HOUSE BILL REPORT

HB 2531

BYRepresentatives Day, D. Sommers, Braddock, Rector and Dellwo; by request of Department of Health

Changing provisions relating to nursing home administration.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (11)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Brooks, Ranking Republican Member; Cantwell, Chandler, Morris, Prentice, D. Sommers, Sprenkle, Vekich and Wolfe.

House Staff:Antonio Sanchez (786-7383)

AS REPORTED BY COMMITTEE ON HEALTH CARE FEBRUARY 1, 1990

BACKGROUND:

Nursing home administrators are licensed under state law according to rules established by the State Board of Examiners.  This board is composed of one consumer and eight other individuals representing professions and institutions concerned with the care and treatment of the chronically ill.  Members serve up to three years.  Three members are appointed for terms of three years, three members serve two years, and three serve one year.  The governor may remove members for improper conduct, however, specific reasons for removal of board members are not specified.

The board has the authority to establish guidelines for licensure.

It is not required under current licensure guidelines for nursing home administrators to hold a baccalaureate degree from a recognized institution.

The active full time administrator of a nursing home is allowed to delegate functions and duties if they are not on-site.  Nursing home administrators are not required to be on-site full time.

SUMMARY:

SUBSTITUTE BILL:  Reasons for the removal of members of the board are specified.  The length of time that a member of the board can serve is increased to five years and all members are allowed to serve up to two consecutive terms.

All nursing home administrators are required to hold a baccalaureate degree from a recognized institution.

It is mandatory for all active nursing home administrators to be on-site full time in the nursing home.  Delegation of duties and functions is not permitted unless the instructions are specifically delegated in writing by the administrator and cover responsibilities while they are away during the administrator's normal working hours.  All decisions made as a result of delegated instructions are subject to the review of the administrator.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  The requirement for nursing home administrators to be full-time in the nursing home is deleted.  The implementation of the requirement for nursing home administrators to have a baccalaureate degree is delayed until July 1, 1991.  Clarification is made to the requirements for a limited license.

Fiscal Note:      Requested January 15, 1990.

House Committee ‑ Testified For:    Maria Gardipee and Russell Akiyama, Board of Examiners for Nursing Home Administrators and Department of Health; and Ralph Smith, Department of Social and Health Services.  Glen Hudson and Carrie Bashaw, Washington Health Care Association (expressed concerns); and Karen Tynes, Washington Association of Homes for the Aging (expressed concerns).

House Committee - Testified Against:      No one.

House Committee - Testimony For:    Requiring nursing home administrators to hold a baccalaureate degree will increase the quality of administration of nursing home facilities.  On-site full-time administrators would be better able to respond to the dynamic needs of the nursing home patients than an administrator who's time is split between other nursing homes or other outside responsibilities.  The proposal should be modified to accommodate the following concerns:  Some nursing home administrators only have a two year nursing degree, yet have shown themselves to be very able administrators.

House Committee - Testimony Against:      Some nursing home administrators only have a two year nursing degree, yet have shown themselves to be very able administrators.  This type of advancement contributes to the appropriate articulation within the nursing field.  Some rural nursing homes and those contained within hospitals do not require and cannot support an on-site full-time administrator.

House Committee - Testimony Against:      (See concerns under Testimony For.)