Bill Text: CT HB06594 | 2013 | General Assembly | Introduced
Bill Title: An Act Concerning Residential Care Homes And Definitions Of "nursing Home Facility" And "medical Review Committee."
Spectrum: Committee Bill
Status: (Introduced - Dead) 2013-03-15 - Public Hearing 03/20 [HB06594 Detail]
Download: Connecticut-2013-HB06594-Introduced.html
General Assembly |
Raised Bill No. 6594 | ||
January Session, 2013 |
LCO No. 3996 | ||
*03996_______PH_* | |||
Referred to Committee on PUBLIC HEALTH |
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Introduced by: |
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(PH) |
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AN ACT CONCERNING RESIDENTIAL CARE HOMES AND DEFINITIONS OF "NURSING HOME FACILITY" AND "MEDICAL REVIEW COMMITTEE."
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 19a-521 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
As used in this section and sections 19a-522 to 19a-534a, inclusive, as amended by this act, 19a-536 to 19a-539, inclusive, as amended by this act, 19a-550 to 19a-554, inclusive, as amended by this act, and 19a-562a, unless the context otherwise requires:
(1) "Nursing home facility" means any nursing home [or residential care home as defined in section 19a-490] or any rest home with nursing supervision [which provides, in addition to personal care required in a residential care home,] that provides nursing supervision under a medical director twenty-four hours per day, or any chronic and convalescent nursing home [which] that provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries; ["department"]
(2) "Department" means the Department of Public Health; [and "commissioner"]
(3) "Commissioner" means the Commissioner of Public Health or the commissioner's designated representative; and
(4) "Residential care home" means an establishment that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services that meet a need beyond the basic provisions of food, shelter and laundry.
Sec. 2. Subsection (c) of section 19a-490 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(c) "Residential care home", "nursing home" or "rest home" means an establishment [which] that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services [which] that meet a need beyond the basic provisions of food, shelter and laundry;
Sec. 3. Subsection (a) of section 17b-451 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) Any physician or surgeon licensed under the provisions of chapter 370, any resident physician or intern in any hospital in this state, whether or not so licensed, any registered nurse, any nursing home administrator, nurse's aide or orderly in a nursing home facility or residential care home, any person paid for caring for a patient in a nursing home facility or residential care home, any staff person employed by a nursing home facility or residential care home, any patients' advocate and any licensed practical nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist, social worker, clergyman, police officer, pharmacist, psychologist or physical therapist, who has reasonable cause to suspect or believe that any elderly person has been abused, neglected, exploited or abandoned, or is in a condition [which] that is the result of such abuse, neglect, exploitation or abandonment, or is in need of protective services, shall, not later than seventy-two hours after such suspicion or belief arose, report such information or cause a report to be made in any reasonable manner to the Commissioner of Social Services or to the person or persons designated by the commissioner to receive such reports. Any person required to report under the provisions of this section who fails to make such report within the prescribed time period shall be fined not more than five hundred dollars, except that, if such person intentionally fails to make such report within the prescribed time period, such person shall be guilty of a class C misdemeanor for the first offense and a class A misdemeanor for any subsequent offense.
Sec. 4. Section 19a-491b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) Any person who is licensed to establish, conduct, operate or maintain a nursing home or residential care home shall notify the Commissioner of Public Health immediately if the owner, conductor, operator or maintainer of [the] such home, any person described in subdivision (3) of subsection (a) of section 19a-491a, or any nurse or nurse's aide has been convicted of (1) a felony, as defined in section 53a-25, (2) cruelty to persons under section 53-20, or (3) assault of a victim sixty or older under section 53a-61a; or has been subject to any decision imposing disciplinary action by the licensing agency in any state, the District of Columbia, a United States possession or territory or a foreign jurisdiction. Failure to comply with the notification requirement shall subject the licensed person to a civil penalty of not more than one hundred dollars.
(b) Each nursing home and residential care home shall require a person described in subdivision (3) of subsection (a) of section 19a-491a or a nurse or nurse's aide to complete and sign an application form which contains questions as to whether the person has been convicted of any crime specified in subsection (a) of this section or has been subject to any decision imposing disciplinary action as described in said subsection. Any person seeking employment in a position connected with the provision of care in a nursing home or residential care home who makes a false written statement regarding such prior criminal convictions or disciplinary action shall be guilty of a Class A misdemeanor.
(c) The Commissioner of Public Health shall require each initial applicant described in subdivision (1) of subsection (a) of section 19a-491a to submit to state and national criminal history records checks. The criminal history records checks required by this subsection shall be conducted in accordance with section 29-17a.
