FINAL BILL REPORT
SHB 1864
PARTIAL VETO
C 372 L 89
BYHouse Committee on Health Care (originally sponsored by Representatives Day, Brooks, Braddock, D. Sommers, R. Meyers, Sprenkle, Cantwell, Morris, Scott, Wolfe, Vekich, Patrick, Chandler, Crane, Winsley, Dellwo, Brough, Wineberry, P. King, S. Wilson, Bowman, Kremen, Dorn, Schoon, Van Luven, Wood, R. King, Cooper, Doty, Todd, McLean and O'Brien)
Concerning quality of care in nursing homes.
House Committe on Health Care
Rereferred House Committee on Appropriations
Senate Committee on Health Care & Corrections and Committee on Ways & Means
SYNOPSIS AS ENACTED
BACKGROUND:
During the last biennium a broad based coalition of nursing home professionals, long term care advocates, consumers, and health professionals identified several significant quality of care issues facing the nursing home industry. Their findings indicated the need for changes in the nurses cost center and for increased formal training for direct care nursing staff and administrators. The wages paid for nursing home nursing staff are 16 to 30 percent below wages paid to nurses in acute care hospitals. Concerns were also expressed about the quality and continuity of care relating to the increasing use of temporary nursing staff.
Supervised nursing students working and training in hospitals are allowed to provide medication to patients. This same professional privilege, however, is not available in nursing homes. Allowing qualified nursing students to provide medications to nursing home residents was identified by the coalition as a way to help alleviate the nursing shortage in nursing homes. Appropriate and effective policies for denial of nursing home licensing, and for stop placement and emergency transfer of patients, were also issues of concern to the coalition.
The state does not assess a fee for post survey visits to nursing homes. These visits verify whether the home has corrected deficiencies found in the initial survey.
Federal nursing home depreciation provisions were changed in July, 1984. One nursing home in Washington state was negatively affected. A nursing home's legal, accounting, and bookkeeping fees are fully reimbursed under the current reimbursement system.
SUMMARY:
Graduate nurses and student nurses are permitted to administer medication to nursing home residents.
The reasons for which the Department of Social and Health Services may deny a nursing home license application are expanded. The department is authorized to order the immediate closure of a nursing home and/or the immediate transfer of residents if an emergency exists affecting the health or safety of residents. The department may deny payment for all Medicaid eligible individuals admitted after the nursing home has been cited for deficiencies and did not correct those deficiencies within three months, or if the home has been found in violation of standards of care on three consecutive surveys. Monetary penalties are also established.
More detailed provisions are provided to govern stop placements and emergency transfers in nursing homes.
The process of dealing with nursing homes in receivership status is changed to ensure the smooth functioning of the nursing home and protection of its residents during the transfer of the home.
Post survey charges of $12 per bed are assessed to the nursing home for those surveys required by the facility after the first post survey or visit.
The department is required to provide written information to the public regarding the availability of long-term care services. The department is authorized to purchase services for persons in need of active treatment in institutions for mental diseases. These services are not allowable costs under the nursing home reimbursement system. A nursing home's legal, accounting, and bookkeeping fees will not be reimbursed if they exceed the eighty-fifth percentile of such costs reported by all nursing homes. Nursing home depreciation provisions are clarified to allow a nursing home to receive federal reimbursement based on the purchase price agreed to in July, 1984.
VOTES ON FINAL PASSAGE:
House 96 0
Senate 43 4 (Senate amended)
House 96 0 (House concurred)
EFFECTIVE:July 23, 1989
Partial Veto Summary: The Governor vetoed the section requiring the Department of Social and Health Services to prepare and distribute printed information regarding the statewide availability of long-term care services and requiring nursing homes to make that information available. (See VETO MESSAGE)