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A04173
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2293
Session of
2022
INTRODUCED BY BONNER, RAPP, EMRICK, B. MILLER, THOMAS, ZIMMERMAN
AND MENTZER, JANUARY 27, 2022
REFERRED TO COMMITTEE ON HEALTH, JANUARY 27, 2022
AN ACT
Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
act relating to health care; prescribing the powers and
duties of the Department of Health; establishing and
providing the powers and duties of the State Health
Coordinating Council, health systems agencies and Health Care
Policy Board in the Department of Health, and State Health
Facility Hearing Board in the Department of Justice;
providing for certification of need of health care providers
and prescribing penalties," providing for temporary health
care services agencies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of July 19, 1979 (P.L.130, No.48), known
as the Health Care Facilities Act, is amended by adding a
chapter to read:
CHAPTER 8-A
TEMPORARY HEALTH CARE SERVICES AGENCIES
Section 801-A. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Controlling person." Any of the following:
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(1) A business entity, officer, program administrator or
director whose responsibilities include the direction of the
management of policies of a temporary health care services
agency.
(2) An individual who, directly or indirectly,
beneficially owns an interest in a corporation, partnership,
or other business association that is a controlling person.
"Health care facility." Any of the following:
(1) A long-term care nursing facility as defined in
section 802.1.
(2) A personal care home or an assisted living
residence, licensed by the Department of Human Services under
the act of June 13, 1967 (P.L.31, No.21), known as the Human
Services Code.
"Health care personnel." Any of the following:
(1) A nurse aide as defined in section 2 of the act of
June 9, 1997 (P.L.169, No.14), known as the Nurse Aide
Resident Abuse Prevention Training Act.
(2) A registered nurse as defined in 49 Pa. Code ยง 21.1
(relating to definitions).
(3) An LPN as defined in 49 Pa. Code ยง 21.141 (relating
to definitions).
(4) A direct care staff person as defined in 55 Pa. Code
ยง 2600.4 (relating to definitions).
"Person." An individual, firm, corporation, partnership, or
association.
"Rate." The hourly rate of pay calculated, including weekend
shift differential and overtime, for the respective health care
personnel.
"Person." Any of the following:
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(1) An individual, firm, corporation, partnership or
association.
(2) A controlling person.
"Registration." A registration issued by the department to a
person that operates a temporary health care services agency
under section 802-A.
"Temporary health care services agency." As follows:
(1) A person engaged for hire in the business of
providing or procuring temporary employment in health care
facilities for health care personnel.
(2) The term does not include an individual who only
engages on the individual's own to provide services on a
temporary basis to health care facilities or a home health
care agency licensed under 28 Pa. Code Ch. 601 (relating to
home health care agencies).
Section 802-A. Registration generally.
(a) Requirement.--A person that owns or operates a temporary
health care services agency shall register annually with the
department and provide a list of each separate location.
(b) Forms.--The department shall establish forms and
procedures for processing each application under subsection (a).
The following apply:
(1) The application shall include at least the
following:
(i) The names and addresses of each person having an
ownership interest in the temporary health care services
agency.
(ii) If the owner is a corporation, copies of the
articles of incorporation or articles of association and
current bylaws, together with the names and addresses of
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officers and directors.
(iii) Any other relevant information that the
department determines necessary to properly evaluate the
application.
(2) The application shall specify the policies and
procedures regarding how the temporary health care services
agency's records shall be immediately available at all times
to the department upon request, except for those records
subject to confidentiality protection under Federal and State
law.
(c) Fees.--The department shall establish a registration fee
for an application under subsection (a) of not less than $1,000
annually . The department may, by regulation, increase the annual
registration fee to meet the necessary expenses of the
department for the administration of this chapter.
(d) Failure to register.--If a temporary health care
services agency fails to provide the items required in this
section to the department:
(1) The department shall immediately suspend or refuse
to issue the temporary health care services agency's
registration.
(2) The temporary health care services agency shall
immediately suspend operations in this Commonwealth.
(e) Term of registration and voided registration.--A
registration issued by the department according to this section
shall be effective for a period of one year from the date of its
issuance unless :
(1) the registration has been revoked or suspended, in
accordance with this section; or
(2) the temporary health care services agency is sold or
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ownership or management is transferred, in which case the
registration shall be voided , but the . The new owner or
operator of the temporary health care services agency may
shall apply and receive approval for a new registration
before operating the temporary health care services agency .
Section 803-A. Conditions of registration.
(a) Requirements generally.--A temporary health care
services agency:
(1) Shall provide to the health care facility to which
any temporary health care personnel are supplied
documentation that each temporary employee meets all
licensing or certification, training and continuing education
standards for the position in which the temporary employee
will be working.
(2) Shall comply with all pertinent requirements
relating to the health and other qualifications of personnel
employed in health care facilities.
(3) May not restrict in any manner the employment
opportunities of its employees. This requirement shall also
apply to a health care facility.
