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SUBSTITUTE
SENATE BILL 5864
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AS
AMENDED BY THE HOUSE
Passed
Legislature - 1999 Regular Session
State of Washington 56th
Legislature 1999 Regular Session
By
Read first time 03/03/99.
Allowing
a health maintenance organization to return an individual to his or her nursing
care facility.
AN
ACT Relating to allowing residents of long-term care facilities to return to
their home; adding a new section to chapter 48.43 RCW; and creating new
sections.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. The
legislature finds that a long-term care facility is home for any individual who
resides there, and the individual has the right to receive services in his or
her own home and to be cared for by the organization with which he or she has a
contractual agreement to provide housing and related services. The legislature
further finds that restricting individuals from returning to the long-term care
facility in which they were residing prior to hospitalization may detrimentally
impact the health and well-being of frail individuals and their families.
NEW
SECTION. Sec. 2. A
new section is added to chapter 48.43 RCW to read as follows:
(1)
A carrier that provides coverage for a person at a long-term care facility
following the person's hospitalization shall, upon the request of the person or
his or her legal representative as authorized in RCW 7.70.065, provide such
coverage at the facility in which the person resided immediately prior to the
hospitalization if:
(a)
The person's primary care physician determines that the medical care needs of
the person can be met at the requested facility;
(b)
The requested facility has all applicable licenses and certifications, and is
not under a stop placement order that prevents the person's readmission;
(c)
The requested facility agrees to accept payment from the carrier for covered
services at the rate paid to similar facilities that otherwise contract with
the carrier to provide such services; and
(d)
The requested facility, with regard to the following, agrees to abide by the
standards, terms, and conditions required by the carrier of similar facilities
with which the carrier otherwise contracts: (i) Utilization review, quality
assurance, and peer review; and (ii) management and administrative procedures,
including data and financial reporting that may be required by the carrier.
(2)
For purposes of this section, "long-term care facility" or
"facility" means a nursing facility licensed under chapter 18.51 RCW,
continuing care retirement community defined under RCW 70.38.025, boarding home
licensed under chapter 18.20 RCW, or assisted living facility.
NEW SECTION. Sec. 3. This
act may be known and cited as the Kitson act.
