HOUSE AMENDED
PRIOR PRINTER'S NOS. 1160, 1169, 1202, PRINTER'S NO. 1298
1235, 1281
No. 968 Session of 2007
INTRODUCED BY ERICKSON, PILEGGI, SCARNATI, WONDERLING, MADIGAN,
McILHINNEY, MELLOW, TARTAGLIONE, WASHINGTON, ORIE, M. WHITE,
MUSTO, KITCHEN, GORDNER, FOLMER, O'PAKE, PIPPY, TOMLINSON,
RAFFERTY, VANCE, BAKER, C. WILLIAMS, D. WHITE, FERLO,
FONTANA, GREENLEAF, STACK, BROWNE AND COSTA, JUNE 11, 2007
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,
JULY 12, 2007
AN ACT
1 Amending the act of March 20, 2002 (P.L.154, No.13), entitled
2 "An act reforming the law on medical professional liability;
3 providing for patient safety and reporting; establishing the
4 Patient Safety Authority and the Patient Safety Trust Fund;
5 abrogating regulations; providing for medical professional
6 liability informed consent, damages, expert qualifications,
7 limitations of actions and medical records; establishing the
8 Interbranch Commission on Venue; providing for medical
9 professional liability insurance; establishing the Medical
10 Care Availability and Reduction of Error Fund; providing for
11 medical professional liability claims; establishing the Joint
12 Underwriting Association; regulating medical professional
13 liability insurance; providing for medical licensure
14 regulation; providing for administration; imposing penalties;
15 and making repeals," providing for reduction and prevention
16 of health care-associated infection AND FOR LONG-TERM CARE <--
17 NURSING FACILITIES.
18 The General Assembly of the Commonwealth of Pennsylvania
19 hereby enacts as follows:
20 Section 1. The act of March 20, 2002 (P.L.154, No.13), known
21 as the Medical Care Availability and Reduction of Error (Mcare)
22 Act, is amended by adding a chapter to read:
1 CHAPTER 4
2 HEALTH CARE-ASSOCIATED INFECTIONS
3 Section 401. Scope. <--
4 This chapter relates to the reduction and prevention of
5 health care-associated infections.
6 Section 402. Definitions.
7 The following words and phrases when used in this chapter
8 shall have the meanings given to them in this section unless the
9 context clearly indicates otherwise:
10 "Antimicrobial agent." A general term for drugs, chemicals
11 or other substances that kill or slow the growth of microbes,
12 including, but not limited to, antibacterial drugs, antiviral
13 agents, antifungal agents and antiparasitic drugs.
14 "Authority." The Patient Safety Authority ESTABLISHED UNDER <--
15 THIS CHAPTER.
16 "CENTERS FOR DISEASE CONTROL AND PREVENTION" OR "CDC." THE
17 UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS
18 FOR DISEASE CONTROL AND PREVENTION.
19 "Colonization." The first stage of microbial infection or
20 the presence of nonreplicating microorganisms usually present in
21 host tissues that are in contact with the external environment.
22 "COUNCIL." THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT <--
23 COUNCIL ESTABLISHED UNDER THE ACT OF JULY 8, 1986 (P.L.408,
24 NO.89), KNOWN AS THE HEALTH CARE COST CONTAINMENT ACT.
25 "Department." The Department of Health of the Commonwealth.
26 "Fund." The Patient Safety Trust Fund as defined in section
27 305.
28 "Health care-associated infection." A localized or systemic
29 condition that results from an adverse reaction to the presence
30 of an infectious agent or its toxins that:
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1 (1) occurs in a patient in a health care setting;
2 (2) was not present or incubating at the time of
3 admission, unless the infection was related to a previous
4 admission to the same setting; and
5 (3) if occurring in a hospital setting, meets the
6 criteria for a specific infection site as defined by the
7 Centers for Disease Control and Prevention and its National
8 Health Care Safety Network.
9 "Health care facility." A hospital or nursing home licensed
10 or otherwise regulated to provide health care services under the
11 laws of this Commonwealth.
12 "Health payor." An individual or entity providing a group
13 health, sickness or accident policy, subscriber contract or
14 program issued or provided by an entity subject to any one of
15 the following:
16 (1) The act of June 2, 1915 (P.L.736, No.338), known as
17 the Workers' Compensation Act.
18 (2) The act of May 17, 1921 (P.L.682, No.284), known as
19 The Insurance Company Law of 1921.
20 (3) The act of December 29, 1972 (P.L.1701, No.364),
21 known as the Health Maintenance Organization Act.
22 (4) The act of May 18, 1976 (P.L.123, No.54), known as
23 the Individual Accident and Sickness Insurance Minimum
24 Standards Act.
25 (5) 40 Pa.C.S. Ch. 61 (relating to hospital plan
26 corporations).
27 "Medicaid." The program established under Title XIX of the <--
28 Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.).
29 "MEDICAL ASSISTANCE." THE COMMONWEALTH'S MEDICAL ASSISTANCE <--
30 PROGRAM ESTABLISHED UNDER THE ACT OF JUNE 13, 1967 (P.L.31,
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1 NO.21), KNOWN AS THE PUBLIC WELFARE CODE.
2 "Medicare." The program established under section 1886 of
3 the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395ww).
4 "Methicillin Resistant Staphylococcus Aureus" or "MRSA." A
5 strain of bacteria that is resistant to certain antibiotics and
6 is difficult to treat medically.
7 "Multidrug resistant organism" or "MDRO." Microorganisms,
8 predominantly bacteria, that are resistant to one or more
9 classes of antimicrobial agents.
10 "NATIONAL HEALTHCARE SAFETY NETWORK" OR "NHSN." A SECURE <--
11 INTERNET-BASED DATA COLLECTION SYSTEM MANAGED BY THE DIVISION OF
12 HEALTHCARE QUALITY PROMOTION AT THE CENTERS FOR DISEASE CONTROL
13 AND PREVENTION.
14 "Nationally recognized standards." Standards developed by
15 organizations specializing in the control of infectious diseases
16 such as the Society for the Healthcare Epidemiology of America
17 (SHEA), the Association for Professionals in Infection Control
18 and Epidemiology (APIC) and the Infectious Disease Society of
19 America (IDSA) and such methods, recommendations and guidelines
20 developed by the Centers for Disease Control and Prevention
21 (CDC) and its National Healthcare Safety Network.
22 "SURVEILLANCE SYSTEM." A COMPREHENSIVE METHOD OF MEASURING <--
23 HEALTH STATUS, OUTCOMES AND RELATED PROCESSES OF CARE, ANALYZING
24 DATA AND PROVIDING INFORMATION FROM A DATA SOURCE TO ASSIST IN
25 REDUCING HEALTH CARE-ASSOCIATED INFECTIONS.
26 Section 403. Infection control plan.
27 (a) Development and compliance.--Within 120 days of the
28 effective date of this section, a health care facility AS <--
29 DEFINED UNDER SUBSECTION (D), shall develop and implement an
30 internal infection control plan that shall be established for
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1 the purpose of improving the health and safety of patients and
2 health care workers and shall include:
3 (1) A multidisciplinary committee including
4 representatives from each of the following if applicable to
5 that specific health care facility:
6 (i) Medical staff. <--
7 (ii) Administration.
8 (iii) Laboratory.
9 (iv) Nursing.
10 (v) Pharmacy.
11 (vi) The community.
12 (I) MEDICAL STAFF, INCLUDING A CHIEF MEDICAL OFFICER <--
13 OR NURSING HOME ADMINISTRATOR.
14 (II) ADMINISTRATION, INCLUDING THE CHIEF EXECUTIVE
15 OFFICER AND THE CHIEF FINANCIAL OFFICER. FOR A NURSING
16 HOME, IT SHALL INCLUDE THE NURSING HOME ADMINISTRATOR.
17 (III) LABORATORY PERSONNEL.
18 (IV) NURSING, INCLUDING THE DIRECTOR OF NURSING.
19 (V) PHARMACY, INCLUDING THE CHIEF OF PHARMACY.
20 (VI) PHYSICAL PLANT PERSONNEL.
21 (VII) A PATIENT SAFETY OFFICER.
22 (VIII) MEMBERS FROM THE INFECTION CONTROL TEAM,
23 WHICH COULD INCLUDE A HOSPITAL EPIDEMIOLOGIST.
24 (IX) THE COMMUNITY, EXCEPT THAT THESE
25 REPRESENTATIVES MAY NOT BE AN AGENT, EMPLOYEE OR
26 CONTRACTOR OF THE HEALTH CARE FACILITY.
27 (2) Effective measures for the detection, control and
28 prevention of health care-associated infections.
29 (3) An active culture surveillance process and policies.
30 (4) A system to identify and designate patients known to
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1 be colonized or infected with MRSA or other MDRO THAT <--
2 INCLUDES:
3 (I) THE PROCEDURES NECESSARY FOR REQUIRING CULTURES
4 AND SCREENINGS FOR NURSING HOME RESIDENTS ADMITTED TO A
5 HOSPITAL.
6 (5) The procedure for identifying other high-risk <--
7 (II) THE PROCEDURE FOR IDENTIFYING OTHER HIGH-RISK <--
8 patients admitted to the facility who shall receive
9 routine cultures and screenings.
10 (5) THE PROCEDURES AND PROTOCOLS FOR STAFF THAT INCLUDE <--
11 RECEIVING CULTURES AND SCREENINGS, PROPHYLAXIS AND FOLLOW-UP
12 CARE AFTER POTENTIAL EXPOSURE TO A PATIENT OR RESIDENT KNOWN
13 TO BE COLONIZED OR INFECTED WITH MRSA OR MDRO.
14 (6) An outreach process for notifying a receiving health
15 care facility of any patient known to be colonized prior to
16 transfer within or between facilities.
17 (7) A required infection-control intervention protocol
18 which includes:
19 (i) Infection control precautions, based on
20 nationally recognized standards, for general surveillance
21 of infected or colonized patients.
22 (ii) Treatment INTERVENTION protocols based on <--
23 evidence-based standards.
24 (iii) Isolation procedures.
25 (iv) Physical plant operations related to infection
26 control.
27 (v) Appropriate use of antimicrobial agents and
28 antibiotics.
29 (vi) Mandatory educational programs for personnel.
