SENATE AMENDED PRIOR PRINTER'S NOS. 940, 1783 PRINTER'S NO. 2587
No. 846 Session of 2001
INTRODUCED BY MACKERETH, VANCE, E. Z. TAYLOR, O'BRIEN, THOMAS, ARMSTRONG, BELFANTI, BROWNE, BUNT, L. I. COHEN, M. COHEN, CORNELL, CORRIGAN, CURRY, CAPPELLI, FICHTER, FRANKEL, GEIST, GEORGE, HARHAI, HENNESSEY, HERMAN, HORSEY, JOSEPHS, LaGROTTA, LAUGHLIN, LEDERER, MAITLAND, J. EVANS, McGILL, MELIO, R. MILLER, NAILOR, ORIE, PETRONE, PISTELLA, READSHAW, SATHER, SAYLOR, B. SMITH, SOLOBAY, TIGUE, WALKO, WASHINGTON, WILT, WOJNAROSKI, YOUNGBLOOD, PICKETT AND BENNINGHOFF, MARCH 6, 2001
SENATOR MURPHY, PUBLIC HEALTH AND WELFARE, IN SENATE, AS AMENDED, OCTOBER 2, 2001
AN ACT 1 Providing for certain immunizations in long-term care 2 facilities.requiring nursing homes to submit information <-- 3 annually to the Department of Health; requiring the 4 Department of Health to place certain information on the 5 Internet; and providing for certain duties of the Department 6 of Health and the Department of Aging. 7 The General Assembly of the Commonwealth of Pennsylvania 8 hereby enacts as follows: 9 CHAPTER 1 <-- 10 PRELIMINARY PROVISIONS 11 Section 101 1. Short title. <-- 12 This act shall be known and may be cited as the Long-Term 13 Care Resident and Employee Immunization and Nursing Home <-- 14 Consumer Internet Information Access Act. 15 Section 102 2. Definitions. <--
1 The following words and phrases when used in this act shall 2 have the meanings given to them in this section unless the 3 context clearly indicates otherwise: 4 "Consumer Information Internet Guide." The Nursing Home <-- 5 Consumer Information Internet Guide required to be published 6 under the provisions of Chapter 5. 7 "Department." The Department of Health of the Commonwealth. 8 "Elderly persons." Those persons residing within this <-- 9 Commonwealth who are 60 years of age or older. 10 "Employee." An individual employed, whether directly, by 11 contract with another entity or as an independent contractor, by 12 a long-term care nursing facility on a part-time or full-time 13 basis. 14 "Long-term care facility" or "facility." A long-term care 15 nursing facility as defined in section 802.1 of the act of July 16 19, 1979 (P.L.130, No.48), known as the Health Care Facilities 17 Act. 18 "Nursing home." A facility that provides either skilled or <-- 19 intermediate nursing care or both levels of such care to two or 20 more elderly persons, who are unrelated to the licensee, for a 21 period exceeding 24 hours. Intermediate care facilities 22 exclusively for the mentally retarded, commonly called ICF/MR, 23 shall not be considered nursing homes for the purpose of Chapter 24 5. 25 CHAPTER 3 26 IMMUNIZATIONS IN LONG-TERM CARE FACILITIES 27 Section 301 3. Long-term care resident and employee <-- 28 immunization. 29 Except as provided in section 304 6, every facility in this <-- 30 Commonwealth shall request that residents and employees be 20010H0846B2587 - 2 -
1 immunized for influenza virus and pneumococcal disease in 2 accordance with this act. 3 Section 302 4. Resident immunization. <-- 4 (a) Notice to resident.--Upon admission, the facility shall 5 notify the resident and legal guardian of the immunization 6 requirements of this act and request that the resident agree to 7 be immunized against influenza virus and pneumococcal disease. 8 (b) Records and immunizations.--Every facility shall 9 document the annual immunization against influenza virus and 10 immunization against pneumococcal disease for each resident, 11 which includes written evidence from a health care provider 12 indicating the date the vaccine was administered. Upon finding 13 that a resident is lacking such immunization or the facility or 14 individual is unable to provide documentation that the 15 individual has received the appropriate immunization, the 16 facility shall make available the immunization. Immunization and <-- 17 the documentation thereof shall take place no later than 18 November 30 of each year. THE IMMUNIZATION AND DOCUMENTATION <-- 19 SHALL TAKE PLACE IN A MANNER CONSISTENT WITH THE RECOMMENDATIONS 20 OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. 21 (c) Other immunizations.--An individual who becomes a <-- 22 resident after November 30 but prior to April 1 shall have his 23 status for influenza and pneumococcal immunization determined by 24 the facility, and, if found to be deficient, the facility shall 25 make available the necessary immunizations. 26 Section 303 5. Employee immunization. <-- 27 (a) Notice to employees.--Every facility shall notify every 28 employee of the immunization requirements of this act and 29 request that the employee agree to be immunized against 30 influenza virus. 20010H0846B2587 - 3 -