Sec. 5. Section 19a-491c of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) As used in this section:
(1) "Criminal history and patient abuse background search" or "background search" means (A) a review of the registry of nurse's aides maintained by the Department of Public Health pursuant to section 20-102bb, (B) checks of state and national criminal history records conducted in accordance with section 29-17a, and (C) a review of any other registry specified by the Department of Public Health which the department deems necessary for the administration of a background search program.
(2) "Direct access" means physical access to a patient or resident of a long-term care facility that affords an individual with the opportunity to commit abuse or neglect against or misappropriate the property of a patient or resident.
(3) "Disqualifying offense" means a conviction of any crime described in 42 USC 1320a-7(a)(1), (2), (3) or (4) or a substantiated finding of neglect, abuse or misappropriation of property by a state or federal agency pursuant to an investigation conducted in accordance with 42 USC 1395i-3(g)(1)(C) or 42 USC 1396r(g)(1)(C).
(4) "Long-term care facility" means any facility, agency or provider that is a nursing home, as defined in section 19a-521, as amended by this act, a residential care home, as defined in section 19a-521, as amended by this act, a home health agency, as defined in section 19a-490, as amended by this act, an assisted living services agency, as defined in section 19a-490, as amended by this act, an intermediate care facility for the mentally retarded, as defined in 42 USC 1396d(d), a chronic disease hospital, as defined in section 19a-550, as amended by this act, or an agency providing hospice care which is licensed to provide such care by the Department of Public Health or certified to provide such care pursuant to 42 USC 1395x.
Sec. 6. Section 19a-497 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) Each institution shall, upon receipt of a notice of intention to strike by a labor organization representing the employees of such institution, in accordance with the provisions of the National Labor Relations Act, 29 USC 158, file a strike contingency plan with the commissioner not later than five days before the date indicated for the strike.
(b) The commissioner may issue a summary order to any nursing home facility, as defined in section 19a-521, as amended by this act, or any residential care home, as defined in section 19a-521, that fails to file a strike contingency plan that complies with the provisions of this section and the regulations adopted by the commissioner pursuant to this section within the specified time period. Such order shall require the nursing home facility or residential care home to immediately file a strike contingency plan that complies with the provisions of this section and the regulations adopted by the commissioner pursuant to this section.
(c) Any nursing home facility or residential care home that is in noncompliance with this section shall be subject to a civil penalty of not more than ten thousand dollars for each day of noncompliance.
(d) (1) If the commissioner determines that a nursing home facility or residential care home is in noncompliance with this section or the regulations adopted pursuant to this section, for which a civil penalty is authorized by subsection (c) of this section, the commissioner may send to an authorized officer or agent of the nursing home facility or residential care home, by certified mail, return receipt requested, or personally serve upon such officer or agent, a notice that includes: (1) A reference to this section or the section or sections of the regulations involved; (2) a short and plain statement of the matters asserted or charged; (3) a statement of the maximum civil penalty that may be imposed for such noncompliance; and (4) a statement of the party's right to request a hearing to contest the imposition of the civil penalty.
(2) A nursing home facility or residential care home may make written application for a hearing to contest the imposition of a civil penalty pursuant to this section not later than twenty days after the date such notice is mailed or served. All hearings under this section shall be conducted in accordance with the provisions of chapter 54. If a nursing home facility or residential care home fails to request a hearing or fails to appear at the hearing or if, after the hearing, the commissioner finds that the nursing home facility or residential care home is in noncompliance, the commissioner may, in the commissioner's discretion, order that a civil penalty be imposed that is not greater than the penalty stated in the notice. The commissioner shall send a copy of any order issued pursuant to this subsection by certified mail, return receipt requested, to the nursing home facility named in such order.
(e) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54: (1) Establishing requirements for a strike contingency plan, which shall include, but not be limited to, a requirement that the plan contain documentation that the institution has arranged for adequate staffing and security, food, pharmaceuticals and other essential supplies and services necessary to meet the needs of the patient population served by the institution in the event of a strike; and (2) for purposes of the imposition of a civil penalty upon a nursing home facility or residential care home pursuant to subsections (c) and (d) of this section.
(f) Such plan shall be deemed a statement of strategy or negotiation with respect to collective bargaining for the purpose of subdivision (9) of subsection (b) of section 1-210.