30 (vii) Fiscal and human resource requirements.
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1 (8) THE PROCEDURES TO DISTRIBUTE ADVISORIES ISSUED UNDER <--
2 SECTION 405(C)(1) SO THEY ARE EASILY ACCESSIBLE AND WIDELY
3 DISTRIBUTED IN EACH HEALTH CARE FACILITY TO ADMINISTRATIVE
4 STAFF, MEDICAL PERSONNEL AND HEALTH CARE WORKERS.
5 (9) A STRATEGIC ASSESSMENT ON THE UTILITY AND EFFICACY
6 OF IMPLEMENTING A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM
7 PURSUANT TO SECTION 404(C) AND (D) FOR THE PURPOSES OF
8 IMPROVING INFECTION CONTROL AND PREVENTION. THIS ASSESSMENT
9 SHALL ALSO INCLUDE AN EXAMINATION OF FINANCIAL AND
10 TECHNOLOGICAL BARRIERS TO IMPLEMENTING A QUALIFIED ELECTRONIC
11 SURVEILLANCE SYSTEM PURSUANT TO SECTION 404(C) AND (D).
12 (b) Department review.--The department shall review each <--
13 health care facility's infection control plan to ensure
14 compliance with this section in accordance with the department's
15 authority under 28 Pa. Code § 146 (relating to infection
16 control) or 28 Pa. Code § 211.1 (relating to reportable
17 diseases) during its regular licensure inspection process.
18 (c) Notification.--Upon review
19 (B) NOTIFICATION.--UPON APPROVAL BY THE DEPARTMENT of its <--
20 infection control plan, a health care facility shall notify all
21 health care workers, PHYSICAL PLANT PERSONNEL and medical staff <--
22 of the health care facility of the infection control plan.
23 Compliance with the infection control plan shall be enforced by
24 the facility.
25 (d) Compliance.--For purposes of compliance with this <--
26 section, a health care facility with an existing infection
27 control plan that meets the criteria set forth in subsection (a)
28 shall be deemed to be in compliance.
29 (C) COMPLIANCE.--A HEALTH CARE FACILITY SHALL SUBMIT ITS <--
30 INFECTION CONTROL PLAN TO THE DEPARTMENT WITHIN 60 DAYS AFTER
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1 MEETING THE REQUIREMENTS UNDER SECTION 403(A). THE DEPARTMENT
2 SHALL REVIEW THE PLAN WITHIN 180 DAYS OF RECEIPT OF THE
3 INFECTION CONTROL PLAN. IF THE DEPARTMENT DOES NOT APPROVE OR
4 DISAPPROVE OF THE INFECTION CONTROL PLAN WITHIN 180 DAYS OF
5 RECEIPT, THE INFECTION CONTROL PLAN SHALL BE PRESUMED TO MEET
6 THE REQUIREMENTS OF THIS ACT AND ALL APPLICABLE LAWS. IF, AT ANY
7 TIME, THE DEPARTMENT FINDS THAT AN INFECTION CONTROL PLAN DOES
8 NOT MEET THE REQUIREMENTS OF THIS ACT OR ANY APPLICABLE LAWS,
9 THE HEALTH CARE FACILITY SHALL CORRECT THE VIOLATION.
10 (D) DEFINITION.--FOR PURPOSES OF THIS SECTION, A HEALTH CARE
11 FACILITY SHALL INCLUDE ANY HEALTH CARE FACILITY PROVIDING
12 CLINICALLY RELATED HEALTH SERVICES, INCLUDING, BUT NOT LIMITED
13 TO, A GENERAL OR SPECIAL HOSPITAL, INCLUDING PSYCHIATRIC
14 HOSPITALS, REHABILITATION HOSPITALS, AMBULATORY SURGICAL
15 FACILITIES, NURSING HOMES, CANCER TREATMENT CENTERS USING
16 RADIATION THERAPY ON AN AMBULATORY BASIS AND INPATIENT DRUG AND
17 ALCOHOL TREATMENT FACILITIES, BOTH PROFIT AND NONPROFIT AND
18 INCLUDING THOSE OPERATED BY AN AGENCY OR STATE OR LOCAL
19 GOVERNMENT. THE TERM SHALL ALSO INCLUDE A RESIDENTIAL OR
20 INPATIENT HOSPICE. THE TERM SHALL NOT INCLUDE AN OFFICE USED
21 PRIMARILY FOR PRIVATE OR GROUP PRACTICE BY HEALTH CARE
22 PRACTITIONERS WHERE NO REVIEWABLE CLINICALLY RELATED HEALTH
23 SERVICE IS OFFERED, A FACILITY PROVIDING TREATMENT SOLELY ON THE
24 BASIS OF PRAYER OR SPIRITUAL MEANS IN ACCORDANCE WITH THE TENETS
25 OF ANY CHURCH OR RELIGIOUS DENOMINATION OR A FACILITY CONDUCTED
26 BY A RELIGIOUS ORGANIZATION FOR THE PURPOSE OF PROVIDING HEALTH
27 CARE SERVICES EXCLUSIVELY TO CLERGY OR OTHER PERSONS IN A
28 RELIGIOUS PROFESSION WHO ARE MEMBERS OF THE RELIGIOUS
29 DENOMINATIONS CONDUCTING THE FACILITY.
30 SECTION 404. HEALTH CARE FACILITY REPORTING.
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1 (A) GENERALLY.--ALL HEALTH CARE-ASSOCIATED INFECTIONS SHALL
2 BE REPORTED BY THE HEALTH CARE FACILITY TO THE DEPARTMENT, THE
3 AUTHORITY AND THE COUNCIL USING CDC DEFINITIONS IN CONJUNCTION
4 WITH NATIONALLY RECOGNIZED STANDARDS PROVIDED THAT THE DATA IS
5 REPORTED ON A PATIENT-SPECIFIC BASIS IN THE FORM, TIME FOR
6 REPORTING AND FORMAT AS DETERMINED BY THE DEPARTMENT IN
7 CONSULTATION WITH THE AUTHORITY AND THE COUNCIL.
8 (B) QUALIFIED ELECTRONIC SURVEILLANCE SYSTEMS.--BY JANUARY
9 1, 2008, THE DEPARTMENT SHALL, IN CONSULTATION WITH THE
10 AUTHORITY AND THE COUNCIL, IDENTIFY QUALIFIED ELECTRONIC
11 SURVEILLANCE SYSTEMS, WHICH MAY BE USED BY A HEALTH CARE
12 FACILITY TO REPORT HEALTH CARE-ASSOCIATED INFECTIONS TO THE
13 COUNCIL AND FOR USE BY THE FACILITY IN ITS HEALTH CARE-
14 ASSOCIATED INFECTION CONTROL EFFORTS. QUALIFIED SYSTEMS SHALL
15 INCLUDE THE FOLLOWING MINIMUM ELEMENTS:
16 (1) EXTRACTIONS OF EXISTING ELECTRONIC CLINICAL DATA
17 FROM HOSPITAL SYSTEMS ON AN ONGOING CONSTANT AND CONSISTENT
18 BASIS.
19 (2) TRANSLATION OF NONSTANDARDIZED LABORATORY, PHARMACY
20 AND/OR RADIOLOGY DATA INTO UNIFORM INFORMATION THAT CAN BE
21 ANALYZED ON A POPULATIONWIDE BASIS.
22 (3) CLINICAL SUPPORT, EDUCATIONAL TOOLS AND TRAINING TO
23 ENSURE THAT INFORMATION PROVIDED UNDER THIS SUBSECTION WILL
24 LEAD TO CHANGE AND MEET OR EXCEED BENCHMARKS.
25 (4) CLINICAL IMPROVEMENT MEASUREMENT AND THE STRUCTURE
26 TO PROVIDE ONGOING POSITIVE AND NEGATIVE FEEDBACK TO HOSPITAL
27 STAFF WHO ARE IMPLEMENTING CHANGE.
28 (5) COLLECTION OF DATA THAT IS PATIENT-SPECIFIC AND FOR
29 THE ENTIRE FACILITY.
30 (C) SURVEILLANCE.--BY DECEMBER 31, 2008, A HEALTH CARE
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1 FACILITY MUST IMPLEMENT A QUALIFIED ELECTRONIC SURVEILLANCE
2 SYSTEM OR UNTIL SUCH TIME AS A HEALTH CARE FACILITY IMPLEMENTS A
3 QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM, THE FACILITY SHALL USE
4 A SURVEILLANCE SYSTEM THAT INCLUDES:
5 (1) A WRITTEN PLAN OF THE ELEMENTS OF THE SURVEILLANCE
6 PROCESS TO INCLUDE, BUT NOT BE LIMITED TO, DEFINITIONS,
7 COLLECTION OF SURVEILLANCE DATA AND REPORTING OF INFORMATION.
8 (2) IDENTIFICATION OF PERSONNEL RESOURCES THAT WILL BE
9 USED IN THE SURVEILLANCE PROCESS.
10 (3) IDENTIFICATION OF INFORMATION OR TECHNOLOGICAL
11 SUPPORT NEEDED TO IMPLEMENT THE SURVEILLANCE SYSTEM.
12 (4) A PROCESS FOR PERIODIC EVALUATION AND VALIDATION TO
13 ENSURE ACCURACY OF SURVEILLANCE.
14 (D) COMPLIANCE.--A HEALTH CARE FACILITY THAT HAS IMPLEMENTED
15 A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM THAT REPORTS DATA
16 UNDER SUBSECTION (A) SHALL BE DEEMED IN COMPLIANCE WITH
17 REPORTING REQUIREMENTS UNDER THIS SECTION.
18 (E) CONTINUED REPORTING.--UNTIL SUCH TIME AS PERMITTED BY
19 THIS CHAPTER, A HEALTH CARE FACILITY UNDER THIS SECTION SHALL
20 CONTINUE TO MEET THE REQUIREMENTS PURSUANT TO SECTION 6 OF THE
21 ACT OF JULY 8, 1986 (P.L.408, NO.89), KNOWN AS THE HEALTH CARE
22 COST CONTAINMENT ACT.
23 Section 404 405. Patient Safety Authority jurisdiction. <--
24 (a) Health care facility reports to authority.--The
25 occurrence of a health care-associated infection in a health
26 care facility shall be deemed a serious event or incident, as
27 applicable, as defined in section 302 and shall be reported to
28 the authority within 24 hours of the health care facility's
29 confirmation of its occurrence. The report to the authority
30 shall be in a form and manner prescribed by the authority and
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1 shall not include the name of any patient or any other
2 identifiable individual information. The report to the authority
3 shall also be subject to all of the confidentiality protections
4 set forth in section 311.