1 (b) Records and immunizations.--The facility shall require 2 documentation of annual immunization against influenza virus for 3 each employee, which includes written evidence from a health 4 care provider indicating the date and location the vaccine was 5 administered. THESE DOCUMENTS SHALL BE MAINTAINED BY THE <-- 6 FACILITY FOR NOT LESS THAN 18 MONTHS. Upon finding that an 7 employee is lacking such immunization or the facility or 8 individual is unable to provide documentation that the 9 individual has received the appropriate immunization, the 10 facility shall make available the immunization. Immunization and <-- 11 the documentation thereof shall take place no later than 12 November 30 of each year. THE IMMUNIZATION AND DOCUMENTATION <-- 13 SHALL TAKE PLACE IN A MANNER CONSISTENT WITH THE RECOMMENDATIONS 14 OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. 15 (c) Other immunizations.--An individual who is newly <-- 16 employed as an employee after November 30 and prior to April 1 17 shall have his status for influenza determined by the facility, 18 and, if found to be deficient, the facility shall make available 19 the necessary immunization. 20 (d) (C) Immunization authorized.--Nothing in this section <-- 21 shall prohibit the immunization against pneumococcal disease to 22 employees. 23 Section 304 6. Exceptions. <-- 24 No resident or employee shall be required to receive either 25 the influenza or pneumococcal vaccine if any of the following 26 apply: 27 (1) the vaccine is contraindicated; 28 (2) it is against his religious beliefs; or 29 (3) the employee, resident or resident's legal guardian 30 refuses the vaccine after being fully informed of the health 20010H0846B2587 - 4 -
1 risks of such action. 2 Section 305 7. Regulations. <-- 3 (a) Promulgation by department.--The department shall MAY <-- 4 promulgate regulations relating to the immunization requirements 5 of this chapter, taking into consideration the recommendations 6 of the Advisory Committee on Immunization Practices (ACIP) of <-- 7 the Centers for Disease Control and Prevention. 8 (b) Educational materials.--The department, in conjunction 9 with the Department of Aging, shall make available educational 10 and informational materials to all facilities with respect to 11 vaccination against influenza virus and pneumococcal disease. 12 (c) Report to General Assembly.--Three years from the 13 effective date of this chapter, and each three-year period 14 thereafter, the department shall report to the General Assembly 15 on the number of outbreaks in facilities each year due to 16 influenza virus and pneumococcal disease. The number of 17 hospitalizations of facility residents each year due to 18 influenza virus, pneumococcal disease and complications thereof 19 must be reported as well. 20 CHAPTER 5 <-- 21 NURSING HOME CONSUMER INTERNET INFORMATION 22 ACCESS 23 Section 501. Nursing Home Consumer Information Report. 24 In addition to the information required by the Department of 25 Health on a form provided by the Department of Health pursuant 26 to the provisions of the act of July 19, 1979 (P.L.130, No.48), 27 known as the Health Care Facilities Act, and regulations 28 promulgated pursuant thereto, each nursing home shall provide to 29 the Department of Health no later than 90 days after the close 30 of each calendar year the following information on the above- 20010H0846B2587 - 5 -
1 referenced form: 2 (1) Nursing hours worked per patient per day and nursing 3 hours required by the Department of Health per patient per 4 day. Actual hours worked per patient per day are for the most 5 recently concluded fiscal or calendar year. 6 (2) Average length of service of professional nursing 7 staff and the average length of service of nurse aide 8 personnel at the nursing home completing the form. 9 (3) Average length of licensure and/or certification of 10 professional nursing staff and the average length of 11 licensure and/or certification of nurse aide personnel. 12 (4) Nursing hours per patient per day of temporary 13 agency professional nursing staff and nurse aide personnel. 14 (5) Whether a resident council exists and meets on a 15 regular basis. 16 Section 502. Nursing home consumer information. 17 (a) Guide.-- 18 (1) The Department of Aging shall produce, in a timely 19 manner, a nursing home information site on the Internet. It 20 shall include: 21 (i) The items listed in section 501. 22 (ii) Information obtained from the annual Long-Term 23 Care Facilities Questionnaires submitted to the 24 Department of Health. 25 (iii) Information obtained from the Health Care 26 Financing Administration Ownership Disclosure Form. 27 (iv) A comparative list of nursing homes developed 28 in the manner provided in subsection (b). 29 (v) The Nursing Home Consumer Inquiry Telephone 30 Hotline telephone number required under subsection (c). 20010H0846B2587 - 6 -
