HOUSE BILL No. 4853 May 29, 1997, Introduced by Reps. Rison, Freeman, Bogardus, Wallace, Brewer, Schauer, Cherry, Kelly, Scott, DeHart, Curtis, Wetters, Hale, Thomas, Brown, Wojno, Callahan, Price, Parks, Mans, Prusi, Godchaux, Quarles, Stallworth, LaForge, Vaughn, Mathieu, Ciaramitaro, Varga, Baird, Willard, Harder, Schermesser, Dobronski, Goschka, Rocca, Emerson, Galloway, Murphy, Brater, Frank, Griffin and Gagliardi and referred to the Committee on Health Policy. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20155 (MCL 333.20155), as amended by 1996 PA 267. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 Sec. 20155. (1) Except as OTHERWISE provided in this sec- 2 tion, the department shall make annual and other visits to each 3 health facility or agency licensed under this article for the 4 purposes of survey, evaluation, and consultation. A VISIT MADE 5 PURSUANT TO A COMPLAINT INVESTIGATION SHALL BE UNANNOUNCED. 6 Except for a health facility or agency described in section 7 20106(1)(c), (f), (h), or (j), the department shall determine 8 whetherthevisitsshall beTHAT ARE NOT MADE PURSUANT TO A 9 COMPLAINT INVESTIGATION ARE announced or unannounced., except10that a complaint investigation shall not be announced and there03497'97 CPD 2 1 IN ADDITION TO VISITS MADE PURSUANT TO A COMPLAINT INVESTIGATION, 2 THE DEPARTMENT shallbeANNUALLY MAKE at least 1 unannounced 3 visitother than a complaint investigation annuallyto a health 4 facility or agency described in section 20106(1)(c), (h),or 5 (j). 6 (2) The department shallmakeDO BOTH OF THE FOLLOWING: 7 (A) MAKE at least a biennial visit to each licensed clinical 8 laboratory, each nursing home,and each hospice residence for 9 the purposes of survey, evaluation, and consultation.If a10nursing home is only partially certified under title XVIII or11title XIX, the department shall include all licensed parts of the12nursing home in a certification survey conducted by the13department.14 (B) IN ADDITION TO VISITS MADE PURSUANT TO COMPLAINT INVES- 15 TIGATIONS, AT LEAST ONCE ANNUALLY MAKE AN UNANNOUNCED VISIT TO 16 AND INSPECT EACH NURSING HOME LICENSED UNDER THIS ARTICLE, 17 REGARDLESS OF WHETHER THE NURSING HOME IS CERTIFIED UNDER TITLE 18 XVIII OR TITLE XIX. 19 (3) The department shall make a biennial visit to each hos- 20 pital for survey and evaluation for the purpose of licensure. 21 Subject to subsection (6), the department may waive the biennial 22 visit required by this subsection if a hospital, as part of a 23 timely application for license renewal, requests a waiver and 24 submits both of the following and if all of the requirements of 25 subsection (5) are met: 26 (a) Evidence that it is currently fully accredited by a body 27 with expertise in hospital accreditation whose hospital 03497'97 3 1 accreditations are accepted by the United States department of 2 health and human services for purposes of section 1865 of title 3 XVIII of the social security act, chapter 531, 49 Stat. 620, 4 42 U.S.C. 1395bb. 5 (b) A copy of the most recent accreditation report for the 6 hospital issued by a body described in subdivision (a), and the 7 hospital's responses to the accreditation report. 8 (4) Except as provided in subsection (8), accreditation 9 information provided to the department under subsection (3) is 10 confidential, is not a public record, and is not subject to court 11 subpoena. The department shall use the accreditation information 12 only as provided in this section and shall return the accredit- 13 ation information to the hospital within a reasonable time after 14 a decision on the waiver request is made. 15 (5) The department shall grant a waiver under subsection (3) 16 if the accreditation report submitted under subsection (3)(b) is 17 less than 2 years old and there is no indication of substantial 18 noncompliance with licensure standards or of deficiencies that 19 represent a threat to public safety or patient care in the 20 report, in complaints involving the hospital, or in any other 21 information available to the department. If the accreditation 22 report is 2 or more years old, the department may do 1 of the 23 following: 24 (a) Grant an extension of the hospital's current license 25 until the next accreditation survey is completed by the body 26 described in subsection (3)(a). 03497'97 4 1 (b) Grant a waiver under subsection (3) based on the 2 accreditation report that is 2 or more years old, on condition 3 that the hospital promptly submit the next accreditation report 4 to the department. 5 (c) Deny the waiver request and conduct the visits required 6 under subsection (3). 7 (6) The department shall not grant more than 2 consecutive 8 waivers under subsection (3). This section does not prohibit the 9 department from citing a violation of this part during a survey, 10 FROM conducting investigations or inspections pursuant to 11 section 20156, or FROM conducting surveys of health facilities or 12 agencies for the purpose of complaint investigations or federal 13 certification. This section does not prohibit the state fire 14 marshal from conducting annual surveys of hospitals, nursing 15 homes, and county medical care facilities. 