OLR Bill Analysis
AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING THE PROTECTION OF RESIDENTS IN HEALTH CARE INSTITUTIONS.
This bill makes various changes to the process by which the Department of Public Health (DPH) issues citations to nursing home facilities and residential care homes (RCH) for violations of state laws and regulations. Among other things, it:
1. allows, rather than requires, DPH to issue such citations;
2. extends, from three to five business days, the time in which a facility or home must notify DPH that it is contesting a citation;
3. eliminates the requirement that DPH hold an informal conference within five business days of a licensee's request and instead requires DPH to notify the licensee of the results of the conference within five business days;
4. increases the civil penalty for (a) certain Class A violations from five to 10 thousand dollars and (b) certain Class B violations from three to five thousand dollars; and
5. allows DPH to appoint temporary management as a disciplinary action against a home or facility.
EFFECTIVE DATE: October 1, 2016
NOTICE AND CONTESTED CITATION REQUIREMENTS
The bill extends, from three to five business days, the amount of time a nursing home or RCH administrator has after a licensee receives a citation to notify the DPH commissioner that the licensee contests the citation. If the administrator fails to provide the notice, the bill deems the citation a final order after that five day period, instead of after the current three day period.
Currently, the DPH commissioner, after receiving such notice, must provide an informal conference with the licensee. The bill (1) eliminates a requirement that the commissioner schedule the conference within five days and (2) allows him to send a designee to the conference in his place. Under the bill, the commissioner must notify the licensee of his conclusions resulting from the conference within five days of its conclusion.
Currently, if the licensee and commissioner fail to reach an agreement at the conference, the commissioner must (1) schedule the matter for a contested case hearing between three and five days after the conference's conclusion and (2) provide notice of the hearing time and date to the facility administrator at least two days before the hearing, though the latter requirement may be waived by agreement. The bill instead requires the commissioner to schedule such a hearing if the licensee notifies the commissioner in writing that he or she disagrees with the commissioner's conclusions. It also eliminates the timeframe in which such a hearing must be scheduled and the associated notice requirement.
Currently, the commissioner must, within three business days after a hearing or after an agreement is reached at a conference, issue a final order affirming, modifying, or vacating the citation. The bill eliminates this three day deadline and specifies that the commissioner must also issue such an order if an agreement is reached as the result of a conference.
The law authorizes the DPH commissioner to take several forms of disciplinary action against a nursing facility or RCH following a contested case hearing and finding that the facility violated the law, regulations, or Public Health Code (e.g., license or certificate suspension or revocation). The bill additionally gives the commissioner the authority under such circumstances to appoint temporary management for the facility in compliance with federal regulations for a period of time he determines (See BACKGROUND).
Under federal regulations, temporary management means the temporary appointment by the state or the Centers for Medicare and Medicaid Services (CMS) of a substitute facility manager or administrator with authority to hire, terminate or reassign staff, obligate facility funds, alter facility procedures, and manage the facility to correct deficiencies identified in the facility's operation. The regulations also specify, among other things, manager qualifications and salary requirements (42 CFR § 488.415).
Public Health Committee
Joint Favorable Substitute