1 (2) If errors are found in the Consumer Information 2 Internet Guide, all facilities shall be sent a correction 3 sheet within 30 days of the Department of Aging's receipt of 4 notification of the error. For the purposes of this section, 5 an error shall be defined as information incorrectly 6 transcribed from the forms provided to the Department of 7 Health to the consumer guide. 8 (3) The Department of Aging will send final proofs to 9 the nursing home of its data profile that will be published 10 in the consumer guide prior to publication. The nursing home 11 will have five days to notify the Department of Aging of any 12 errors to be corrected. If the Department of Aging receives 13 no notification of errors, the data profile will be 14 considered accurate and will be published. 15 (b) Comparative list.--The comparative list of nursing homes 16 shall be developed and included in the Consumer Information 17 Internet Guide by the Department of Aging. It shall include the 18 following information: 19 (1) Name of facility. 20 (2) Facility address and telephone number. 21 (3) Bed capacity. 22 (4) Owner of facility and managing company, if 23 applicable. 24 (5) Type of sponsorship, including, but not limited to, 25 governmental, nonprofit and for-profit or religious 26 affiliation, if applicable. 27 (6) Payment sources accepted, including, but not limited 28 to, Medicare, Medicaid, Veterans' Administration, long-term 29 care insurance and private pay. 30 (7) Current license, deficiency and certification status 20010H0846B2587 - 7 -
1 as determined by the Department of Health; whether, within 2 the previous five years, the facility has been subject to a 3 provisional license, a ban on admissions, penalties imposed 4 in connection with the licensure or certification process, a 5 license revocation or appointment of a temporary manager to 6 operate the facility or Medicare or Medicaid decertification 7 and the corresponding dates. 8 (8) Nursing hours per patient per day and nursing hours 9 required by the Department of Health per patient per day. 10 Actual hours worked per patient per day are for the most 11 recently concluded fiscal or calendar year. 12 (9) Average length of service at the nursing home of 13 professional nursing staff and the average length of service 14 of nurse aide staff. 15 (10) Average length of licensure and/or certification of 16 professional nursing staff and the average length of 17 licensure and/or certification of nurse aide personnel. 18 (11) Nursing hours per patient per day of temporary 19 agency professional nursing staff and nurse aide personnel. 20 (12) A listing of existence and availability of specific 21 therapy services, including, but not limited to, physical 22 therapy, occupational therapy, speech therapy and respiratory 23 therapy. 24 (13) Whether a resident council exists and meets on a 25 regular basis. 26 (14) Name and telephone number of a local ombudsman. 27 (15) Costs per day, month and year. 28 (16) Visiting hours. 29 (17) If there are telephones available for private 30 conversations. 20010H0846B2587 - 8 -
1 (18) If there is a registered dietitian. 2 (19) If there is a written emergency evacuation plan. 3 (20) The nearest hospital and the distance in miles from 4 the nursing home. 5 (21) If there are isolation rooms for patients with 6 contagious illnesses. 7 (22) If there is an Alzheimer/Parkinson disease program. 8 (23) Whether there are qualified physical therapists 9 onsite. 10 (24) Whether there is a written description of patients 11 rights and responsibilities. 12 (25) Whether there are written policies on "do not 13 resuscitate orders," physical restraints and chemical 14 sedation. 15 (26) What medical services are available onsite, 16 including dentists, podiatrists, pharmacists, 17 ophthalmologists. 