have the same rights and privileges concerning pharmacy providers as participants or beneficiaries of health benefit plans.

     (2)  "Long-term care facility" means any skilled nursing facility, extended care home, intermediate care facility, personal care home or boarding home that is subject to regulation or licensure by the State Department of Health.

     (3)  A patient in a long-term care facility shall not be limited in his choice of a pharmacy or pharmacist provider if that provider meets the same standards of dispensing guidelines required of long-term care facilities.

     (4)  A long-term care facility may require that a patient or the person who normally makes health care decisions on behalf of the patient sign a document that identifies his pharmacy or pharmacist provider of choice and that releases the facility of any liability for the dispensing of the prescription until the facility accepts control of the dispensed drug.

     SECTION 10.  Section 73-17-5, Mississippi Code of 1972, is brought forward as follows:

     73-17-5.  As used in this chapter:

          (a)  The term "nursing home administrator" or "administrator" means any individual who is charged with the general administration of a nursing home, whether or not such individual has an ownership interest in such home and whether or not the functions and duties are shared with one or more individuals.  "General administration of a nursing home" shall mean the duties of administrative performance and the making of day-to-day decisions involved in the planning, organizing, directing and/or controlling of a nursing home. 

          (b)  The term "nursing home" means a place, either governmental or private, profit or nonprofit, which provides group living arrangements for four (4) or more persons who are unrelated to the operator and who are being provided food, shelter and personal care, and which employs at least one (1) registered nurse or licensed practical nurse.  The term "nursing home" does not include hospitals, clinics, personal care homes and other institutions devoted primarily to providing medical services. 

          (c)  "Board" means the Mississippi State Board of Nursing Home Administrators. 

          (d)  "Person" means an individual or natural person, and does not include a firm, corporation, association, partnership, institution, public body, joint stock association or other group of individuals.

     SECTION 11.  This act shall take effect and be in force from and after June 30, 2011.