HOUSE BILL No. 4224 February 9, 1999, Introduced by Reps. Gieleghem, Jamnick, Cherry, Dennis, Woodward, Switalski, Lemmons, Bogardus, Wojno, DeHart, Rivet, Minore, Schauer, Prusi, Jacobs and Spade and referred to the Committee on Senior Health, Security and Retirement. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20155 (MCL 333.20155), as amended by 1996 PA 267. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 20155. (1) Except as OTHERWISE provided in this sec- 2 tion, the department shall make annual and other visits to each 3 health facility or agency licensed under this article for the 4 purposes of survey, evaluation, and consultation. A VISIT MADE 5 PURSUANT TO A COMPLAINT INVESTIGATION SHALL BE UNANNOUNCED. 6 Except for ahealth facility or agency described in section720106(1)(c), (f), (h), or (j)COUNTY MEDICAL CARE FACILITY, A 8 HOME FOR THE AGED, A NURSING HOME, AND A HOSPICE RESIDENCE, the 9 department shall determine whetherthevisitsshall beTHAT 10 ARE NOT MADE PURSUANT TO A COMPLAINT INVESTIGATION ARE announced 00915'99 CPD 2 1 or unannounced., except that a complaint investigation shall2not be announced and thereIN ADDITION TO VISITS MADE PURSUANT 3 TO A COMPLAINT INVESTIGATION, THE DEPARTMENT shallbeANNUALLY 4 MAKE at least 1 unannounced visitother than a complaint inves-5tigation annuallytoa health facility or agency described in6section 20106(1)(c), (h), or (j)EACH COUNTY MEDICAL CARE FACIL- 7 ITY AND HOSPICE RESIDENCE. 8 (2) The department shallmakeDO BOTH OF THE FOLLOWING: 9 (A) MAKE at least a biennial visit to each licensed clinical 10 laboratory, each nursing home,and each hospice residence for 11 the purposes of survey, evaluation, and consultation.If a12nursing home is only partially certified under title XVIII or13title XIX, the department shall include all licensed parts of the14nursing home in a certification survey conducted by the15department.16 (B) IN ADDITION TO VISITS MADE PURSUANT TO COMPLAINT INVES- 17 TIGATIONS, AT LEAST ONCE ANNUALLY MAKE AN UNANNOUNCED VISIT TO 18 AND INSPECT EACH NURSING HOME LICENSED UNDER THIS ARTICLE, 19 REGARDLESS OF WHETHER THE NURSING HOME IS CERTIFIED UNDER TITLE 20 XVIII OR TITLE XIX. 21 (3) The department shall make a biennial visit to each hos- 22 pital for survey and evaluation for the purpose of licensure. 23 Subject to subsection (6), the department may waive the biennial 24 visit required by this subsection if a hospital, as part of a 25 timely application for license renewal, requests a waiver and 26 submits both of the following and if all of the requirements of 27 subsection (5) are met: 00915'99 3 1 (a) Evidence that it is currently fully accredited by a body 2 with expertise in hospital accreditation whose hospital accredit- 3 ations are accepted by the United States department of health and 4 human services for purposes of section 1865 of title XVIII of the 5 social security act, chapter 531, 49 Stat. 620, 6 42 U.S.C. 1395bb. 7 (b) A copy of the most recent accreditation report for the 8 hospital issued by a body described in subdivision (a), and the 9 hospital's responses to the accreditation report. 10 (4) Except as provided in subsection (8), accreditation 11 information provided to the department under subsection (3) is 12 confidential, is not a public record, and is not subject to court 13 subpoena. The department shall use the accreditation information 14 only as provided in this section and shall return the accredit- 15 ation information to the hospital within a reasonable time after 16 a decision on the waiver request is made. 17 (5) The department shall grant a waiver under subsection (3) 18 if the accreditation report submitted under subsection (3)(b) is 19 less than 2 years old and there is no indication of substantial 20 noncompliance with licensure standards or of deficiencies that 21 represent a threat to public safety or patient care in the 22 report, in complaints involving the hospital, or in any other 23 information available to the department. If the accreditation 24 report is 2 or more years old, the department may do 1 of the 25 following: 00915'99 4 1 (a) Grant an extension of the hospital's current license 2 until the next accreditation survey is completed by the body 3 described in subsection (3)(a). 4 (b) Grant a waiver under subsection (3) based on the accred- 5 itation report that is 2 or more years old, on condition that the 6 hospital promptly submit the next accreditation report to the 7 department. 8 (c) Deny the waiver request and conduct the visits required 9 under subsection (3). 10 (6) The department shall not grant more than 2 consecutive 11 waivers under subsection (3). This section does not prohibit the 12 department from citing a violation of this part during a survey, 13 FROM conducting investigations or inspections pursuant to 14 section 20156, or FROM conducting surveys of health facilities or 15 agencies for the purpose of complaint investigations or federal 16 certification. This section does not prohibit the state fire 17 marshal from conducting annual surveys of hospitals, nursing 18 homes, and county medical care facilities. 