THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY STABACK, BELFANTI, BOBACK, FABRIZIO, FREEMAN, GEORGE, GRUCELA, HORNAMAN, JOSEPHS, KORTZ, KOTIK, KULA, McGEEHAN, MUNDY, M. O'BRIEN, PASHINSKI, READSHAW, SEIP, SIPTROTH, K. SMITH, WALKO, WANSACZ, WATSON, YOUNGBLOOD, YUDICHAK AND MOUL, FEBRUARY 10, 2009

REFERRED TO COMMITTEE ON AGING AND OLDER ADULT SERVICES, FEBRUARY 10, 2009  

AN ACT

Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An

act to consolidate, editorially revise, and codify the public

welfare laws of the Commonwealth," in general powers and

duties of Department of Public Welfare, providing for onsite

complaint investigations and plans of correction.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The act of June 13, 1967 (P.L.31, No.21), known

as the Public Welfare Code, is amended by adding a section to

read:

Section 211.1.  Onsite Complaint Investigations and Plans of

Correction.--(a)  The department shall initiate onsite

investigations of complaints at personal care homes and assisted

living residences as follows:

(1)  If the complaint is a Level 1 complaint, the onsite

inspection shall be initiated within twenty-four hours of the

complaint intake.

(2)  If the complaint is a Level 2 complaint, the onsite

inspection shall be initiated within seven calendar days of the

complaint intake.

(3)  If the complaint is a Level 3 complaint, the onsite

inspection shall be initiated within twenty-one calendar days of

the complaint intake.

(b)  The department shall contact and coordinate the

investigation with appropriate local agencies, including the

Area Agency on Aging, specifically the Protective Services or

Long-Term Care Ombudsman Program, County Mental Health/Mental

Retardation, local or Pennsylvania State Police, local code

enforcement or fire officials.

(c)  The department shall conduct an unannounced onsite

inspection of the personal care home or assisted living

residence within the time frame established under subsection (a)

(1), (2) or (3). The complaint investigation shall include the

following components and adhere to the following time frames:

(1)  Conduct an entrance interview with administrator or

designee, providing general information regarding the complaint,

but maintaining confidentiality of residents and complainant.

(2)  Interview relevant subjects to the complaint such as

residents, families, staff or other witnesses.

(3)  Preserve evidence by obtaining signed witness

statements, making copies of documents and taking photographs.

(4)  Review relevant documents such as resident, staff and

facility records.

(5)  Observe physical site conditions related to the

complaint.

(6)  Contact the appropriate manager in the department

regarding Level 1 high-risk issues.

(7)  Ensure that immediate threats are resolved before

leaving the personal care home or assisted living residence.

(8)  Record all relevant information, including violations,

as directed by department policies and procedures.

(9)  Conduct an exit interview with the administrator or the

most appropriate employe onsite and provide an opportunity to

respond to preliminary findings, unless the disclosure may

jeopardize ongoing aspects of the investigation.

(10)  Determine and discuss findings with the appropriate

manager in the department and determine if each allegation is

founded, unfounded or requires further investigation.

(11)  Additional collateral contacts, interviews and site

inspections shall be made as indicated by the seriousness of the

complaint allegation and based on the initial onsite inspection.

(12)  The complaint investigation, including all collateral

contacts, interviews and onsite inspections, must be concluded

within fifteen days following the onsite inspection. 

(d)  Within four business days of the conclusion of the

complaint investigation for Level 1 high-risk complaints, within

ten business days of the conclusion of the complaint

investigation for Level 2 complaints and within 15 business days

of the conclusion of the complaint investigation for Level 3

complaints, the department shall prepare a violation report if

applicable, review the violation report with the appropriate

manager in the department and transmit the violation report to

the personal care home or assisted living residence for

corrective action.

(e)  If a violation report is provided by the department, the

personal care home or assisted living residence must submit a

plan of correction within seven calendar days of receipt of the

violation report.

(f)  Within ten business days of receiving the plan of

correction from the personal care home or assisted living

residence, the department shall review the plan of correction

and refer the plan to the appropriate manager in the department

for plan approval or denial.

(g)  If the personal care home or assisted living residence

does not submit a plan of correction within the required seven-

day time frame, the department may suspend, revoke or limit a

license, or may issue a ban on admissions for the personal care

home or assisted living residence.

(h)  Once the plan of correction has been approved by the

department, the follow-up complaint inspection of the personal

care home or assisted living residence shall be conducted onsite

after the longest target date for compliance has been reached as

noted on the plan of correction, but no later than ninety days

after the initial onsite complaint inspection by the department

to ensure compliance with the plan of correction.

(i)  If the plan of correction is disapproved, the department

shall contact the personal care home or assisted living

residence within forty-eight hours of the disapproval decision

and require an alternate plan of correction within four business

days. If the personal care home or assisted living residence

returns an approved plan of correction within the required time

frame, the department shall conduct a follow-up onsite

inspection of the personal care home or assisted living

residence as outlined under subsection (h).

(j)  If the alternate plan of correction is not resubmitted

by the personal care home or assisted living residence within

the required time frame, the department may suspend, revoke or

limit a license, or may issue a ban on admissions for the

personal care home or assisted living residence.

(k)  Within ten business days of the conclusion of the

investigation and determination on each of the complaint

allegations, the department shall send a complaint response

letter to the complainant.

(l)  The department may exceed the timelines relating to a

Level 3 complaint if it determines that resources are otherwise

necessary to address risks to the health and safety of other

residents in the personal care home or assisted living

residence.

(m)  For purposes of this section:

"Level 1 complaint" shall mean a complaint with a high risk,

including, but not limited to, incidents related to immediate

fire safety, physical assault or abuse, no food or water, no

heat in winter, no staff or serious illness outbreak.

"Level 2 complaint" shall mean a complaint with a medium

risk, including, but not limited to, incidents related to

inadequate staffing, quality of care issues, nutrition,

sanitation or medication administration.

"Level 3 complaint" shall mean a complaint with a low risk,

including, but not limited to, incidents related to menus,

policies, assessments, support plans, financial management or

contracts.

Section 2.  This act shall take effect in 60 days.