5 (b) Report submission.--Subject to the notice and reporting
6 requirements set forth in subsection (c)(4), a health care
7 facility shall begin reporting health care-associated infections
8 in its facility as serious events or incidents, consistent with
9 the requirements of this section and the provisions of Chapter
10 3.
11 (c) Duties.--In addition to its existing responsibilities,
12 the authority is responsible for all of the following:
13 (1) Establishing uniform definitions based on nationally <--
14 recognized standards for the identification and reporting of
15 health care-associated infections.
16 (2) Developing and implementing uniform reporting
17 requirements utilizing the uniform definitions established
18 under paragraph (1), which a health care facility shall
19 follow for purposes of reporting health care-associated
20 infections if applicable to that specific health care
21 facility:
22 (i) to the authority pursuant to subsection (b);
23 (ii) to the Health Care Cost Containment Council
24 pursuant to section 6(c)(7) of the act of July 8, 1986
25 (P.L.408, No.89), known as the Health Care Cost
26 Containment Act; and
27 (iii) to any other State agency, including
28 independent State agencies.
29 (3) Developing a methodology using nationally recognized
30 standards for determining and assessing the rate of health
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1 care-associated infections that occur in health care
2 facilities in this Commonwealth as compared with the rate of
3 health care-associated infections occurring in health care
4 facilities on a nationwide basis.
5 (4) (1) Publishing a notice in the Pennsylvania Bulletin <--
6 stating the uniform reporting requirements established
7 pursuant to this subsection and the effective date for the
8 commencement of required reporting by health care facilities
9 consistent with this chapter, which, at a minimum, shall
10 begin 120 days after publication of the notice.
11 (5) Issuing advisories under <--
12 (2) ISSUING ADVISORIES TO HEALTH CARE FACILITIES IN A <--
13 MANNER SIMILAR TO section 304(a)(7).
14 (6) (3) Including a separate category for providing <--
15 information about health care-associated infections in the
16 annual report under section 304(c).
17 (4) CREATING AND CONDUCTING TRAINING PROGRAMS FOR <--
18 INFECTION CONTROL TEAMS, HEALTH CARE WORKERS, PHYSICAL PLANT
19 PERSONNEL AND CONSUMERS ABOUT THE PREVENTION AND CONTROL OF
20 HEALTH CARE-ASSOCIATED INFECTIONS. NOTHING IN THIS ACT
21 PRECLUDES THE AUTHORITY FROM WORKING WITH THE DEPARTMENT OR
22 ANY ORGANIZATION IN CONDUCTING THESE PROGRAMS.
23 (7) (5) Appointing an advisory panel of health care- <--
24 associated infection control experts, including at least one
25 representative of a nursing home and at least one <--
26 REPRESENTATIVE OF A NOT-FOR-PROFIT NURSING HOME, AT LEAST ONE <--
27 REPRESENTATIVE OF A FOR-PROFIT NURSING HOME AND AT LEAST ONE
28 representative of a hospital, to assist in carrying out the
29 requirements of this chapter.
30 Section 405 406. Payment for performing routine cultures and <--
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1 screenings.
2 The full cost of routine cultures and screenings performed on <--
3 patients in compliance with a health care facility's infection
4 control plan shall be considered a reimbursable cost to be paid
5 by health payors and Medicaid, SUBJECT TO FEDERAL APPROVAL, <--
6 MEDICAL ASSISTANCE. THESE COSTS SHALL BE subject to any
7 copayment, coinsurance or deductible in amounts imposed in any
8 applicable policy issued by a health payor and to any agreements
9 between a health care facility and payor.
10 Section 406 407. Incentive payment. <--
11 (a) General rule.--Commencing on January 1, 2009, a health
12 care facility that achieves at least a 10% reduction for that
13 facility in the total number of reported health care-associated
14 infections over the preceding year PURSUANT TO SECTION 408(7)(I) <--
15 shall be eligible to receive an incentive payment. For calendar
16 year 2010 and thereafter, the Department of Public Welfare shall
17 consult with the authority DEPARTMENT to establish appropriate <--
18 percentage benchmarks for the reduction of health care-
19 associated infections in EACH health care facilities in order to <--
20 be eligible for an incentive payment pursuant to this section.
21 (B) ADDITIONAL INCENTIVE PAYMENTS.--NOTHING IN THIS SECTION <--
22 SHALL PREVENT THE DEPARTMENT OF PUBLIC WELFARE IN CONSULTATION
23 WITH THE DEPARTMENT FROM PROVIDING ADDITIONAL INCENTIVE PAYMENTS
24 TO A HEALTH CARE FACILITY THAT HAS IMPLEMENTED A QUALIFIED
25 ELECTRONIC SURVEILLANCE SYSTEM AND ACHIEVES OR EXCEEDS THE
26 REDUCTIONS IN THE TOTAL NUMBER OF REPORTED HEALTH CARE-
27 ASSOCIATED INFECTIONS ESTABLISHED IN SUBSECTION (A).
28 (C) ELIGIBILITY.--IN ADDITION TO THE REQUIREMENTS CONTAINED
29 IN THIS SECTION, TO BE ELIGIBLE FOR AN INCENTIVE PAYMENT UNDER
30 THIS SECTION A HEALTH CARE FACILITY MUST BE IN COMPLIANCE WITH
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1 HEALTH CARE-ASSOCIATED REPORTING REQUIREMENTS CONTAINED IN THIS
2 ACT AND THE ACT OF JULY 8, 1986 (P.L.408, NO.89), KNOWN AS THE
3 HEALTH CARE COST CONTAINMENT ACT.
4 (b) (D) Distribution of funds.--Funds for the purpose of <--
5 implementing this section shall be appropriated to the
6 Department of Public Welfare and distributed to eligible health
7 care facilities as set forth in this section. Incentive payments
8 to health care facilities shall be limited to funds available
9 for this purpose.
10 Section 407 408. Duties of Department of Health. <--
11 The department is responsible for the following:
12 (1) The development of a public health awareness
13 campaign on health care-associated infections to be known as
14 the Community Awareness Program. The program shall provide
15 information to the public on causes and symptoms of health
16 care-associated infections, diagnosis and treatment
17 prevention methods and the proper use of antibiotics.
18 (2) The consideration and determination of the
19 feasibility of establishing an active surveillance program
20 involving other entities, such as athletic teams,
21 correctional facilities or other entities to identify those
22 persons in the community that are actively colonized and at
23 risk of susceptibility to and transmission of MRSA bacteria.
