1226-S.E AAS 4/10/91
ESHB 1226 - S COMM AMD
By Committee on Health & Long-Term Care
ADOPTED AS AMENDED 4/10/91 - Voice Vote
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1. A new section is added to chapter 74.42 RCW to read as follows:
Each time a medicaid recipient is discharged from a medicaid provider's facility for the purpose of hospitalization, the provider shall hold open the recipient's bed for the recipient for a minimum of three days immediately following the day of discharge and shall not deny the recipient readmission and placement in the same bed vacated if sought during such three-day period following the day of discharge. If the medicaid recipient is eligible for medicare, the recipient may be readmitted to a bed in a medicare distinct part. In addition, the medicaid recipient may be readmitted to bed in a heavy care wing of the medicaid provider's facility, if the attending physician determines that the recipient's health status warrants the additional heavy care."
"NEW SECTION. Sec. 2. A new section is added to chapter 74.46 RCW to read as follows:
The department shall develop and adopt rules to accurately keep record of a resident's social leave time and hospitalization time."
"Sec. 3. RCW 18.52.020 and 1991 c 3 s 116 are each amended to read as follows:
When used in this chapter, unless the context otherwise clearly requires:
(1) "Board" means the state board ((of
examiners for the licensing)) of nursing home administrators representative
of the professions and institutions concerned with the care of the chronically
ill and infirm aged patients.
(2) (("Secretary" means the
secretary of health)) "Department" means the department of
health.
(3) "Nursing home" means any facility or portion thereof licensed under state law as a nursing home.
(4) "Nursing home administrator"
means an individual in active administrative charge, as defined by the
board, of a nursing home((s as defined herein, whether or not
having an ownership interest in such homes, and although functions and duties
may be shared with or delegated to other persons: PROVIDED HOWEVER, That
nothing in this definition or this chapter shall be construed to prevent any
person, so long as he or she is otherwise qualified, from obtaining and
maintaining a license even though he or she has not administered or does not
continue to administer a nursing home)).
(5) "Secretary" means the secretary of health or the secretary's designee."
"NEW SECTION. Sec. 4. A new section is added to chapter 18.52 RCW to read as follows:
In addition to any other authority provided by law, the secretary shall have the following authority:
(1) To set all fees required in this chapter in accordance with RCW 43.70.250 which may include fees for approval of continuing competency, supervision of practical experience, all applications, verification, renewal, examination, and late penalties;
(2) To establish forms necessary to administer this chapter;
(3) To issue a license to any applicant who has met the education, training, and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure, except that proceedings concerning the denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;
(4) To employ clerical, administrative, and investigative staff as needed to implement and administer this chapter and to employ individuals including those licensed under this chapter to serve as examiners or consultants as necessary to implement and administer this chapter; and
(5) To maintain the official department record of all applicants and licensees."
"Sec. 5. RCW 18.52.030 and 1970 ex.s. c 57 s 3 are each amended to read as follows:
((On or after July 1, 1970)) Nursing
homes operating within this state ((must)) shall be under the
active, overall administrative charge and supervision of an on-site,
full-time administrator licensed as provided in this chapter. ((An
administrator may delegate functions and duties to other persons.)) No
person acting in any capacity, unless ((he is)) the holder of a nursing
home administrator's license issued under this chapter, shall be charged with
the overall responsibility to make decisions or direct actions involved in
managing the internal operation of a nursing home, except as specifically
delegated in writing by the administrator to identify a responsible person to
act on the administrator's behalf when the administrator is absent during the
administrator's normal working hours. The administrator shall review the
decisions upon the administrator's return and amend the decisions if
necessary. The board shall define by rule the parameters for on-site,
full-time administrators in nursing homes with small resident populations,
nursing homes in rural areas, or separately licensed facilities collocated on
the same campus, as well as provide for the requirements for nursing homes that
are temporarily without administrators."
"Sec. 6. RCW 18.52.040 and 1975 1st ex.s. c 97 s 1 are each amended to read as follows:
((There is hereby created a)) The
state board of ((examiners for)) nursing home administrators ((which))
shall consist of nine members appointed by the governor. ((All members
shall be representative of the professions and institutions concerned with the
care and treatment of chronically ill or infirm elderly patients. However, at
no time shall representatives of a single profession or a single institutional
category compose a majority of the board membership. In addition, no member
who is a noninstitutional representative shall have any direct financial
interest in nursing homes while serving as a member of the board. For purposes
of this section, nursing home administrators are considered representatives of
institutions. Eight of the board's members shall be privately or self-employed
persons who the governor finds have had at least four years of actual
experience in the administration or overall management of licensed nursing
homes in this state immediately prior to the governor's appointment of them to
the board; or shall be representatives from the medical professions, or health
care administration education, or persons with four years actual experience in
the administration of the nursing home unit of a licensed hospital immediately
preceding the governor's appointment of them to the board; and shall be privately
or self-employed persons, or persons employed by educational institutions, whom
the governor appoints because of their special knowledge or expertise in the
field of long term care or the care of the aged and chronically ill: PROVIDED,
That one member shall be a citizen eligible for medicare who shall have no
financial interest in or family ownership connection with nursing homes. Board
members selected who meet any of the preceding qualifications may in addition
be nurses, physicians or other persons with special health care training.))
