SENATE BILL REPORT

                                   SHB 1258

             AS REPORTED BY COMMITTEE ON HEALTH & LONG-TERM CARE,

                               FEBRUARY 27, 1992

Brief Description:  Changing provisions relating to nursing home administration.

SPONSORS:House Committee on Health Care (originally sponsored by Representatives Day, Moyer, Prentice, Braddock, Paris and Orr; by request of Department of Health).

HOUSE COMMITTEE ON HEALTH CARE

SENATE COMMITTEE ON HEALTH & LONG‑TERM CARE

Majority Report:  Do pass as amended. 

      Signed by Senators West, Chairman; L. Smith, Vice Chairman; M. Kreidler, Niemi, and Wojahn.

Staff:  Sarena Seifer (786‑7417)

Hearing Dates: February 26, 1992; February 27, 1992

BACKGROUND:

Nursing home administrators are licensed by the state under the Nursing Home Administrator Practice Act.  The regulatory authority for the profession is the State Board of Examiners for Licensing Nursing Home Administrators which is appointed by the Governor.  The practice act specifies that there shall be nine members on the board and it provides specific requirements for board membership.  Board members may be removed from office by the Governor for cause.

Under current state statutes, nursing homes must be under the overall administrative charge and supervision of a licensed administrator.  There is no statutory requirement that the administrator be located on site at the nursing home.  The board establishes minimum educational requirements of nursing home administrators, including classroom hours of approved educational programs.  Inactive administrators may be relicensed upon meeting board requirements for continued competency.

All fees collected from licensure of nursing home administrators are deposited in the state general fund.

SUMMARY:

The State Board of Examiners for the Licensing of Nursing Home Administrators is renamed as the State Board of Nursing Home Administrators.  Membership requirements on the State Board of Nursing Home Administrators are made less restrictive than current requirements.  Four members are required to have actual experience as nursing home administrators prior to appointment.  Four members shall be health care professionals who provide services in nursing homes, or individuals specializing in health care administration or long-term care who are employed at educational institutions.  One member shall be a person interested in long-term care and the welfare of nursing home patients.  Board members may serve no more than two consecutive terms and shall serve until a successor is appointed.

A nursing home administrator is required to be on site at the nursing home, except that a reasonable person may substitute for the administrator while on leave if such responsibility is delegated in writing.  The board shall establish rules defining parameters for on-site administrators in nursing homes with small populations, in rural areas and when nursing homes are temporarily without administrators.

A baccalaureate degree will be required for those who apply for licensure after July 1, 1992.  Applicants must also meet any additional educational requirements the federal government may require.  The administrator must also complete a practical experience requirement, pass the board's examination, be at least 21 years of age and must not have been charged with a violation of the Uniform Disciplinary Act.  Relicensure requires fulfilling a continuing education requirement.  A limited license is available for administrators demonstrating membership in a church or religious denomination, teaching religious or spiritual means for healing through prayer.

Parts of the chapter pertaining to duties of the board and qualifications for licensure are rewritten using uniform credentialing boiler plate language.  Fees collected from licensure will be deposited in the state's health professional account.

Appropriation:  none

Revenue:  none

Fiscal Note:  available

Effective Date:  Section 7 takes effect July 1, 1992.

SUMMARY OF PROPOSED SENATE AMENDMENT:

It is clarified that individuals not actively serving as nursing home administrators but who are qualified by education, experience, training and examination may be licensed as nursing home administrators.  Nursing home administrators are required to be both on-site and full time.

Board authority is expanded to include determining the minimum education and experience requirements for licensure, including, but not limited to, approval of educational programs.  The board must establish rules defining parameters for on-site full time administrators of separately licensed facilities that are located on the same campus and operated by one firm.  The consumer member of the board must be a resident of a nursing home or a family member of a resident or a person eligible for Medicare.

The effective date to apply for a license under the new educational requirements is extended for one year to July 1, 1993.

TESTIMONY FOR:

Nursing home administrators need to be both on-site and full time in order to be effective administrators and to solve problems that may arise.  Recent proposed federal regulations require nursing home administrators to have bachelor's degrees.  The bill will greatly improve the administration of nursing homes in Washington State.

TESTIMONY AGAINST:  None

TESTIFIED:  PRO:  Sherman Cox, Department of Health; Charles Reed, Department of Social and Health Services; Dennis Austin, Department of Social and Health Services; Hilke Faber, Washington Nursing Home Councils Association; Mildred Gray, Manor Care; Dan Fruichante, Orchard Park; Charles Lewis, Tacoma Terrace; Scott Sigmon, Washington Health Care Association; Frank Winslow, Alzheimer Society of Washington; Kary Hyre, Long-Term Care Ombudsman; Evan Iverson, Senior Lobby