(4) Shall carry medical malpractice insurance of not
less than $500,000 to insure against loss, damages or
expenses incident to a claim arising out of the death or
injury of any person individual as the result of negligence
or malpractice in the provision of health care services by
the temporary health care services agency or an employee,
agent or contractor of the temporary health care services
agency.
(5) Shall carry for each employee a dishonesty bond in
the amount of $10,000.
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(6) Shall maintain insurance coverage for workers'
compensation for all health care personnel provided or
procured by the temporary health care services agency.
(7) Shall file with the Department of Revenue the name
and address of the bank, savings bank or savings association
in which the temporary health care services agency deposits
all employee income tax withholdings or, if the temporary
health care services agency purports that the income is not
subject to withholding, the name and address of any health
care personnel whose income is derived from the placement by
the temporary health care services agency.
(8) Shall retain all records for 10 calendar years in a
manner to allow the records to be immediately available to
the department for inspection to determine compliance with
this chapter.
(9) Shall provide health care facilities with proof of
applicable criminal records checks for each temporary
employee consistent with their regulatory requirements.
(b) Supplemental requirements.--The requirements under
subsection (a) may be supplemented by rules or regulations
promulgated by the department in accordance with this chapter.
(c) Compliance.--Failure of a temporary health care services
agency to comply with this section shall subject the temporary
health care services agency to revocation or nonrenewal of its
registration the sanctions imposed under section 807-A .
Section 804-A. Rates.
(a) Maximum rate.--A temporary health care services agency
may not bill or receive payments from a health care facility at
a rate higher than 150% of the sum of the average rate, plus a
factor to incorporate payroll taxes, for the health care
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facility's location as determined under subsection (c).
(b) Determination of average rate.--The average rate shall
be determined by the department and reported on an annual basis.
A health care facility shall provide to the department
information necessary for the department to determine the
average rates for applicable regions of this Commonwealth.
(c) Standard.--The average rate for health care personnel
shall be established for each metropolitan statistical area of
the Department of Labor and Industry.
(d) Components of maximum rate.--The maximum rate shall
include all charges for administrative fees, contract fees or
other special charges, in addition to the hourly rate for the
health care personnel supplied to a health care facility.
(e) Payments by health care facility.--A health care
facility that pays for the actual travel and housing costs for
health care personnel at the health care facility and that pays
these costs to the temporary health care services agency, an
employee of the temporary health care services agency or another
vendor shall not be considered in violation of the limitation on
charges described in this section.
(f) Cost reports.--The department shall:
(1) Establish a system for each temporary health care
services agency to complete and file a cost report annually.
(2) Conduct annual audits of each cost report.
(g) Publication.--The department shall transmit notice to
the Legislative Reference Bureau for publication in the
Pennsylvania Bulletin of the maximum rate established in this
section.
(h) Penalty.--A temporary health care services agency that
has violated this section shall be subject to a fine equal to
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200% of the amount billed or received in excess of the maximum
rate permitted under this section.
Section 805-A. Oversight.
Section 804-A. Oversight.
(a) Oversight by department.--The department shall provide
oversight of temporary health care services agencies through
complaint investigations and other actions necessary to ensure
compliance with this chapter the provisions of this chapter and
the regulations promulgated under section 808-A .
(b) Complaint process.--The department shall establish a
system for reporting complaints against a temporary health care
services agency or its employees. Complaints may be made by any
member of the public.
(c) Administrative procedure.--The registration of a
temporary health care services agency may not be revoked without
a hearing held as a contested case before the department's
Bureau of Facility Licensure and Certification. The following
apply:
(1) If a controlling person has been notified by the
department that the temporary health care services agency
will not receive an initial registration or that a renewal of
that registration has been denied, the controlling person, or
a legal representative on behalf of the temporary health care
services agency, may request and receive a hearing on the
denial.
(2) The department may not issue or renew a registration
to a temporary health care services agency or a controlling
person whose registration was not renewed or was revoked
because of noncompliance with this chapter until at least
five years have elapsed following the effective date of the
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nonrenewal or revocation.
Section 806-A 805-A . Reports.
The department shall report annually on the progress in
implementing and administering this chapter. Each report shall
be submitted to the chairperson and minority chairperson of the
Health and Human Services Committee of the Senate and the
chairperson and minority chairperson of the Health Committee of
the House of Representatives.
Section 2. This act shall take effect in 90 days.
Section 806-A. Remedies and plans of correction.
(a) Correction of violations.--Upon determining that a
temporary health care services agency has violated the
provisions of this chapter or the regulations promulgated under
section 808-A, the department may issue a written notice to the
person that owns or operates the temporary health care services
agency stating that a violation has been committed by the
temporary health care services agency. The following shall
apply:
(1) The department shall state in the written notice
under this subsection that the temporary health care services
agency is required to take immediate action to remedy the
violation or, if the temporary health care services agency is
unable to immediately remedy the violation, submit a plan of
correction to the department.