Four members shall be persons licensed under this chapter who have at least
four years actual experience in the administration of a licensed nursing home
in this state immediately preceding appointment to the board and who are not
employed by the state or federal government.
Four members shall be representatives of the health care professions providing medical or nursing services in nursing homes who are privately or self-employed; or shall be persons employed by educational institutions who have special knowledge or expertise in the field of health care administration, health care education or long-term care or both, or care of the aged and chronically ill.
One member shall be a nursing home resident or a family member of a nursing home resident. No member who is a nonadministrator representative shall have any direct or family financial interest in nursing homes while serving as a member of the board. The governor shall consult with and seek the recommendations of the appropriate state-wide business and professional organizations and societies primarily concerned with long term health care facilities in the course of considering his appointments to the board. Board members presently serving shall continue to serve until the expiration of their appointments."
"Sec. 7. RCW 18.52.050 and 1970 ex.s. c 57 s 5 are each amended to read as follows:
Members of the board shall be citizens of the
United States and residents of this state. ((Except for the initial
appointments to the first board,)) All administrator members of the
board shall be holders of licenses under this chapter. ((Three members of
the board shall be appointed initially for terms of three years, three members
shall be appointed for terms of two years, and three members shall be appointed
for terms of one year. Thereafter)) The terms of all members shall
be ((three)) five years. ((Members of the board may be removed
by the governor for cause after appropriate notice and hearing.)) Any
board member may be removed for just cause including a finding of fact of
unprofessional conduct or impaired practice. The governor may appoint a new
member to fill any vacancy on the board for the remainder of the unexpired
term. No board member may serve more than two consecutive terms, whether full
or partial. Board members shall serve until their successors are appointed.
Board members shall be compensated in accordance with RCW 43.03.240 and shall
be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060.
The board may elect annually a chair and vice-chair to direct the meetings of
the board. The board shall meet at least four times each year and may hold
additional meetings as called by the secretary or the chair."
"NEW SECTION. Sec. 8. A new section is added to chapter 18.52 RCW to read as follows:
In addition to any authority provided by law, the board shall have the following authority:
(1) To adopt rules in accordance with chapter 34.05 RCW necessary to implement this chapter;
(2) To determine the minimum education and experience requirements for licensure, including but not limited to approval of educational programs;
(3) To prepare and administer or approve the preparation and administration of examinations for licensure;
(4) To conduct a hearing on an appeal of a denial of license based on the applicant's failure to meet the minimum qualifications for licensure. The hearing shall be conducted pursuant to chapter 34.05 RCW;
(5) To establish by rule the procedures for an appeal of an examination failure;
(6) To adopt rules implementing a continuing competency program;
(7) To issue subpoenas, statements of charges, statements of intent to deny licenses, and orders, and to delegate in writing to a designee to issue subpoenas; and
(8) To issue temporary license permits under circumstances defined by the board."
"NEW SECTION. Sec. 9. A new section is added to chapter 18.52 RCW to read as follows:
The department shall issue a license to any person applying for a nursing home administrator's license after July 1, 1992, who meets the following requirements:
(1) Successful completion of the requirements for a baccalaureate degree from a recognized institution of higher learning: PROVIDED, That if education requirements are adopted by the federal government, the board may adopt rules requiring educational qualifications to meet those requirements;
(2) Successful completion of a practical experience requirement as determined by the board;
(3) Successful completion of examinations administered or approved by the board, or both, which shall be designed to test the candidate's competence to administer a nursing home;
(4) At least twenty-one years of age; and
(5) Not having engaged in unprofessional conduct as defined in RCW 18.130.180 or being unable to practice with reasonable skill and safety as defined in RCW 18.130.170. The board shall establish by rule what constitutes adequate proof of meeting the above requirements.
A limited license indicating the limited extent of authority to administer institutions certified by such church or denomination teaching religious or spiritual means for healing through prayer, shall be issued to individuals demonstrating membership in such church or denomination. However, nothing in this chapter shall be construed to require an applicant certified by any well established and generally recognized church or religious denomination teaching reliance on spiritual means alone to demonstrate proficiency in any medical techniques or to meet any medical educational qualifications or medical standards not in accord with the remedial care and treatment provided in such institutions."
"Sec. 10. RCW 18.52.110 and 1991 c 3 s 120 are each amended to read as follows:
(1) Every holder of a nursing home
administrator's license shall reregister ((it annually with the secretary))
on dates specified by the secretary ((by making application for
reregistration on forms provided by the secretary)). Such ((reregistration))
relicensure shall be granted ((automatically)) upon receipt of a
fee determined by the secretary as provided in RCW 43.70.250, and upon
fulfilling the continuing ((education)) competency requirement.