Sec. 7. Subsection (d) of section 19a-498 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(d) In addition, when the Commissioner of Social Services deems it necessary, said commissioner, or a designated representative of said commissioner, may examine and audit the financial records of any nursing home facility, as defined in section 19a-521, as amended by this act, any residential care home, as defined in section 19a-521, as amended by this act, or any nursing facility management services certificate holder, as defined in section 19a-561. Each nursing home facility, residential care home and nursing facility management services certificate holder shall retain all financial information, data and records relating to the operation of the nursing home facility or residential care home for a period of not less than ten years, and all financial information, data and records relating to any real estate transactions affecting such operation, for a period of not less than twenty-five years, which financial information, data and records shall be made available, upon request, to the Commissioner of Social Services or such designated representative at all reasonable times. In connection with any inquiry, examination or investigation, the commissioner or the commissioner's designated representative may issue subpoenas, order the production of books, records and documents, administer oaths and take testimony under oath. The Attorney General, upon request of said commissioner or the commissioner's designated representative, may apply to the Superior Court to enforce any such subpoena or order.
Sec. 8. Subsection (b) of section 19a-502 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(b) If any person conducting, managing or operating any nursing home facility, as defined in section 19a-521, as amended by this act, or residential care home, as defined in section 19a-521, as amended by this act, fails to maintain or make available the financial information, data or records required under subsection (d) of section 19a-498, as amended by this act, such person's license as a nursing home facility or residential care home administrator may be revoked or suspended in accordance with section 19a-517 or the license of such nursing home facility or residential care home may be revoked or suspended in the manner provided in section 19a-494, or both.
Sec. 9. Section 19a-521c of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
No nursing home facility, as defined in section 19a-521, as amended by this act, or residential care home, as defined in section 19a-521, as amended by this act, shall restrict any patient from obtaining prescription drugs through a prescription drug program or health plan offered by the United States Department of Veterans Affairs. If a nursing home facility or residential care home patient obtains prescription drugs through a prescription drug program or health plan offered by the United States Department of Veterans Affairs, the nursing home facility or residential care home may require such prescription drugs to be dispensed and administered according to [the] such facility's or home's policies, provided such policies conform to applicable state and federal laws. At the request of a patient, [a nursing home] such facility or home shall dispense and administer prescription drugs obtained through a prescription drug program or health plan operated by the United States Department of Veterans Affairs regardless of the form of the drugs' packaging. Nothing in this section shall prevent [a nursing home facility] such facility or home from dispensing and administering to a patient prescription drugs that are obtained from sources other than a prescription drug program or health plan operated by the United States Department of Veterans Affairs when the patient requires such drugs before the drugs can be obtained from such drug program or health plan.
Sec. 10. Section 19a-522 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) The commissioner shall adopt regulations, in accordance with chapter 54, concerning the health, safety and welfare of patients in nursing home facilities or residential care homes, classification of violations relating to such facilities, medical staff qualifications, record-keeping, nursing service, dietary service, personnel qualifications and general operational conditions. The regulations shall: (1) Assure that each patient admitted to a nursing home facility or residential care home is protected by adequate immunization against influenza and pneumococcal disease in accordance with the recommendations of the National Advisory Committee on Immunization Practices, established by the Secretary of Health and Human Services; (2) specify that each patient be protected annually against influenza and be vaccinated against pneumonia in accordance with the recommendations of the National Advisory Committee on Immunization; and (3) provide appropriate exemptions for patients for whom such immunizations are medically contraindicated and for patients who object to such immunization on religious grounds.
(b) Nursing home facilities or residential care homes may not charge the family or estate of a deceased self-pay patient beyond the date on which such patient dies. Nursing home facilities or residential care homes shall reimburse the estate of a deceased self-pay patient, within sixty days after the death of such patient, for any advance payments made by or on behalf of the patient covering any period beyond the date of death. Interest, in accordance with subsection (a) of section 37-1, on such reimbursement shall begin to accrue from the date of such patient's death.
Sec. 11. Section 19a-523 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) If, from the results of an inspection and investigation in accordance with section 19a-498, or upon receipt of a report or complaint from the Commissioner of Social Services, pursuant to section 17b-408, and upon such review and further investigation, as the Commissioner of Public Health deems necessary, the Commissioner of Public Health determines that such nursing home facility or residential care home has violated any provision of the Public Health Code relating to the operation or maintenance of a nursing home facility or residential care home, the Commissioner of Public Health may, notwithstanding the provisions of chapter 54, request the Attorney General to seek a temporary or permanent injunction and such other relief as may be appropriate to enjoin such nursing home facility or residential care home from continuing such violation or violations. If the court determines such violation or violations exist, it may grant such injunctive relief and such other relief as justice may require and may set a time period within which such nursing home facility or residential care home shall comply with any such order.