(2) If the temporary health care services agency is
required to submit a plan of correction to the department
under paragraph (1), the department may direct that the
violation be remedied within a specified period of time. The
temporary health care services agency must submit the plan of
correction within 30 days of the department's issuance of the
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written notice under this subsection.
(3) If the department determines that the temporary
health care services agency is required to take immediate
corrective action, the department shall state in the written
notice under this subsection that the temporary health care
services agency is required to provide prompt confirmation to
the department that the corrective action has been taken.
(b) Contrary to public interest . --The department may not
provide an opportunity for a temporary health care services
agency to remediate a violation under subsection (a) without
imposing sanctions under section 807-A(b) if the department
determines that it is contrary to the public interest.
Section 807-A. Sanctions.
(a) Grounds for sanctions.--The department may sanction a
temporary health care services agency or a controlling person of
the temporary health care services agency or refuse to issue a
registration to the person that owns or operates the temporary
health care services agency, as applicable, for any of the
following reasons:
(1) Violating the provisions of this chapter or the
regulations promulgated under section 808-A.
(2) Failing to take immediate action to remedy a
violation of the provisions of this chapter or the
regulations promulgated under section 808-A in accordance
with section 806-A(a).
(3) Failing to submit a plan of correction to the
department or failing to comply with a plan of correction in
accordance with section 806-A(a).
(4) Engaging in fraud or deceit in obtaining or
attempting to obtain a registration.
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(5) Lending the temporary health care services agency's
registration to another person.
(6) Enabling another person to manage or operate the
temporary health care services agency who is not subject to
the temporary health care services agency's registration.
(7) Using the registration of another person or in any
way knowingly aiding or abetting the improper granting of a
registration.
(8) Violating an order previously issued by the
department in a disciplinary matter.
(9) For a temporary health care services agency
operating in this Commonwealth on the effective date of this
section , continuing operations without complying with the
provisions of this chapter on or after the date when the
provisions of this chapter are applicable to the temporary
health services agency.
(10) Any other reasons specified in the regulations
promulgated by the department under section 808-A as
necessary to implement this chapter or to protect the health
and safety of health care personnel, health care facilities
or the public.
(b) Types of sanctions.--The department may impose any of
the following sanctions for a reason specified under subsection
(a):
(1) Deny the application for registration or renewal of
the registration.
(2) Revoke, suspend, limit or otherwise restrict the
registration.
(3) Impose a civil penalty of no more than $5,000 for
each incident in which the temporary health care services
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agency engages in conduct prohibited under subsection (a).
Each day when the temporary health care services agency
engages in conduct prohibited under subsection (a) shall
constitute a separate and distinct incident.
(4) Stay enforcement of any revocation, suspension,
limitation or other restriction under paragraph (2) or any
other discipline and place the temporary health care services
agency on probation with the right to vacate the probationary
order for noncompliance with the provisions of this chapter.
(c) Reinstatement of registration.--
(1) If a temporary health care services agency's
registration has been revoked by the department, the person
that owns or operates the temporary health care services
agency may not apply for reinstatement of the registration.
(2) No earlier than five years after the date of the
revocation of the registration, the person that owns or
operates the temporary health care services agency may submit
a petition to the department to apply for a new registration.
The person that owns or operates the temporary health care
services agency shall include an averment to facts to
establish that the temporary health care services agency has
been rehabilitated and the issuance of a new registration is
not contrary to the public interest.
(3) The department may grant or deny the petition under
paragraph (2) without conducting a hearing if department
accepts as true all facts averred in the petition, other than
the conclusory averments regarding the temporary health care
services agency's rehabilitation. If the department grants
the petition under paragraph (2), the person that owns or
operates the temporary health care services agency shall
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comply with the provisions of this chapter. If the department
denies the petition under paragraph (2), the person that owns
or operates the temporary health care services agency may not
submit a new petition until one year has elapsed from the
date of the denial.
(d) Administrative proceedings.--The department shall hold
hearings and issue adjudications for proceedings conducted under
this chapter in accordance with 2 Pa.C.S. (relating to
administrative law and procedure) and shall conduct the
proceedings in accordance with 1 Pa. Code Pt. II (relating to
general rules of administrative practice and procedure).
(e) Judicial appeals.--Department adjudications issued under
this chapter may be appealed to Commonwealth Court under 42
Pa.C.S. ยง 763 (relating to direct appeals from government
agencies).
Section 808-A. Regulations.
Within two years of the effective date of this section, the
department shall promulgate regulations necessary to implement
the provisions of this chapter.
Section 2. This act shall apply as follows:
(1) For a temporary health care services agency that
commences operations in this Commonwealth after the effective
date of this section, the requirements in the addition of
Chapter 8-A of the act shall apply to the temporary health
care services agency beginning 90 days after the effective
date of this section.
(2) For a temporary health care services agency
operating in this Commonwealth on the effective date of this
section, the requirements in the addition of Chapter 8-A of
the act shall apply to the temporary health care services
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agency beginning 180 days after the effective date of this
section.
Section 3. This act shall take effect immediately.
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