In the event that any license is not reregistered ((within thirty days after
the date for reregistration specified by the secretary)), the secretary ((shall,
in accordance with rules prescribed by the board, give notice to the license
holder, and)) may ((thereafter in accordance with rules prescribed by
the board)) charge up to double the ((normal reregistration)) relicensure
fee. In the event that the license of an individual is not ((reregistered))
relicensed within two years from the most recent date for ((reregistration))
relicensure it shall lapse and such individual must again apply for
licensing and meet all requirements of this chapter for a new applicant. The
board may prescribe rules for maintenance of a license at a reduced fee for
temporary or permanent withdrawal or retirement from the active practice of
nursing home administration.
(2) A condition of ((reregistration)) relicensure
shall be the presentation of proof by the applicant that ((he or she has
attended the number of classroom hours of approved educational programs,
classes, seminars, or proceedings set by the board. The board shall have the
power to approve programs, classes, seminars, or proceedings offered in this
state or elsewhere by any accredited institution of higher learning or any
national or local group or society if such programs, classes, seminars, or
proceedings are reasonably related to the administration of nursing homes. The
board shall establish rules providing that the applicant for reregistration may
present such proofs yearly, or may obtain the cumulative number of required
hours over a three year period and present such proofs over periods of three
years. In no event shall the number of classroom hours required for any time
period exceed the number of such board approved classroom hours reasonably
available over such time period on an adult or continuing education basis to
nonmatriculating participants in this state.
(3) An individual may obtain and reregister a
license under this chapter although he or she does not actively engage in
nursing home administration. The licensee shall meet requirements set by the
board to ensure the individual's continued competency)) the board requirement
for continuing competency related to the administration of nursing homes has
been met."
"Sec. 11. RCW 18.52.130 and 1991 c 3 s 121 are each amended to read as follows:
The secretary may issue a nursing home
administrator's license to anyone who holds a current administrator's license
from another jurisdiction upon receipt of an application fee ((determined
by the secretary as provided in RCW 43.70.250)) and an annual license fee,
((the secretary may issue a nursing home administrator's license, without
examination, to any person who holds a current license as a nursing home
administrator from another jurisdiction)) as provided in RCW 43.70.250:
PROVIDED, ((That the board finds)) That the standards for
licensing in such other jurisdiction are ((at least the)) substantially
equivalent ((of)) to those prevailing in this state, and that the
applicant is otherwise qualified as determined by the board. ((In
the event that there is developed a nationally recognized standard for the licensing
of nursing home administrators which is in fact utilized in licensing
procedures on a reasonably uniform basis the board may by rule or regulation
provide for granting reciprocal licensing on a showing of compliance with such
standard.))"
"Sec. 12. RCW 18.52.140 and 1970 ex.s. c 57 s 14 are each amended to read as follows:
It shall be unlawful and constitute a gross misdemeanor for any person to act or serve in the capacity of a nursing home administrator unless he or she is the holder of a nursing home administrator's license issued in accordance with the provisions of this chapter: PROVIDED HOWEVER, That persons carrying out functions and duties delegated by a licensed administrator as defined in RCW 18.52.030 shall not be construed to be committing any unlawful act under this chapter."
"NEW SECTION. Sec. 13. The following acts or parts of acts are each repealed:
(1) RCW 18.52.060 and 1991 c 3 s 117, 1984 c 287 s 40, 1979 c 158 s 45, 1975-'76 2nd ex.s. c 34 s 38, & 1970 ex.s. c 57 s 6;
(2) RCW 18.52.100 and 1991 c 35 s 119, 1987 c 150 s 33, 1977 ex.s. c 243 s 4, & 1970 ex.s. c 57 s 10; and
(3) RCW 18.52.170 and 1970 ex.s. c 57 s 19."
"NEW SECTION. Sec. 14. RCW 18.52.070 and 1991 c 3 s 118, 1984 c 279 s 65, 1977 ex.s. c 243 s 2, 1975 1st ex.s. c 30 s 52, & 1970 ex.s. c 57 s 7 are each repealed, effective July 1, 1992."
ESHB 1226 - S COMM AMD
By Committee on Health & Long-Term Care
ADOPTED AS AMENDED 4/10/91 - Voice Vote
On page 1, line 1 of the title, after "homes;" strike the remainder of the title and insert "amending RCW 18.52.020, 18.52.030, 18.52.040, 18.52.050, 18.52.110, 18.52.130, and 18.52.140; adding a new section to chapter 74.42 RCW; adding a new section to chapter 74.46 RCW; adding new sections to chapter 18.52 RCW; and repealing RCW 18.52.060, 18.52.100, 18.52.170, and 18.52.070."