H-278                _______________________________________________

                                                     HOUSE BILL NO. 65

                        _______________________________________________

State of Washington                              49th Legislature                              1985 Regular Session

By Representatives J. King, Ballard, Day, Barrett, Tanner, Isaacson, Dobbs, Gallagher, Van Luven, Fisch, Winsley and Dellwo

Read first time 1/18/85 and referred to Committee on Social & Health Services.

AN ACT Relating to nursing home survey standards, certification, and compliance enforcement; and adding new sections to chapter 74.42 RCW.

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

NEW SECTION. Sec. 1.     (1) It is the intent of the legislature that a high standard of quality patient care be achieved and maintained by all licensed nursing homes.  In order that such licensees may achieve and maintain such standards of care, it is essential that the facilities first be made aware of the precise standards of performance, rules, interpretive guidelines, implementation procedures, and sanctions for nonperformance to which they are to be held accountable, and that each such licensee be accorded a reasonable opportunity to bring itself into compliance with the standards prior to the commencement of enforcement procedures. In addition, it is desirable that, through the associations representing the facilities, the facilities have an opportunity to review and provide input on these standards prior to their adoption or implementation.

          (2) It is the further intent of the legislature to promote compliance with the standards of patient care considered necessary by the department of social and health services through the process described in sections 2 and 3 of this act.  The imposition of sanctions should be considered by the department as a last resort to enforce the applicable standard.

NEW SECTION. Sec. 2.     (1) Prior to the adoption of any and all rules, standards of performance, interpretive guidelines, implementation procedures, and sanctions for nonperformance as may be necessary to effectively assure that a high standard of quality patient care is maintained by all nursing homes licensed by the state to deliver such care, the secretary shall actively seek, accept, consider, and, to the extent it is appropriate, incorporate the input of the several provider associations.  The department shall inform the several provider associations in writing of the reasons for not incorporating their input.

          (2) Prior to initiating enforcement of any such rules, standards, guidelines, procedures, and sanctions, the department shall first provide each affected licensee with a written copy thereof together with a written summary of the department's intended methods of implementation and enforcement in order that the licensee has a reasonable opportunity to bring itself into compliance with the standards and rules prior to the initiation of compliance review, surveys, and other such inspections aimed at assuring consistent compliance by all licensees.

NEW SECTION. Sec. 3.     The department may adopt standards and rules on an emergency basis if the life, health, or safety of the residents of a facility is jeopardized by the conditions that are the subject of the emergency rules.  In such cases, however, the department shall deliver by certified mail or by hand a copy of the emergency rules to each licensee prior to or upon commencement of a compliance inspection.  Further, within thirty days of the emergency adoption, the department shall begin deliberations of the emergency rules with representatives of the several provider associations and may amend the rules as needed.  The department must provide the opportunity for and seriously consider the incorporation of provider input in order for the rules to continue in force and effect.

NEW SECTION. Sec. 4.     Unless the granting of such advance opportunity to achieve corrections and effect compliance would, in the opinion of the secretary, constitute a clear and apparent threat to the lives, health, or safety of the residents of an individual licensee, the rules for imposition of sanctions, including but not limited to decertification or a decision to stop placement of patients in the facility, shall include provisions for the responsible departmental authority to serve the licensee with a notice of intent to impose such a sanction, which shall specify the conditions and interpretations of standards or elements which prompt the decision to impose the sanctions.  The department shall provide the licensee with the three calendar days in which to respond in writing to the department to show cause why the intended sanctions should not be promptly imposed.  The department shall consider the licensee's written responses, when provided, in making the decision to impose such greater or lesser sanctions as may be determined most appropriate in order to achieve compliance at the earliest practicable date.

NEW SECTION. Sec. 5.     The enactment of sections 2, 3, and 4 of this act does not affect any administrative or judicial review available to a facility seeking review of enforcement actions or rules adopted under this chapter.

NEW SECTION. Sec. 6.     Sections 1 through 5 of this act are added to chapter 74.42 RCW.