HOUSE BILL REPORT

                      HB 1126

                              As Passed House

                               March 12, 1991

Title:  An act relating to utilization review of nursing facilities.

Brief Description:  Revising provisions for nursing facilities.

Sponsor(s):  Representatives Braddock and Orr; by request of Department of Social and Health Services.

Brief History:

   Reported by House Committee on:

Health Care, February 14, 1991, DP;

Passed House, March 12, 1991, 98-0.

HOUSE COMMITTEE ON

HEALTH CARE

Majority Report: Do pass.  Signed by 10 members:  Representatives Braddock, Chair; Day, Vice Chair; Moyer, Ranking Minority Member; Casada, Assistant Ranking Minority Member; Edmondson; Franklin; Morris; Paris; Prentice; and Sprenkle.

Staff:  Antonio Sanchez (786-7383).

Background:  Currently, nursing homes are licensed as "skilled nursing facilities" (SNF), or  "intermediate care facilities" (ICF).  These two designations for nursing homes represent licenses for differing levels of care.  The 1987 Omnibus Budget Reconciliation Act (OBRA), mandated the elimination of level of care distinction, making ICF's subject to federal "nursing facilities" (NF) requirements and waver provisions.  Current state law is not in compliance with this federally mandated requirement.

Needs assessments are currently conducted by the Department of Social and Health Services (DSHS) to review each medicaid nursing home resident annually, or as needed.  This departmental review is called a client profile.  This review has been historically conducted by the department to make sure the resident's plan of care is appropriately tailored to their care needs and to aid in the measurement of the quality of resident care.  In addition, a similar standardized national assessment is also currently being conducted for each resident by every medicaid certified nursing home as a result of the 1987 federal OBRA requirements.  The collection of resident information by both the Department of Social and Health Services client's profile assessment and individual nursing homes can be considered redundant.

Summary of Bill:  All statutory references to "skilled nursing facilities" and "intermediate care facilities" are eliminated and replaced with nursing facility.  All nursing facilities will be required to meet nursing facilities standards.

Existing language regarding resident needs assessments is eliminated.  The Department of Social and Health Services is given the authority to design an assessment system that complies with federal OBRA requirements.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  These changes are needed to comply with federal Medicaid requirements mandated in the 1987 Omnibus Budget Reconciliation Act (OBRA).  Failure to implement these changes would result in the possible loss of Medicaid reimbursement.

Testimony Against:  None.

Witnesses:  Cathy Wiggins, Department of Social & Health Services (Pro); and Jerry Reilly, Washington Health Care Association (Pro).