24 (3) THE REVIEW OF EACH HEALTH CARE FACILITY'S INFECTION <--
25 CONTROL PLAN DURING ITS REGULAR LICENSURE INSPECTION PROCESS
26 TO ENSURE COMPLIANCE WITH THIS CHAPTER. THIS REVIEW SHALL BE
27 PERFORMED PURSUANT TO THE DEPARTMENT'S AUTHORITY UNDER THE
28 HEALTH CARE FACILITIES ACT AND THE REGULATIONS PROMULGATED
29 THEREUNDER.
30 (4) THE DEVELOPMENT OF RECOMMENDATIONS AND PRACTICES
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1 REGARDING BEST PRACTICES TO IMPLEMENT AND EFFECTUATE
2 SCREENING AND CULTURES CONSISTENT WITH THE PROVISIONS OF THIS
3 CHAPTER AND OTHER MEANS OF REDUCTION AND ELIMINATION OF
4 HEALTH CARE-ASSOCIATED INFECTIONS AND HOW THESE
5 RECOMMENDATIONS AND PRACTICES MAY APPLY TO HEALTH CARE
6 FACILITIES.
7 (5) THE DEVELOPMENT OF RECOMMENDATIONS REGARDING
8 EVIDENCE-BASED SCREENING PROTOCOLS OF PATIENTS AND NURSING
9 HOME RESIDENTS FOR MRSA AND MDRO UPON ADMISSION AND DURING
10 THE INPATIENT PERIOD OR NURSING HOME STAY.
11 (6) THE REVIEW OF STRATEGIC ASSESSMENTS UNDER SECTION
12 403(A)(9) AND OFFER OF ASSISTANCE TO HEALTH CARE FACILITIES
13 TO IMPLEMENT A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM
14 PURSUANT TO THE REQUIREMENTS OF SECTION 404(A) AND (B).
15 (7) THE DEVELOPMENT OF A METHODOLOGY, IN CONSULTATION
16 WITH THE AUTHORITY AND THE COUNCIL, FOR DETERMINING AND
17 ASSESSING THE RATE OF HEALTH CARE-ASSOCIATED INFECTIONS THAT
18 OCCUR IN HEALTH CARE FACILITIES IN THIS COMMONWEALTH. THIS
19 METHODOLOGY SHALL BE USED:
20 (I) TO DETERMINE THE RATE OF REDUCTION IN HEALTH
21 CARE-ASSOCIATED INFECTION RATES WITHIN A HEALTH CARE
22 FACILITY DURING A REPORTING PERIOD;
23 (II) TO COMPARE HEALTH CARE-ASSOCIATED INFECTION
24 RATES BETWEEN HEALTH CARE FACILITIES WITHIN THIS
25 COMMONWEALTH; AND
26 (III) TO COMPARE HEALTH CARE-ASSOCIATED INFECTION
27 RATES AMONG HEALTH CARE FACILITIES NATIONWIDE.
28 (8) THE DEVELOPMENT, IN CONSULTATION WITH THE AUTHORITY
29 AND THE COUNCIL, OF REASONABLE BENCHMARKS AGAINST WHICH TO
30 MEASURE THE PROGRESS OF HEALTH CARE FACILITIES TO REDUCE
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1 HEALTH CARE-ASSOCIATED INFECTIONS. ALL HEALTH CARE FACILITIES
2 SHALL BE MEASURED AGAINST THE BENCHMARKS. THOSE HEALTH CARE
3 FACILITIES WITH RATES OF HEALTH CARE-ASSOCIATED INFECTIONS
4 THAT ARE ABOVE THE BENCHMARK SHALL BE REQUIRED TO SUBMIT A
5 PLAN OF REMEDIATION TO THE DEPARTMENT WITHIN 60 DAYS AFTER
6 BEING NOTIFIED OF MISSING THE STANDARD. IF AFTER 180 DAYS,
7 THE FACILITY HAS NOT SHOWN PROGRESS IN REDUCING RATES OF
8 INFECTIONS, THE FACILITY IS REQUIRED TO CONSULT WITH THE
9 DEPARTMENT TO DEVELOP A NEW PLAN OF REMEDIATION TO BE
10 APPROVED BY THE DEPARTMENT THAT SHALL INCLUDE A LIST OF
11 RESOURCES AVAILABLE TO ASSIST THE HEALTH CARE FACILITY. IF
12 AFTER AN ADDITIONAL 180 DAYS THE FACILITY CONTINUES TO FAIL
13 TO SHOW PROGRESS IN LOWERING ITS RATES OF INFECTION, THE
14 DEPARTMENT MAY TAKE ACTION PURSUANT TO THE HEALTH CARE
15 FACILITIES ACT.
16 (9) PUBLISH A NOTICE IN THE PENNSYLVANIA BULLETIN OF THE
17 SPECIFIC BENCHMARKS THE DEPARTMENT SHALL USE TO MEASURE THE
18 PROGRESS OF HEALTH CARE FACILITIES IN REDUCING HEALTH CARE-
19 ASSOCIATED INFECTIONS.
20 (10) PUBLISH A NOTICE IN THE PENNSYLVANIA BULLETIN OF
21 THE UNIFORM REPORTING REQUIREMENTS ESTABLISHED UNDER SECTION
22 404(A), INCLUDING FORM, TIME FOR REPORTING AND FORMAT, FOR
23 HEALTH CARE-ASSOCIATED INFECTIONS. THESE REQUIREMENTS SHALL
24 APPLY AND BE UTILIZED FOR ALL REPORTS, EXCEPT THOSE REQUIRED
25 UNDER SECTION 405, MADE TO THE DEPARTMENT, THE COUNCIL AND
26 THE AUTHORITY. THE REPORTING REQUIREMENTS CONTAINED IN
27 SECTION 6 OF THE ACT OF JULY 8, 1986 (P.L.408, NO.89), KNOWN
28 AS THE HEALTH CARE COST CONTAINMENT ACT, SHALL CONTINUE TO
29 REMAIN IN EFFECT AS THEY RELATE TO HEALTH CARE-ASSOCIATED
30 INFECTIONS UNTIL 120 DAYS AFTER PUBLICATION OF THE NOTICE.
20070S0968B1298 - 16 -
1 Section 408 409. Nursing home assessment to Patient Safety <--
2 Authority.
3 (a) Assessment.--Commencing January JULY 1, 2008, each <--
4 nursing home shall pay the department a surcharge on its
5 licensing fee as necessary to provide sufficient revenues to
6 operate the authority for its responsibilities under this
7 chapter. The total annual assessment for all nursing homes shall
8 not be more than an aggregate amount of $1,000,000. The
9 department shall transfer the total assessment amount to the
10 fund within 30 days of receipt.
11 (b) Base amount.--For each succeeding calendar year, the
12 authority shall determine the appropriate assessment amount and
13 the department shall assess each nursing home its proportionate
14 share of the authority's budget for its responsibilities under
15 this chapter. The total assessment amount shall not be more than
16 $1,000,000 in fiscal year 2007-2008 2008-2009 and shall be <--
17 increased according to the Consumer Price Index in each
18 succeeding fiscal year.
19 (c) Expenditures.--Money appropriated to the fund under this
20 chapter shall be expended by the authority to implement this
21 chapter.
22 (d) Dissolution.--In the event that the fund is discontinued
23 or the authority is dissolved by operation of law, any balance
24 paid by nursing homes remaining in the fund, after deducting
25 administrative costs of liquidation, shall be returned to the
26 nursing homes in proportion to their financial contributions to
27 the fund in the preceding licensing period.
28 (e) Failure to pay surcharge.--If after 30 days' notice a
29 nursing home fails to pay a surcharge levied by the department
30 under this chapter, the department may assess an administrative
20070S0968B1298 - 17 -
1 penalty of $1,000 per day until the surcharge is paid.
2 (F) REIMBURSABLE COST.--SUBJECT TO FEDERAL APPROVAL, THE <--
3 ANNUAL ASSESSMENT AMOUNT PAID BY A NURSING HOME SHALL BE A
4 REIMBURSABLE COST UNDER THE MEDICAL ASSISTANCE PROGRAM. THE
5 DEPARTMENT OF PUBLIC WELFARE SHALL PAY EACH NURSING HOME, AS A
6 SEPARATE, PASS-THROUGH PAYMENT, AN AMOUNT EQUAL TO THE
7 ASSESSMENT PAID BY A NURSING HOME MULTIPLIED BY THE FACILITY'S
8 MEDICAL ASSISTANCE OCCUPANCY RATE AS REPORTED IN ITS ANNUAL COST
9 REPORT.
10 Section 409 410. Scope of reporting. <--
11 For purposes of reporting health care-associated infections
12 to the Commonwealth, its agencies and independent agencies, this
13 chapter sets forth the applicable criteria to be utilized by
14 health care facilities in making such reports. NOTHING IN THIS <--
15 ACT SHALL SUPERSEDE THE REQUIREMENTS SET FORTH IN THE ACT OF
16 APRIL 23, 1956 (1955 P.L.1510, NO.500), KNOWN AS THE DISEASE
17 PREVENTION AND CONTROL LAW OF 1955, AND THE REGULATIONS
18 PROMULGATED THEREUNDER.
19 Section 410 411. Penalties. <--
20 (a) Violation of Health Care Facilities Act.--The failure of
21 a health care facility to report a health care-associated
22 infection as a serious event or incident as required by this
23 chapter or the failure of a health care facility to develop,
24 implement and comply with its infection control plan in
25 accordance with the requirements of section 403 shall be a
26 violation of the act of July 19, 1979 (P.L.130, No.48), known as
27 the Health Care Facilities Act.
28 (b) Administrative penalty.--In addition to any penalty that
29 may be imposed under the Health Care Facilities Act or under 18
30 Pa.C.S. Ch. 32 (relating to abortion), a health care facility
20070S0968B1298 - 18 -
1 which fails to report a health care-associated infection as a
2 serious event or incident may be subject to an administrative
3 penalty of $1,000 per day imposed by the department.
4 Section 2. This act shall take effect in 30 days. <--
5 SECTION 2. THIS ACT SHALL TAKE EFFECT AS FOLLOWS: <--
6 (1) THE ADDITION OF SECTION 403 OF THE ACT SHALL TAKE
7 EFFECT IMMEDIATELY.
8 (2) SECTION 408(10) SHALL TAKE EFFECT IN 90 DAYS.
9 (3) THIS SECTION SHALL TAKE EFFECT IMMEDIATELY.
10 (4) THE REMAINDER OF THIS ACT SHALL TAKE EFFECT IN 180
11 DAYS.
12 SECTION 401. SCOPE. <--
13 THIS CHAPTER RELATES TO THE REDUCTION AND PREVENTION OF
14 HEALTH CARE-ASSOCIATED INFECTIONS.
15 SECTION 402. DEFINITIONS.
16 THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS CHAPTER
17 SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
18 CONTEXT CLEARLY INDICATES OTHERWISE:
19 "AMBULATORY SURGICAL FACILITY." AN ENTITY DEFINED AS AN
20 AMBULATORY SURGICAL FACILITY UNDER THE ACT OF JULY 19, 1979
21 (P.L.130, NO.48), KNOWN AS THE HEALTH CARE FACILITIES ACT.
22 "ANTIMICROBIAL AGENT." A GENERAL TERM FOR DRUGS, CHEMICALS
23 OR OTHER SUBSTANCES THAT KILL OR SLOW THE GROWTH OF MICROBES,
24 INCLUDING, BUT NOT LIMITED TO, ANTIBACTERIAL DRUGS, ANTIVIRAL
25 AGENTS, ANTIFUNGAL AGENTS AND ANTIPARASITIC DRUGS.
26 "AUTHORITY." THE PATIENT SAFETY AUTHORITY ESTABLISHED UNDER
27 THIS ACT.
28 "CENTERS FOR DISEASE CONTROL AND PREVENTION" OR "CDC." THE
29 UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS
30 FOR DISEASE CONTROL AND PREVENTION.
20070S0968B1298 - 19 -
1 "COLONIZATION." THE FIRST STAGE OF MICROBIAL INFECTION OR
2 THE PRESENCE OF NONREPLICATING MICROORGANISMS USUALLY PRESENT IN
3 HOST TISSUES THAT ARE IN CONTACT WITH THE EXTERNAL ENVIRONMENT.
4 "COUNCIL." THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT
5 COUNCIL ESTABLISHED UNDER THE ACT OF JULY 8, 1986 (P.L.408,
6 NO.89), KNOWN AS THE HEALTH CARE COST CONTAINMENT ACT.
7 "DEPARTMENT." THE DEPARTMENT OF HEALTH OF THE COMMONWEALTH.
8 "FUND." THE PATIENT SAFETY TRUST FUND AS DEFINED IN SECTION
9 305.
10 "HEALTH CARE-ASSOCIATED INFECTION." A LOCALIZED OR SYSTEMIC
11 CONDITION THAT RESULTS FROM AN ADVERSE REACTION TO THE PRESENCE
12 OF AN INFECTIOUS AGENT OR ITS TOXINS THAT:
13 (1) OCCURS IN A PATIENT IN A HEALTH CARE SETTING;
14 (2) WAS NOT PRESENT OR INCUBATING AT THE TIME OF
15 ADMISSION, UNLESS THE INFECTION WAS RELATED TO A PREVIOUS
16 ADMISSION TO THE SAME SETTING; AND
17 (3) IF OCCURRING IN A HOSPITAL SETTING, MEETS THE
18 CRITERIA FOR A SPECIFIC INFECTION SITE AS DEFINED BY THE
19 CENTERS FOR DISEASE CONTROL AND PREVENTION AND ITS NATIONAL
20 HEALTH CARE SAFETY NETWORK.
21 "HEALTH CARE FACILITIES ACT." THE ACT OF JULY 19, 1979
22 (P.L.130, NO.48), KNOWN AS THE HEALTH CARE FACILITIES ACT.
