AN ACT Relating to nursing home administration; 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 new sections to chapter 18.52 RCW; and repealing RCW 18.52.060, 18.52.100, 18.52.170, and 18.52.070.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. Section 2, chapter 57, Laws of 1970 ex. sess. as amended by section 44, chapter 158, Laws of 1979 and RCW 18.52.020 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) ((~~"Director" means the director of licensing.~~

~~(3)~~)) "Nursing home" means any facility or portion thereof licensed under state law as a nursing home.

((~~(4)~~)) (3) "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 is otherwise qualified, from obtaining and maintaining a license even though he has not administered or does not continue to administer a nursing home)).

(4) "Secretary" means the secretary of health or the secretary's designee.

(5) "Department" means the department of health.

NEW SECTION. Sec. 2. 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 education, 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. 3. Section 3, chapter 57, Laws of 1970 ex. sess. and RCW 18.52.030 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 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.

Sec. 4. Section 4, chapter 57, Laws of 1970 ex. sess. as amended by section 1, chapter 97, Laws of 1975 1st ex. sess. and RCW 18.52.040 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 citizen eligible for medicare. 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. 5. Section 5, chapter 57, Laws of 1970 ex. sess. and RCW 18.52.050 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. 6. 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. 7. A new section is added to chapter 18.52 RCW to read as follows:

On or after July 1, 1991, the department shall issue a license to any applicant for nursing home administrator's licensure 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. 8. Section 11, chapter 57, Laws of 1970 ex. sess. as last amended by section 69, chapter 279, Laws of 1984 and RCW 18.52.110 are each amended to read as follows:

(1) Every holder of a nursing home administrator's license shall reregister ((~~it annually with the director~~)) on dates specified by the ((~~director by making application for reregistration on forms provided by the director~~)) secretary. Such ((~~reregistration~~)) relicensure shall be granted ((~~automatically~~)) upon receipt of a fee determined by the ((~~director~~)) secretary as provided in RCW ((~~43.24.086~~)) 43.70.250, and upon fulfilling the continuing education requirement. In the event that any license is not reregistered ((~~within thirty days after the date for reregistration specified by the director~~)), the ((~~director shall, in accordance with rules prescribed by the board, give notice to the license holder, and~~)) secretary 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 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 and regulations 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 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 education related to the administration of nursing homes has been met.

Sec. 9. Section 13, chapter 57, Laws of 1970 ex. sess. as last amended by section 50, chapter 7, Laws of 1985 and RCW 18.52.130 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 director as provided in RCW 43.24.086~~)) and an annual license fee, ((~~the director 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. 10. Section 14, chapter 57, Laws of 1970 ex. sess. and RCW 18.52.140 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. 11. The following acts or parts of acts are each repealed:

(1) Section 6, chapter 57, Laws of 1970 ex. sess., section 38, chapter 34, Laws of 1975-'76 2nd ex. sess., section 45, chapter 158, Laws of 1979, section 40, chapter 287, Laws of 1984 and RCW 18.52.060;

(2) Section 10, chapter 57, Laws of 1970 ex. sess., section 4, chapter 243, Laws of 1977 ex. sess., section 33, chapter 150, Laws of 1987 and RCW 18.52.100; and

(3) Section 19, chapter 57, Laws of 1970 ex. sess. and RCW 18.52.170.

NEW SECTION. Sec. 12. Effective July 1, 1991, section 7, chapter 57, Laws of 1970 ex. sess., section 52, chapter 30, Laws of 1975 1st ex. sess., section 2, chapter 243, Laws of 1977 ex. sess., section 65, chapter 279, Laws of 1984 and RCW 18.52.070 are each repealed.