19 (7) At the request of a health facility or agency, the 20 department may conduct a consultation engineering survey of a 21 health facility and provide professional advice and consultation 22 regarding health facility construction and design. A health 23 facility or agency may request a voluntary consultation survey 24 under this subsection at any time between licensure surveys. The 25 fees for a consultation engineering survey are the same as the 26 fees established for waivers under section 20161(10). 00915'99 5 1 (8) If the department determines that substantial 2 noncompliance with licensure standards exists or that 3 deficiencies that represent a threat to public safety or patient 4 care exist based on a review of an accreditation report submitted 5 pursuant to subsection (3)(b), the department shall prepare a 6 written summary of the substantial noncompliance or deficiencies 7 and the hospital's response to the department's determination. 8 The department's written summary and the hospital's response are 9 public documents. 10 (9)Investigations or inspectionsIN ADDITION TO THE 11 INSPECTION CONDUCTED UNDER SUBSECTION (2)(B), AN INVESTIGATION OR 12 INSPECTION, other thaninspectionsAN INSPECTION of financial 13 records, of ahealth facility or agency described in section1420106(1)(c), (f), (h), or (j)COUNTY MEDICAL CARE FACILITY, A 15 HOME FOR THE AGED, A NURSING HOME, OR A HOSPICE RESIDENCE shall 16 be conducted without prior notice to the health facility or 17 agency. An employee of a state agency charged with INVESTIGATING 18 OR inspecting the health facility or agency or an employee of a 19 local health department who directly or indirectly gives prior 20 notice regarding an INVESTIGATION OR AN inspection, other than an 21 inspection of the financial records, to the health facility or 22 agency or to an employee of the health facility or agency, is 23 guilty of a misdemeanor.Consultation visits that areA CON- 24 SULTATION VISIT THAT IS not for the purpose of annual or 25 follow-up inspection or survey may be announced. 26 (10) The department shall maintain a record indicating 27 whethervisits areA VISIT AND INSPECTION IS announced or 00915'99 6 1 unannounced. Information gathered atall visitsEACH VISIT AND 2 INSPECTION, WHETHER announced or unannounced, shall be taken into 3 account in licensure decisions. 4 (11) The department shall require periodic reports and a 5 health facility or agency shall give the department access to 6 books, records, and other documents maintained by a health facil- 7 ity or agency to the extent necessary to carry out the purpose of 8 this article and the rules promulgated under this article. The 9 department shall respect the confidentiality of a patient's clin- 10 ical record and shall not divulge or disclose the contents of 11the recordsA PATIENT CLINICAL RECORD in a manner that identi- 12 fies an individual except under court order. The department may 13 copy health facility or agency records as required to document 14 findings. 15 (12) The department may delegate survey, evaluation, or con- 16 sultation functions to another state agency or to a local health 17 department qualified to perform those functions. However, the 18 department shall not delegate survey, evaluation, or consultation 19 functions to a local health department that owns or operates a 20 hospice or hospice residence licensed under this article. The 21 delegation shall be by cost reimbursement contract between the 22 department and the state agency or local health department. 23 Survey, evaluation, or consultation functions shall not be dele- 24 gated to nongovernmental agencies, except as provided in this 25 section. The department may accept voluntary inspections per- 26 formed by an accrediting body with expertise in clinical 27 laboratory accreditation under part 205 if the accrediting body 00915'99 7 1 utilizes forms acceptable to the department, applies the same 2 licensing standards as applied to other clinical laboratories and 3 provides the same information and data usually filed by the 4 department's own employees when engaged in similar inspections or 5 surveys. The voluntary inspection described in this subsection 6 shall be agreed upon by both the licensee and the department. 7 (13) If, upon investigation, the department or a state 8 agency determines that an individual licensed to practice a pro- 9 fession in this state has violated the applicable licensure stat- 10 ute or the rules promulgated under that statute, the department, 11 state agency, or local health department shall forward the evi- 12 dence it has to the appropriate licensing agency. 13 (14) As used in this section: 14 (a) "Title XVIII" means title XVIII of the social security 15 act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 16 1395b-2, 1395b-6 TO 1395b-7, 1395c to 1395i, 1395i-2 to1395i-417 1395i-5, 1395j to 1395t, 1395u to1395w-21395w,1395w-4 to181395yy1395w-2 TO 1395w-4, 1395w-21 TO 1395w-28, 1395x TO 19 1395yy, and 1395bbb to1395ccc1395ggg. 20 (b) "Title XIX" means title XIX of the social security act, 21 chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to1396v1396f, 22 1396g-1 TO 1396r-6, AND 1396r-8 TO 1396v. 00915'99 Final page. 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