23 "HEALTH CARE FACILITY." A HOSPITAL OR NURSING HOME LICENSED
24 OR OTHERWISE REGULATED TO PROVIDE HEALTH CARE SERVICES UNDER THE
25 LAWS OF THIS COMMONWEALTH.
26 "HEALTH PAYOR." AN INDIVIDUAL OR ENTITY PROVIDING A GROUP
27 HEALTH, SICKNESS OR ACCIDENT POLICY, SUBSCRIBER CONTRACT OR
28 PROGRAM ISSUED OR PROVIDED BY AN ENTITY, INCLUDING ANY ONE OF
29 THE FOLLOWING:
30 (1) THE ACT OF JUNE 2, 1915 (P.L.736, NO.338), KNOWN AS
20070S0968B1298 - 20 -
1 THE WORKERS' COMPENSATION ACT.
2 (2) THE ACT OF MAY 17, 1921 (P.L.682, NO.284), KNOWN AS
3 THE INSURANCE COMPANY LAW OF 1921.
4 (3) THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364),
5 KNOWN AS THE HEALTH MAINTENANCE ORGANIZATION ACT.
6 (4) THE ACT OF MAY 18, 1976 (P.L.123, NO.54), KNOWN AS
7 THE INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM
8 STANDARDS ACT.
9 (5) 40 PA.C.S. CH. 61 (RELATING TO HOSPITAL PLAN
10 CORPORATIONS).
11 (6) 40 PA.C.S. CH. 63 (RELATING TO PROFESSIONAL HEALTH
12 SERVICES PLAN CORPORATIONS).
13 "MEDICAL ASSISTANCE." THE COMMONWEALTH'S MEDICAL ASSISTANCE
14 PROGRAM ESTABLISHED UNDER THE ACT OF JUNE 13, 1967 (P.L.31,
15 NO.21), KNOWN AS THE PUBLIC WELFARE CODE.
16 "METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS" OR "MRSA." A
17 STRAIN OF BACTERIA THAT IS RESISTANT TO CERTAIN ANTIBIOTICS AND
18 IS DIFFICULT TO TREAT MEDICALLY.
19 "MULTIDRUG RESISTANT ORGANISM" OR "MDRO." MICROORGANISMS,
20 PREDOMINANTLY BACTERIA, THAT ARE RESISTANT TO MORE THAN ONE
21 CLASS OF ANTIMICROBIAL AGENTS.
22 "NATIONAL HEALTHCARE SAFETY NETWORK" OR "NHSN." A SECURE
23 INTERNET-BASED DATA COLLECTION SYSTEM MANAGED BY THE DIVISION OF
24 HEALTHCARE QUALITY PROMOTION AT THE CENTERS FOR DISEASE CONTROL
25 AND PREVENTION.
26 "NATIONALLY RECOGNIZED STANDARDS." STANDARDS DEVELOPED BY
27 THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE
28 CONTROL AND PREVENTION (CDC) AND ITS NATIONAL HEALTHCARE SAFETY
29 NETWORK.
30 "NURSING HOME." AN ENTITY LICENSED AS A LONG-TERM CARE
20070S0968B1298 - 21 -
1 NURSING FACILITY UNDER THE ACT OF JULY 19, 1979 (P.L.130,
2 NO.48), KNOWN AS THE HEALTH CARE FACILITIES ACT.
3 "SURVEILLANCE SYSTEM." AN ONGOING AND COMPREHENSIVE METHOD
4 OF MEASURING HEALTH STATUS, OUTCOMES AND RELATED PROCESSES OF
5 CARE, ANALYZING DATA AND PROVIDING INFORMATION FROM DATA SOURCES
6 WITHIN A HEALTH CARE FACILITY TO ASSIST IN REDUCING HEALTH CARE-
7 ASSOCIATED INFECTIONS.
8 SECTION 403. INFECTION CONTROL PLAN.
9 (A) DEVELOPMENT AND COMPLIANCE.--WITHIN 120 DAYS OF THE
10 EFFECTIVE DATE OF THIS SECTION, A HEALTH CARE FACILITY AND AN
11 AMBULATORY SURGICAL FACILITY SHALL DEVELOP AND IMPLEMENT AN
12 INTERNAL INFECTION CONTROL PLAN THAT SHALL BE ESTABLISHED FOR
13 THE PURPOSE OF IMPROVING THE HEALTH AND SAFETY OF PATIENTS AND
14 HEALTH CARE WORKERS AND SHALL INCLUDE:
15 (1) A MULTIDISCIPLINARY COMMITTEE INCLUDING
16 REPRESENTATIVES FROM EACH OF THE FOLLOWING, IF APPLICABLE TO
17 THAT SPECIFIC HEALTH CARE FACILITY:
18 (I) MEDICAL STAFF THAT COULD INCLUDE THE CHIEF
19 MEDICAL OFFICER OR THE NURSING HOME MEDICAL DIRECTOR.
20 (II) ADMINISTRATION REPRESENTATIVES THAT COULD
21 INCLUDE THE CHIEF EXECUTIVE OFFICER, THE CHIEF FINANCIAL
22 OFFICER OR THE NURSING HOME ADMINISTRATOR.
23 (III) LABORATORY PERSONNEL.
24 (IV) NURSING STAFF THAT COULD INCLUDE A DIRECTOR OF
25 NURSING OR A NURSING SUPERVISOR.
26 (V) PHARMACY STAFF THAT COULD INCLUDE THE CHIEF OF
27 PHARMACY.
28 (VI) PHYSICAL PLANT PERSONNEL.
29 (VII) A PATIENT SAFETY OFFICER.
30 (VIII) MEMBERS FROM THE INFECTION CONTROL TEAM,
20070S0968B1298 - 22 -
1 WHICH COULD INCLUDE AN EPIDEMIOLOGIST.
2 (IX) THE COMMUNITY, EXCEPT THAT THESE
3 REPRESENTATIVES MAY NOT BE AN AGENT, EMPLOYEE OR
4 CONTRACTOR OF THE HEALTH CARE FACILITY OR AMBULATORY
5 SURGICAL FACILITY.
6 (2) EFFECTIVE MEASURES FOR THE DETECTION, CONTROL AND
7 PREVENTION OF HEALTH CARE-ASSOCIATED INFECTIONS.
8 (3) CULTURE SURVEILLANCE PROCESSES AND POLICIES.
9 (4) A SYSTEM TO IDENTIFY AND DESIGNATE PATIENTS KNOWN TO
10 BE COLONIZED OR INFECTED WITH MRSA OR OTHER MDRO THAT
11 INCLUDES:
12 (I) THE PROCEDURES NECESSARY FOR REQUIRING CULTURES
13 AND SCREENINGS FOR NURSING HOME RESIDENTS ADMITTED TO A
14 HOSPITAL.
15 (II) THE PROCEDURES FOR IDENTIFYING OTHER HIGH-RISK
16 PATIENTS ADMITTED TO THE HOSPITAL WHO NECESSITATE ROUTINE
17 CULTURES AND SCREENING.
18 (5) THE PROCEDURES AND PROTOCOLS FOR STAFF WHO MAY HAVE
19 HAD POTENTIAL EXPOSURE TO A PATIENT OR RESIDENT KNOWN TO BE
20 COLONIZED OR INFECTED WITH MRSA OR MDRO, INCLUDING CULTURES
21 AND SCREENINGS, PROPHYLAXIS AND FOLLOW-UP CARE.
22 (6) AN OUTREACH PROCESS FOR NOTIFYING A RECEIVING HEALTH
23 CARE FACILITY OR AN AMBULATORY SURGICAL FACILITY OF ANY
24 PATIENT KNOWN TO BE COLONIZED PRIOR TO TRANSFER WITHIN OR
25 BETWEEN FACILITIES.
26 (7) A REQUIRED INFECTION-CONTROL INTERVENTION PROTOCOL
27 WHICH INCLUDES:
28 (I) INFECTION CONTROL PRECAUTIONS, BASED ON
29 NATIONALLY RECOGNIZED STANDARDS, FOR GENERAL SURVEILLANCE
30 OF INFECTED OR COLONIZED PATIENTS.
20070S0968B1298 - 23 -
1 (II) INTERVENTION PROTOCOLS BASED ON EVIDENCE-BASED
2 STANDARDS.
3 (III) ISOLATION PROCEDURES.
4 (IV) PHYSICAL PLANT OPERATIONS RELATED TO INFECTION
5 CONTROL.
6 (V) APPROPRIATE USE OF ANTIMICROBIAL AGENTS.
7 (VI) MANDATORY EDUCATIONAL PROGRAMS FOR PERSONNEL.
8 (VII) FISCAL AND HUMAN RESOURCE REQUIREMENTS.