18 (27) The current resident profile, including average 19 age, race and sex. 20 (28) Information on how to contact the local area agency 21 on aging, including the services available to persons over 60 22 years of age through the local area agency on aging. 23 (29) Information on community resources that can assist 24 in the selection of a long-term care facility, such as trade 25 associations or consumer advocacy groups. 26 (c) Nursing Home Consumer Inquiry Telephone Hotline.--The 27 Department of Aging shall establish a Statewide telephone number 28 to serve as the Nursing Home Consumer Inquiry Telephone Hotline. 29 This number shall be a toll-free number. The purpose of this 30 telephone number is to respond to calls regarding the current 20010H0846B2587 - 9 -
1 licensure, deficiency and certification status of nursing homes. 2 All data provided by the hotline shall be updated each week 3 using information provided by the Department of Health in a 4 timely fashion. This telephone number shall be prominently 5 displayed in the annual Consumer Information Internet Guide. 6 (d) Disclosure.--The State Long-Term Care Ombudsman in the 7 Department of Aging shall mail at least the address of the 8 Consumer Information Internet Guide to the local long-term care 9 ombudsman of each area agency on aging, to each nursing home and 10 to the Pennsylvania Council on Aging annually. 11 (e) Availability.--Each nursing home shall post next to its 12 Department of Health license an exact copy of its listing as 13 found in the Consumer Information Internet Guide. A nursing home 14 shall provide to each prospective resident and family member of 15 such prospective resident who visits the facility, or any member 16 of the public upon request, during normal business or visiting 17 hours, Sunday through Saturday, an exact copy of its listing as 18 set forth in the Consumer Information Internet Guide. 19 (f) Inspections.--The Department of Health shall verify the 20 availability of the listing during annual licensing surveys. The 21 Department of Health shall monitor compliance with the 22 requirements of this act for regular filing of the Long-Term 23 Care Facilities Questionnaire with the Department of Health. 24 (g) Update.--The Department of Health shall issue 25 modifications to the Long-Term Care Facilities Questionnaire 26 resulting from changes in the reimbursement system for nursing 27 homes. Such modifications shall provide the same information in 28 an updated format. 29 (h) Regulations.--The Department of Aging shall promulgate 30 regulations setting forth proposed additions, changes, or both, 20010H0846B2587 - 10 -
1 if the department does any of the following: 2 (1) Expands the scope of the consumer guide beyond those 3 topics expressly set forth in subsection (a). 4 (2) Expands the scope of the comparative list beyond 5 those topics expressly set forth in subsection (b). 6 (3) Expands the scope of any topic expressly set forth 7 in subsection (a) or (b). 8 Section 503. Complaints. 9 Complaints of noncompliance with this act shall be filed with 10 the Department of Aging. A complainant shall include a local 11 ombudsman, a nursing home employee, a nursing home resident, a 12 prospective nursing home resident, or any person representing 13 the interests of a nursing home resident or prospective nursing 14 home resident. 15 Section 504. Additional consumer information. 16 Each nursing home shall provide to each prospective resident 17 or representative thereof at the time of initial inquiry, a 18 companion consumer guide which describes how to select a nursing 19 home. This information can be either a publication of the 20 Department of Aging, a camera-ready copy of a publication 21 provided by the Department of Aging or a comparable publication 22 that will inform the consumer on how to choose a nursing home. 23 Section 505. Penalties. 24 The Department of Aging shall have the authority to assess a 25 $1,000 civil penalty for each violation of this chapter. Any 26 person aggrieved by an adjudication by the Department of Aging 27 shall have the right to appeal under 42 Pa.C.S. (relating to 28 judiciary and judicial procedure). 29 CHAPTER 7 30 MISCELLANEOUS PROVISIONS 20010H0846B2587 - 11 -
1 Section 701. Repeals. 2 All acts and parts of acts are repealed insofar as they are 3 inconsistent with this act. 4 SECTION 702. EFFECTIVE DATE. 5 SECTION 8. EFFECTIVE DATE. <-- 6 This act shall take effect in 90 days. B7L35JAM/20010H0846B2587 - 12 -