16 (7) At the request of a health facility or agency, the 17 department may conduct a consultation engineering survey of a 18 health facility and provide professional advice and consultation 19 regarding health facility construction and design. A health 20 facility or agency may request a voluntary consultation survey 21 under this subsection at any time between licensure surveys. The 22 fees for a consultation engineering survey are the same as the 23 fees established for waivers under section 20161(10). 24 (8) If the department determines that substantial noncompli- 25 ance with licensure standards exists or that deficiencies that 26 represent a threat to public safety or patient care exist based 27 on a review of an accreditation report submitted pursuant to 03497'97 5 1 subsection (3)(b), the department shall prepare a written summary 2 of the substantial noncompliance or deficiencies and the 3 hospital's response to the department's determination. The 4 department's written summary and the hospital's response are 5 public documents. 6 (9)Investigations or inspectionsIN ADDITION TO THE 7 INSPECTION CONDUCTED UNDER SUBSECTION (2)(B), AN INVESTIGATION OR 8 INSPECTION, other thaninspectionsAN INSPECTION of financial 9 records, of a health facility or agency described in section 10 20106(1)(c), (f), (h), or (j) shall be conducted without prior 11 notice to the health facility or agency. An employee of a state 12 agency charged with INVESTIGATING OR inspecting the health facil- 13 ity or agency or an employee of a local health department who 14 directly or indirectly gives prior notice regarding an 15 INVESTIGATION OR AN inspection, other than an inspection of the 16 financial records, to the health facility or agency or to an 17 employee of the health facility or agency, is guilty of a 18 misdemeanor.Consultation visits that areA CONSULTATION VISIT 19 THAT IS not for the purpose of annual or follow-up inspection or 20 survey may be announced. 21 (10) The department shall maintain a record indicating 22 whethervisits areA VISIT AND INSPECTION IS announced or 23 unannounced. Information gathered atall visitsEACH VISIT AND 24 INSPECTION, WHETHER announced or unannounced, shall be taken into 25 account in licensure decisions. 26 (11) The department shall require periodic reports and a 27 health facility or agency shall give the department access to 03497'97 6 1 books, records, and other documents maintained by a health 2 facility or agency to the extent necessary to carry out the pur- 3 pose of this article and the rules promulgated under this 4 article. The department shall respect the confidentiality of a 5 patient's clinical record and shall not divulge or disclose the 6 contents ofthe recordsA PATIENT CLINICAL RECORD in a manner 7 that identifies an individual except under court order. The 8 department may copy health facility or agency records as required 9 to document findings. 10 (12) The department may delegate survey, evaluation, or con- 11 sultation functions to another state agency or to a local health 12 department qualified to perform those functions. However, the 13 department shall not delegate survey, evaluation, or consultation 14 functions to a local health department that owns or operates a 15 hospice or hospice residence licensed under this article. The 16 delegation shall be by cost reimbursement contract between the 17 department and the state agency or local health department. 18 Survey, evaluation, or consultation functions shall not be dele- 19 gated to nongovernmental agencies, except as provided in this 20 section. The department may accept voluntary inspections per- 21 formed by an accrediting body with expertise in clinical labora- 22 tory accreditation under part 205 if the accrediting body uti- 23 lizes forms acceptable to the department, applies the same 24 licensing standards as applied to other clinical laboratories and 25 provides the same information and data usually filed by the 26 department's own employees when engaged in similar inspections or 03497'97 7 1 surveys. The voluntary inspection described in this subsection 2 shall be agreed upon by both the licensee and the department. 3 (13) If, upon investigation, the department or a state 4 agency determines that an individual licensed to practice a pro- 5 fession in this state has violated the applicable licensure stat- 6 ute or the rules promulgated under that statute, the department, 7 state agency, or local health department shall forward the evi- 8 dence it has to the appropriate licensing agency. 9 (14) As used in this section: 10 (a) "Title XVIII" means title XVIII of the social security 11 act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 12 1395c to 1395i, 1395i-2 to 1395i-4, 1395j to 1395t, 1395u to 13 1395w-2, 1395w-4 to 1395yy, and 1395bbb to 1395ccc. 14 (b) "Title XIX" means title XIX of the social security act, 15 chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to1396v1396f AND 16 1396g-1 TO 1396v. 03497'97 Final page. CPD