9 (8) THE PROCEDURE FOR DISTRIBUTION OF ADVISORIES ISSUED
10 UNDER SECTION 405(B)(4) SO AS TO ENSURE EASY ACCESS IN EACH
11 HEALTH CARE FACILITY FOR ALL ADMINISTRATIVE STAFF, MEDICAL
12 PERSONNEL AND HEALTH CARE WORKERS.
13 (B) DEPARTMENT REVIEW.--NO LATER THAN 14 DAYS AFTER
14 IMPLEMENTATION OF ITS INFECTION CONTROL PLAN, A HEALTH CARE
15 FACILITY AND AN AMBULATORY SURGICAL FACILITY SHALL SUBMIT THE
16 PLAN TO THE DEPARTMENT. THE DEPARTMENT SHALL REVIEW EACH HEALTH
17 CARE FACILITY'S AND AMBULATORY SURGICAL FACILITY'S INFECTION
18 CONTROL PLAN TO ENSURE COMPLIANCE UNDER THE HEALTH CARE
19 FACILITIES ACT AND SECTION 408(3). IF, AT ANY TIME, THE
20 DEPARTMENT FINDS THAT AN INFECTION CONTROL PLAN DOES NOT MEET
21 THE REQUIREMENTS OF THIS CHAPTER OR ANY APPLICABLE LAWS, THE
22 HEALTH CARE FACILITY OR AMBULATORY SURGICAL FACILITY SHALL
23 MODIFY ITS PLAN TO COME INTO COMPLIANCE.
24 (C) NOTIFICATION.--UPON SUBMISSION TO THE DEPARTMENT OF ITS
25 INFECTION CONTROL PLAN, A HEALTH CARE FACILITY AND AN AMBULATORY
26 SURGICAL FACILITY SHALL NOTIFY ALL HEALTH CARE WORKERS, PHYSICAL
27 PLANT PERSONNEL AND MEDICAL STAFF OF THE FACILITY OF THE
28 INFECTION CONTROL PLAN. COMPLIANCE WITH THE INFECTION CONTROL
29 PLAN SHALL BE ENFORCED BY THE FACILITY.
30 SECTION 404. HEALTH CARE FACILITY REPORTING.
20070S0968B1298 - 24 -
1 (A) NURSING HOME REPORTING.--IN ADDITION TO REPORTING
2 PURSUANT TO THE HEALTH CARE FACILITIES ACT, A NURSING HOME SHALL
3 ALSO ELECTRONICALLY REPORT HEALTH CARE-ASSOCIATED INFECTION DATA
4 TO THE DEPARTMENT AND THE AUTHORITY USING NATIONALLY RECOGNIZED
5 STANDARDS BASED ON CDC DEFINITIONS, PROVIDED THAT THE DATA IS
6 REPORTED ON A PATIENT-SPECIFIC BASIS IN THE FORM, WITH THE TIME
7 FOR REPORTING AND FORMAT AS DETERMINED BY THE DEPARTMENT AND THE
8 AUTHORITY.
9 (B) HOSPITAL REPORTING.--A HOSPITAL SHALL REPORT HEALTH
10 CARE-ASSOCIATED INFECTION DATA TO THE CDC AND ITS NATIONAL
11 HEALTHCARE SAFETY NETWORK NO LATER THAN 180 DAYS FOLLOWING THE
12 EFFECTIVE DATE OF THIS SECTION. A HOSPITAL SHALL:
13 (1) REPORT ALL COMPONENTS AS DEFINED IN THE NHSN MANUAL,
14 PATIENT SAFETY COMPONENT PROTOCOL, AND ANY SUCCESSOR EDITION,
15 FOR ALL PATIENTS THROUGHOUT THE FACILITY ON A CONTINUOUS
16 BASIS.
17 (2) REPORT PATIENT-SPECIFIC DATA TO INCLUDE, AT A
18 MINIMUM, PATIENT IDENTIFICATION NUMBER, GENDER AND DATE OF
19 BIRTH. THE PATIENT IDENTIFICATION NUMBER MUST BE COMPATIBLE
20 WITH THE PATIENT IDENTIFIER ON THE UNIFORM BILLING FORMS
21 SUBMITTED TO THE COUNCIL.
22 (3) REPORT DATA ON A MONTHLY BASIS IN ACCORDANCE WITH
23 PROTOCOLS DEFINED IN THE NHSN MANUAL AS UPDATED BY THE CDC.
24 (4) AUTHORIZE THE DEPARTMENT, THE AUTHORITY AND THE
25 COUNCIL TO HAVE ACCESS TO THE NHSN FOR FACILITY-SPECIFIC
26 REPORTS OF HEALTH CARE-ASSOCIATED INFECTION DATA CONTAINED IN
27 THE NHSN DATABASE FOR PURPOSES OF VIEWING AND ANALYZING THAT
28 DATA.
29 (C) STRATEGIC ASSESSMENTS.--EACH HOSPITAL, OTHER THAN THOSE
30 CURRENTLY USING A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM,
20070S0968B1298 - 25 -
1 SHALL BY DECEMBER 31, 2007, CONDUCT A STRATEGIC ASSESSMENT OF
2 THE UTILITY AND EFFICACY OF IMPLEMENTING A QUALIFIED ELECTRONIC
3 SURVEILLANCE SYSTEM PURSUANT TO SUBSECTIONS (D) AND (E) FOR THE
4 PURPOSE OF IMPROVING INFECTION CONTROL AND PREVENTION. THE
5 ASSESSMENT SHALL ALSO INCLUDE AN EXAMINATION OF FINANCIAL AND
6 TECHNOLOGICAL BARRIERS TO IMPLEMENTATION OF A QUALIFIED
7 ELECTRONIC SURVEILLANCE SYSTEM PURSUANT TO SUBSECTIONS (D) AND
8 (E). THE ASSESSMENT SHALL BE SUBMITTED TO THE DEPARTMENT WITHIN
9 14 DAYS OF COMPLETION.
10 (D) QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM.--A QUALIFIED
11 ELECTRONIC SURVEILLANCE SYSTEM SHALL INCLUDE THE FOLLOWING
12 MINIMUM ELEMENTS:
13 (1) EXTRACTIONS OF EXISTING ELECTRONIC CLINICAL DATA
14 FROM HEALTH CARE FACILITY SYSTEMS ON AN ONGOING, CONSTANT AND
15 CONSISTENT BASIS.
16 (2) TRANSLATION OF NONSTANDARDIZED LABORATORY, PHARMACY
17 AND/OR RADIOLOGY DATA INTO UNIFORM INFORMATION THAT CAN BE
18 ANALYZED ON A POPULATION-WIDE BASIS.
19 (3) CLINICAL SUPPORT, EDUCATIONAL TOOLS AND TRAINING TO
20 ENSURE THAT INFORMATION PROVIDED UNDER THIS SUBSECTION WILL
21 ASSIST THE HOSPITAL IN REDUCING THE INCIDENCE OF HEALTH CARE-
22 ASSOCIATED INFECTIONS IN A MANNER THAT MEETS OR EXCEEDS
23 BENCHMARKS.
24 (4) CLINICAL IMPROVEMENT MEASUREMENTS DESIGNED TO
25 PROVIDE POSITIVE AND NEGATIVE FEEDBACK TO HEALTH CARE
26 FACILITY INFECTION CONTROL STAFF.
27 (5) COLLECTION OF DATA THAT IS PATIENT-SPECIFIC FOR THE
28 ENTIRE FACILITY.
29 (E) ELECTRONIC SURVEILLANCE SYSTEM IMPLEMENTATION.--EXCEPT
30 AS OTHERWISE PROVIDED IN THIS SUBSECTION, A HOSPITAL SHALL HAVE
20070S0968B1298 - 26 -
1 A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM IN PLACE BY DECEMBER
2 31, 2008. THE FOLLOWING APPLY:
