READ FIRST TIME 02/16/11.   

     AN ACT Relating to employment of physicians by nursing homes; reenacting and amending RCW 74.42.010; adding a new section to chapter 18.51 RCW; and creating a new section.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 18.51 RCW to read as follows:
     (1) A nursing home licensed under this chapter may employ physicians for the provision of professional services to its residents under the following conditions:
     (a) The nursing home may not in any manner, directly or indirectly, supplant, diminish, or regulate any employed physician's judgment concerning the practice of medicine or the diagnosis and treatment of any patient; and
     (b) The employed physicians may provide professional services only to residents of the nursing home or a related living facility.
     (2) The employment of physicians as authorized by this section may be through the following entities:
     (a) The entity licensed to operate the nursing home; or
     (b) A separate entity authorized to conduct business in the state of Washington that has common or overlapping ownership as an affiliate or subsidiary of the licensee, as long as the licensee complies with subsection (3) of this section.
     (3) Nothing in this section relieves the licensee of its ultimate responsibility for the daily operations of the nursing home.
     (4) Nothing in this section may be construed to interfere with the federal resident rights requirements found in 42 C.F.R. 483.10, or successor rules, or found in this chapter, chapter 74.42 RCW, or the rules adopted by the department addressing resident's rights under this chapter or chapter 74.42 RCW.
     (5) As used in this section, "related living facility" means (a) a separate nursing home that is owned, controlled, or managed by the same or an affiliated or subsidiary entity; or (b) a facility that (i) provides independent living services or boarding home services under chapter 18.20 RCW, in a single contiguous campus as the nursing home, and (ii) is owned, controlled, or managed by the same or related entity as the nursing home. For purposes of this subsection "contiguous" means land adjoining or touching property on which the nursing home is located, including land divided by a public road.

Sec. 2   RCW 74.42.010 and 2010 c 94 s 27 are each reenacted and amended to read as follows:
     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Department" means the department of social and health services and the department's employees.
     (2) "Facility" refers to a nursing home as defined in RCW 18.51.010.
     (3) "Licensed practical nurse" means a person licensed to practice practical nursing under chapter 18.79 RCW.
     (4) "Medicaid" means Title XIX of the Social Security Act enacted by the social security amendments of 1965 (42 U.S.C. Sec. 1396; 79 Stat. 343), as amended.
     (5) "Nurse practitioner" means a person licensed to practice advanced registered nursing under chapter 18.79 RCW.
     (6) "Nursing care" means that care provided by a registered nurse, an advanced registered nurse practitioner, a licensed practical nurse, or a nursing assistant in the regular performance of their duties.
     (7) "Physician" means a person practicing pursuant to chapter 18.57 or 18.71 RCW, including, but not limited to, a physician employed by the facility as provided in chapter 18.51 RCW.
     (8) "Physician assistant" means a person practicing pursuant to chapter((s)) 18.57A ((and)) or 18.71A RCW.
     (((8))) (9) "Qualified therapist" means:
     (a) An activities specialist who has specialized education, training, or experience specified by the department.
     (b) An audiologist who is eligible for a certificate of clinical competence in audiology or who has the equivalent education and clinical experience.
     (c) A mental health professional as defined in chapter 71.05 RCW.
     (d) An intellectual disabilities professional who is a qualified therapist or a therapist approved by the department and has specialized training or one year experience in treating or working with persons with intellectual or developmental disabilities.
     (e) An occupational therapist who is a graduate of a program in occupational therapy or who has equivalent education or training.
     (f) A physical therapist as defined in chapter 18.74 RCW.
     (g) A social worker who is a graduate of a school of social work.
     (h) A speech pathologist who is eligible for a certificate of clinical competence in speech pathology or who has equivalent education and clinical experience.
     (((9))) (10) "Registered nurse" means a person licensed to practice registered nursing under chapter 18.79 RCW.
     (((10))) (11) "Resident" means an individual residing in a nursing home, as defined in RCW 18.51.010.

NEW SECTION.  Sec. 3   The department of social and health services shall monitor nursing homes who hire physicians on staff and report to the legislature by January 1, 2013. The report shall include information on consumer satisfaction and medical cost implications of including physicians on staff in nursing facilities.