3 (1) IF A DETERMINATION HAS BEEN MADE UNDER SUBSECTION
4 (C) THAT A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM CAN BE
5 IMPLEMENTED, THE HOSPITAL SHALL COMPLY WITH SUBSECTION (F)
6 UNTIL IMPLEMENTATION.
7 (2) IF A DETERMINATION HAS BEEN MADE UNDER SUBSECTION
8 (C) THAT A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM CANNOT BE
9 IMPLEMENTED, BY DECEMBER 31, 2008, THE HOSPITAL SHALL COMPLY
10 WITH SUBSECTION (F) UNTIL SUCH TIME AS A QUALIFIED ELECTRONIC
11 SURVEILLANCE SYSTEM IS IMPLEMENTED.
12 (F) SURVEILLANCE SYSTEM.--UNTIL A HOSPITAL IMPLEMENTS A
13 QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM, THE FACILITY SHALL USE
14 A SURVEILLANCE SYSTEM THAT INCLUDES:
15 (1) A WRITTEN PLAN OF THE ELEMENTS OF THE SURVEILLANCE
16 PROCESS TO INCLUDE, BUT NOT BE LIMITED TO, DEFINITIONS,
17 COLLECTION OF SURVEILLANCE DATA AND REPORTING OF INFORMATION.
18 (2) IDENTIFICATION OF PERSONNEL RESOURCES THAT WILL BE
19 USED IN THE SURVEILLANCE PROCESS.
20 (3) IDENTIFICATION OF INFORMATION OR TECHNOLOGICAL
21 SUPPORT NEEDED TO IMPLEMENT THE SURVEILLANCE SYSTEM.
22 (4) A PROCESS FOR PERIODIC EVALUATION AND VALIDATION TO
23 ENSURE ACCURACY OF SURVEILLANCE.
24 (G) CONTINUED REPORTING.--UNTIL HOSPITALS BEGIN REPORTING TO
25 NHSN AND HAVE AUTHORIZED ACCESS TO THE DEPARTMENT, THE AUTHORITY
26 AND THE COUNCIL, HOSPITALS SHALL CONTINUE TO MEET REPORTING
27 REQUIREMENTS PURSUANT TO CHAPTER 3 OF THIS ACT AND SECTION 6 OF
28 THE ACT OF JULY 8, 1986 (P.L.408, NO.89), KNOWN AS THE HEALTH
29 CARE COST CONTAINMENT ACT.
30 SECTION 405. PATIENT SAFETY AUTHORITY JURISDICTION.
20070S0968B1298 - 27 -
1 (A) HEALTH CARE FACILITY REPORTS TO AUTHORITY.--THE
2 OCCURRENCE OF A HEALTH CARE-ASSOCIATED INFECTION IN A HEALTH
3 CARE FACILITY SHALL BE DEEMED A SERIOUS EVENT, AS DEFINED IN
4 SECTION 302. THE REPORT TO THE AUTHORITY SHALL ALSO BE SUBJECT
5 TO ALL OF THE CONFIDENTIALITY PROTECTIONS SET FORTH IN SECTION
6 311. THE OCCURRENCE OF A HEALTH CARE-ASSOCIATED INFECTION SHALL
7 ONLY CONSTITUTE A SERIOUS EVENT FOR HOSPITALS IF IT MEETS THE
8 CRITERIA FOR REPORTING AS DEFINED BY THE CURRENT CDC AND NHSN
9 MANUAL, PATIENT SAFETY COMPONENT PROTOCOL AND ANY SUCCESSOR
10 EDITION.
11 (B) DUTIES.--IN ADDITION TO ITS EXISTING RESPONSIBILITIES,
12 THE AUTHORITY IS RESPONSIBLE FOR ALL OF THE FOLLOWING:
13 (1) ESTABLISHING, BASED ON CDC DEFINITIONS, UNIFORM
14 DEFINITIONS USING NATIONALLY RECOGNIZED STANDARDS FOR THE
15 IDENTIFICATION AND REPORTING OF HEALTH CARE-ASSOCIATED
16 INFECTIONS BY NURSING HOMES.
17 (2) PUBLISHING A NOTICE IN THE PENNSYLVANIA BULLETIN
18 STATING THE UNIFORM REPORTING REQUIREMENTS ESTABLISHED
19 PURSUANT TO THIS SUBSECTION AND THE EFFECTIVE DATE FOR THE
20 COMMENCEMENT OF REQUIRED REPORTING BY HOSPITALS CONSISTENT
21 WITH THIS CHAPTER, WHICH, AT A MINIMUM, SHALL BEGIN 120 DAYS
22 AFTER PUBLICATION OF THE NOTICE.
23 (3) PUBLISHING A NOTICE IN THE PENNSYLVANIA BULLETIN
24 STATING THE UNIFORM REPORTING REQUIREMENTS ESTABLISHED
25 PURSUANT TO THIS SUBSECTION AND SECTION 404(A) AND THE
26 EFFECTIVE DATE FOR THE COMMENCEMENT OF REQUIRED REPORTING BY
27 NURSING HOMES CONSISTENT WITH THIS CHAPTER, WHICH, AT A
28 MINIMUM, SHALL BEGIN 120 DAYS AFTER PUBLICATION OF THE
29 NOTICE.
30 (4) ISSUING ADVISORIES TO HEALTH CARE FACILITIES IN A
20070S0968B1298 - 28 -
1 MANNER SIMILAR TO SECTION 304(A)(7).
2 (5) INCLUDING A SEPARATE CATEGORY FOR PROVIDING
3 INFORMATION ABOUT HEALTH CARE-ASSOCIATED INFECTIONS IN THE
4 ANNUAL REPORT UNDER SECTION 304(C).
5 (6) CREATING AND CONDUCTING TRAINING PROGRAMS FOR
6 INFECTION CONTROL TEAMS, HEALTH CARE WORKERS AND PHYSICAL
7 PLANT PERSONNEL ABOUT THE PREVENTION AND CONTROL OF HEALTH
8 CARE-ASSOCIATED INFECTIONS. NOTHING IN THIS ACT SHALL
9 PRECLUDE THE AUTHORITY FROM WORKING WITH THE DEPARTMENT OR
10 ANY ORGANIZATION IN CONDUCTING THESE PROGRAMS.
11 (7) APPOINTING AN ADVISORY PANEL OF HEALTH CARE-
12 ASSOCIATED INFECTION CONTROL EXPERTS, INCLUDING AT LEAST ONE
13 REPRESENTATIVE OF A NOT-FOR-PROFIT NURSING HOME, AT LEAST ONE
14 REPRESENTATIVE OF A FOR-PROFIT NURSING HOME, AT LEAST ONE
15 REPRESENTATIVE OF A COUNTY NURSING HOME AND AT LEAST TWO
16 REPRESENTATIVES OF A HOSPITAL, ONE OF WHICH MUST BE FROM A
17 RURAL HOSPITAL, TO ASSIST IN CARRYING OUT THE REQUIREMENTS OF
18 THIS CHAPTER.
19 (C) PUBLIC COMMENT.--PRIOR TO PUBLISHING A NOTICE UNDER
20 SUBSECTION (B)(2) AND (3), THE AUTHORITY SHALL SOLICIT PUBLIC
21 COMMENTS FOR AT LEAST 30 DAYS. THE AUTHORITY SHALL RESPOND TO
22 THE COMMENTS IT RECEIVES DURING THE 30-DAY PUBLIC COMMENT
23 PERIOD.
24 SECTION 406. PAYMENT FOR PERFORMING ROUTINE CULTURES AND
25 SCREENINGS.
26 THE COST OF ROUTINE CULTURES AND SCREENINGS PERFORMED ON
27 PATIENTS IN COMPLIANCE WITH A HEALTH CARE FACILITY'S AND
28 AMBULATORY SURGICAL FACILITY'S INFECTION CONTROL PLAN SHALL BE
29 CONSIDERED A REIMBURSABLE COST TO BE PAID BY HEALTH PAYORS AND
30 MEDICAL ASSISTANCE UPON FEDERAL APPROVAL. THESE COSTS SHALL BE
20070S0968B1298 - 29 -
1 SUBJECT TO ANY COPAYMENT, COINSURANCE OR DEDUCTIBLE IN AMOUNTS
2 IMPOSED IN ANY APPLICABLE POLICY ISSUED BY A HEALTH PAYOR AND TO
3 ANY AGREEMENTS BETWEEN A HEALTH CARE FACILITY, AMBULATORY
4 SURGICAL FACILITY AND PAYOR.
5 SECTION 407. QUALITY IMPROVEMENT PAYMENT.
6 (A) GENERAL RULE.--COMMENCING ON JANUARY 1, 2009, THE
7 DEPARTMENT OF PUBLIC WELFARE IN CONSULTATION WITH THE DEPARTMENT
8 SHALL MAKE A QUALITY IMPROVEMENT PAYMENT TO A HEALTH CARE
9 FACILITY THAT ACHIEVES AT LEAST A 10% REDUCTION FOR THAT
10 FACILITY IN THE TOTAL NUMBER OF REPORTED HEALTH CARE-ASSOCIATED
11 INFECTIONS OVER THE PRECEDING YEAR PURSUANT TO SECTION
12 408(7)(I). FOR CALENDAR YEAR 2010 AND THEREAFTER, THE DEPARTMENT
13 OF PUBLIC WELFARE SHALL CONSULT WITH THE DEPARTMENT TO ESTABLISH
14 APPROPRIATE PERCENTAGE BENCHMARKS FOR THE REDUCTION OF HEALTH
15 CARE-ASSOCIATED INFECTIONS IN EACH HEALTH CARE FACILITY IN ORDER
16 TO BE ELIGIBLE FOR A PAYMENT PURSUANT TO THIS SECTION.
17 (B) ADDITIONAL QUALITY IMPROVEMENT PAYMENTS.--NOTHING IN
18 THIS SECTION SHALL PREVENT THE DEPARTMENT OF PUBLIC WELFARE IN
19 CONSULTATION WITH THE DEPARTMENT FROM PROVIDING ADDITIONAL
20 QUALITY IMPROVEMENT PAYMENTS TO A HEALTH CARE FACILITY THAT HAS
21 IMPLEMENTED A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM AND HAS
22 ACHIEVED OR EXCEEDED REDUCTIONS IN THE TOTAL NUMBER OF REPORTED
23 HEALTH CARE-ASSOCIATED INFECTIONS FOR THAT FACILITY OVER THE
24 PRECEDING YEAR AS PROVIDED IN SUBSECTION (A).
25 (C) ELIGIBILITY.--IN ADDITION TO MEETING THE REQUIREMENTS
26 CONTAINED IN THIS SECTION, TO BE ELIGIBLE FOR A QUALITY
27 IMPROVEMENT PAYMENT, A HEALTH CARE FACILITY MUST BE IN
28 COMPLIANCE WITH HEALTH CARE-ASSOCIATED REPORTING REQUIREMENTS
29 CONTAINED IN THIS ACT AND THE HEALTH CARE FACILITIES ACT.
30 (D) DISTRIBUTION OF FUNDS.--FUNDS FOR THE PURPOSE OF
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1 IMPLEMENTING THIS SECTION SHALL BE APPROPRIATED TO THE
2 DEPARTMENT OF PUBLIC WELFARE AND DISTRIBUTED TO ELIGIBLE HEALTH
3 CARE FACILITIES AS SET FORTH IN THIS SECTION. QUALITY
4 IMPROVEMENT PAYMENTS TO HEALTH CARE FACILITIES SHALL BE LIMITED
5 TO FUNDS AVAILABLE FOR THIS PURPOSE.
6 SECTION 408. DUTIES OF DEPARTMENT OF HEALTH.
7 THE DEPARTMENT IS RESPONSIBLE FOR THE FOLLOWING:
8 (1) THE DEVELOPMENT OF A PUBLIC HEALTH AWARENESS
9 CAMPAIGN ON HEALTH CARE-ASSOCIATED INFECTIONS TO BE KNOWN AS
10 THE COMMUNITY AWARENESS PROGRAM. THE PROGRAM SHALL PROVIDE
11 INFORMATION TO THE PUBLIC ON CAUSES AND SYMPTOMS OF HEALTH
12 CARE-ASSOCIATED INFECTIONS, DIAGNOSIS AND TREATMENT
13 PREVENTION METHODS AND THE PROPER USE OF ANTIMICROBIAL
14 AGENTS.
15 (2) THE CONSIDERATION AND DETERMINATION OF THE
16 FEASIBILITY OF ESTABLISHING AN ACTIVE SURVEILLANCE PROGRAM
17 INVOLVING OTHER ENTITIES, SUCH AS ATHLETIC TEAMS OR
18 CORRECTIONAL FACILITIES FOR THE PURPOSE OF IDENTIFYING THOSE
19 PERSONS IN THE COMMUNITY THAT ARE COLONIZED AND AT RISK OF
20 SUSCEPTIBILITY TO AND TRANSMISSION OF MRSA BACTERIA.
21 (3) THE REVIEW OF EACH HEALTH CARE FACILITY'S AND
22 AMBULATORY SURGICAL FACILITY'S INFECTION CONTROL PLAN. THIS
23 REVIEW SHALL BE PERFORMED PURSUANT TO THE DEPARTMENT'S
24 AUTHORITY UNDER THE HEALTH CARE FACILITIES ACT AND THE
25 REGULATIONS PROMULGATED THEREUNDER.
26 (4) THE DEVELOPMENT OF RECOMMENDATIONS AND BEST
27 PRACTICES THAT IMPLEMENT AND EFFECTUATE IMPROVED SCREENINGS
28 AND CULTURES AND OTHER MEANS FOR THE REDUCTION AND
29 ELIMINATION OF HEALTH CARE-ASSOCIATED INFECTIONS.
30 (5) THE DEVELOPMENT OF RECOMMENDATIONS REGARDING
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1 EVIDENCE-BASED SCREENING PROTOCOLS FOR AN INDIVIDUAL WITH
2 MRSA AND MDRO PRIOR TO ADMISSION TO A HOSPITAL.
3 (6) THE REVIEW OF STRATEGIC ASSESSMENTS UNDER SECTION
4 404(C) AND THE PROVISION OF ASSISTANCE TO HOSPITALS IN
5 IMPLEMENTING A QUALIFIED ELECTRONIC SURVEILLANCE SYSTEM
6 PURSUANT TO THE REQUIREMENTS OF SECTION 404(D) AND (E).
7 (7) THE DEVELOPMENT OF A METHODOLOGY, IN CONSULTATION
8 WITH THE AUTHORITY AND THE COUNCIL, FOR DETERMINING AND
9 ASSESSING THE RATE OF HEALTH CARE-ASSOCIATED INFECTIONS THAT
10 OCCUR IN HEALTH CARE FACILITIES IN THIS COMMONWEALTH. THIS
11 METHODOLOGY SHALL BE USED:
12 (I) TO DETERMINE THE RATE OF REDUCTION IN HEALTH
13 CARE-ASSOCIATED INFECTION RATES WITHIN A HEALTH CARE
14 FACILITY DURING A REPORTING PERIOD;
15 (II) TO COMPARE HEALTH CARE-ASSOCIATED INFECTION
16 RATES AMONG SIMILAR HEALTH CARE FACILITIES WITHIN THIS
17 COMMONWEALTH; AND
18 (III) TO COMPARE HEALTH CARE-ASSOCIATED INFECTION
19 RATES AMONG SIMILAR HEALTH CARE FACILITIES NATIONWIDE.
20 (8) THE DEVELOPMENT, IN CONSULTATION WITH THE AUTHORITY
21 AND THE COUNCIL, OF REASONABLE BENCHMARKS TO MEASURE THE
22 PROGRESS HEALTH CARE FACILITIES MAKE TOWARD REDUCING HEALTH
23 CARE-ASSOCIATED INFECTIONS. BEGINNING IN 2010, ALL HEALTH
24 CARE FACILITIES SHALL BE MEASURED AGAINST THESE BENCHMARKS. A
25 HEALTH CARE FACILITY WITH A RATE OF HEALTH CARE-ASSOCIATED
26 INFECTIONS THAT DOES NOT MEET THE BENCHMARK APPROPRIATE TO
27 THAT TYPE OF FACILITY SHALL BE REQUIRED TO SUBMIT A PLAN OF
28 CORRECTION TO THE DEPARTMENT WITHIN 60 DAYS OF RECEIVING
29 NOTIFICATION THAT THE RATE DOES NOT MEET THE BENCHMARK. AFTER
30 180 DAYS, A FACILITY THAT HAS NOT SHOWN PROGRESS IN REDUCING
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1 ITS RATE OF INFECTION SHALL CONSULT WITH AND OBTAIN
2 DEPARTMENT APPROVAL FOR A NEW PLAN OF CORRECTION THAT
3 INCLUDES RESOURCES AVAILABLE TO ASSIST THE HEALTH CARE
4 FACILITY. AFTER AN ADDITIONAL 180 DAYS, A FACILITY THAT FAILS
5 TO SHOW PROGRESS IN REDUCING ITS RATE OF INFECTION MAY BE
6 SUBJECT TO ACTION UNDER THE HEALTH CARE FACILITIES ACT.
7 (9) PUBLISHING A NOTICE IN THE PENNSYLVANIA BULLETIN OF
8 THE SPECIFIC BENCHMARKS THE DEPARTMENT SHALL USE TO MEASURE
9 THE PROGRESS OF HEALTH CARE FACILITIES IN REDUCING HEALTH
10 CARE-ASSOCIATED INFECTIONS. PRIOR TO PUBLISHING THE NOTICE,
11 THE DEPARTMENT SHALL SEEK PUBLIC COMMENTS FOR AT LEAST 30
12 DAYS. THE DEPARTMENT SHALL RESPOND TO THE COMMENTS IT
13 RECEIVES DURING THE 30-DAY PUBLIC COMMENT PERIOD.
14 SECTION 409. NURSING HOME ASSESSMENT TO PATIENT SAFETY
15 AUTHORITY.
16 (A) ASSESSMENT.--COMMENCING JULY 1, 2008, EACH NURSING HOME
17 SHALL PAY THE DEPARTMENT A SURCHARGE ON ITS LICENSING FEE AS
18 NECESSARY TO PROVIDE SUFFICIENT REVENUES FOR THE AUTHORITY TO
19 PERFORM ITS RESPONSIBILITIES UNDER THIS CHAPTER. THE TOTAL
20 ANNUAL ASSESSMENT FOR ALL NURSING HOMES SHALL NOT BE MORE THAN
21 AN AGGREGATE AMOUNT OF $1,000,000. THE DEPARTMENT SHALL TRANSFER
22 THE TOTAL ASSESSMENT AMOUNT TO THE FUND WITHIN 30 DAYS OF
23 RECEIPT.
24 (B) BASE AMOUNT.--FOR EACH SUCCEEDING CALENDAR YEAR, THE
25 AUTHORITY SHALL DETERMINE THE APPROPRIATE ASSESSMENT AMOUNT AND
26 THE DEPARTMENT SHALL ASSESS EACH NURSING HOME ITS PROPORTIONATE
27 SHARE OF THE AUTHORITY'S BUDGET FOR ITS RESPONSIBILITIES UNDER
28 THIS CHAPTER. THE TOTAL ASSESSMENT AMOUNT SHALL NOT BE MORE THAN
29 $1,000,000 IN FISCAL YEAR 2008-2009 AND SHALL BE INCREASED
30 ACCORDING TO THE CONSUMER PRICE INDEX IN EACH SUCCEEDING FISCAL
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1 YEAR.
2 (C) EXPENDITURES.--MONEY APPROPRIATED TO THE FUND UNDER THIS
3 CHAPTER SHALL BE EXPENDED BY THE AUTHORITY TO IMPLEMENT THIS
4 CHAPTER.
5 (D) DISSOLUTION.--IN THE EVENT THAT THE FUND IS DISCONTINUED
6 OR THE AUTHORITY IS DISSOLVED BY OPERATION OF LAW, ANY BALANCE
7 PAID BY NURSING HOMES REMAINING IN THE FUND, AFTER DEDUCTING
8 ADMINISTRATIVE COSTS OF LIQUIDATION, SHALL BE RETURNED TO THE
9 NURSING HOMES IN PROPORTION TO THEIR FINANCIAL CONTRIBUTIONS TO
10 THE FUND IN THE PRECEDING LICENSING PERIOD.
11 (E) FAILURE TO PAY SURCHARGE.--IF AFTER 30 DAYS' NOTICE A
12 NURSING HOME FAILS TO PAY A SURCHARGE LEVIED BY THE DEPARTMENT
13 UNDER THIS CHAPTER, THE DEPARTMENT MAY ASSESS AN ADMINISTRATIVE
14 PENALTY OF $1,000 PER DAY UNTIL THE SURCHARGE IS PAID.
15 (F) REIMBURSABLE COST.--SUBJECT TO FEDERAL APPROVAL, THE
16 ANNUAL ASSESSMENT AMOUNT PAID BY A NURSING HOME SHALL BE A
17 REIMBURSABLE COST UNDER THE MEDICAL ASSISTANCE PROGRAM. THE
18 DEPARTMENT OF PUBLIC WELFARE SHALL PAY EACH NURSING HOME, AS A
19 SEPARATE, PASS-THROUGH PAYMENT, AN AMOUNT EQUAL TO THE
20 ASSESSMENT PAID BY A NURSING HOME MULTIPLIED BY THE FACILITY'S
21 MEDICAL ASSISTANCE OCCUPANCY RATE AS REPORTED IN ITS ANNUAL COST
22 REPORT.
23 SECTION 410. SCOPE OF REPORTING.
24 FOR PURPOSES OF REPORTING HEALTH CARE-ASSOCIATED INFECTIONS
25 TO THE COMMONWEALTH, ITS AGENCIES AND INDEPENDENT AGENCIES, THIS
26 CHAPTER SETS FORTH THE APPLICABLE CRITERIA TO BE UTILIZED BY
27 HEALTH CARE FACILITIES IN MAKING SUCH REPORTS. NOTHING IN THIS
28 ACT SHALL SUPERSEDE THE REQUIREMENTS SET FORTH IN THE ACT OF
29 APRIL 23, 1956 (1955 P.L.1510, NO.500), KNOWN AS THE DISEASE
30 PREVENTION AND CONTROL LAW OF 1955, AND THE REGULATIONS
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1 PROMULGATED THEREUNDER.
2 SECTION 411. PENALTIES.
3 (A) VIOLATION OF HEALTH CARE FACILITIES ACT.--THE FAILURE OF
4 A HEALTH CARE FACILITY TO REPORT HEALTH CARE-ASSOCIATED
5 INFECTIONS AS REQUIRED BY SECTIONS 404 AND 405 OR THE FAILURE OF
6 A HEALTH CARE FACILITY OR AMBULATORY SURGICAL FACILITY TO
7 DEVELOP, IMPLEMENT AND COMPLY WITH ITS INFECTION CONTROL PLAN IN
8 ACCORDANCE WITH THE REQUIREMENTS OF SECTION 403 SHALL BE A
9 VIOLATION OF THE HEALTH CARE FACILITIES ACT.
10 (B) ADMINISTRATIVE PENALTY.--IN ADDITION TO ANY PENALTY THAT
11 MAY BE IMPOSED UNDER THE HEALTH CARE FACILITIES ACT, A HEALTH
12 CARE FACILITY WHICH NEGLIGENTLY FAILS TO REPORT A HEALTH CARE-
13 ASSOCIATED INFECTION AS REQUIRED UNDER THIS CHAPTER MAY BE
14 SUBJECT TO AN ADMINISTRATIVE PENALTY OF $1,000 PER DAY IMPOSED
15 BY THE DEPARTMENT.
16 SECTION 2. THE ACT IS AMENDED BY ADDING A CHAPTER TO READ:
17 CHAPTER 6
18 LONG-TERM CARE NURSING FACILITIES
19 (RESERVED)
20 SECTION 3. THIS ACT SHALL TAKE EFFECT IN 30 DAYS.
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