(b) Any appeal taken from any permanent injunction granted under subsection (a) of this section shall not stay the operation of such injunction unless the court is of the opinion that great and irreparable injury will be done by not staying the operation of such injunction.
Sec. 12. Section 19a-524 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
If, upon review, investigation or inspection pursuant to section 19a-498, as amended by this act, the Commissioner of Public Health determines that a nursing home facility or residential care home has violated any provision of section 17b-406, 19a-521 to 19a-529, inclusive, as amended by this act, 19a-531 to 19a-551, inclusive, as amended by this act, or 19a-553 to 19a-555, inclusive, as amended by this act, section 19a-491a, 19a-491b, 19a-493a or 19a-528a or any regulation in the Public Health Code or regulation relating to licensure or the Fire Safety Code relating to the operation or maintenance of a nursing home facility, which violation has been classified in accordance with section 19a-527, he or she shall immediately issue or cause to be issued a citation to the licensee of such nursing home facility. Governmental immunity shall not be a defense to any citation issued or civil penalty imposed pursuant to sections 19a-524 to 19a-528, inclusive, as amended by this act. Each such citation shall be in writing, shall provide notice of the nature and scope of the alleged violation or violations and shall be sent by certified mail to the licensee at the address of the nursing home facility or residential care home in issue. A copy of such citation shall also be sent to the licensed administrator at the address of the [facility] nursing home facility or residential care home.
Sec. 13. Section 19a-525 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) The administrator of the nursing home facility or residential care home, or his or her designee, shall, within three days, excluding Saturdays, Sundays and holidays, of receipt of the citation by the licensee, notify the commissioner if the licensee contests the citation. If the administrator fails to so notify the commissioner within such three-day period, the citation shall be deemed a final order of the commissioner, effective upon the expiration of said period.
(b) If any administrator of a nursing home facility or residential care home, or his or her designee, notifies the commissioner that the licensee contests the citation, the commissioner shall provide within five days of such notice, excluding Saturdays, Sundays and holidays, an informal conference between the licensee and the commissioner. If the licensee and commissioner fail to reach an agreement at such conference, the commissioner shall set the matter down for a hearing as a contested case in accordance with chapter 54, not more than five nor less than three days after such conference, with notice of the date of such hearing to the administrator not less than two days before such hearing, provided the minimum time requirements may be waived by agreement. The commissioner shall, [within] not later than three days, excluding Saturdays, Sundays and holidays, after the conference if agreement is reached at such conference, or after the hearing, issue a final order, based on findings of fact, affirming, modifying or vacating the citation.
Sec. 14. Section 19a-526 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) When, in the case of a class A or B violation, a final order becomes effective, the citation, the order, if any, affirming or modifying the citation and the finding shall be filed by the Commissioner of Public Health in the office of the clerk of the superior court for the judicial district of Hartford. Said clerk shall cause said citation, order, if any, and finding to be filed in said court. Upon such filing, the civil penalty imposed may be enforced in the same manner as a judgment of the Superior Court, provided if an appeal is taken in accordance with section 19a-529, as amended by this act, the court or a judge thereof may, in its or his discretion, stay execution of such order.
(b) Civil penalties imposed pursuant to this section shall be paid not later than fifteen days after the final date by which an appeal may be taken as provided in section 19a-529, as amended by this act, or, if an appeal is taken, not later than fifteen days after the final judgment on such appeal. In the event such fines are not paid, the Commissioner of Public Health shall notify the Commissioner of Social Services who is authorized to immediately withhold from the nursing home's or residential care home's next medical assistance payment, an amount equal to the amount of the civil penalty.
Sec. 15. Section 19a-527 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
Citations issued pursuant to section 19a-524, as amended by this act, shall be classified according to the nature of the violation and shall state such classification and the amount of the civil penalty to be imposed on the face thereof. The Commissioner of Public Health shall, by regulation in accordance with chapter 54, classify violations as follows:
(a) Class A violations are conditions [which] that the Commissioner of Public Health determines present an immediate danger of death or serious harm to any patient in the nursing home facility. For each class A violation, a civil penalty of not more than five thousand dollars may be imposed;
(b) Class B violations are conditions [which] that the Commissioner of Public Health determines present a probability of death or serious harm in the reasonably foreseeable future to any patient in the nursing home facility or residential care home, but [which] that he or she does not find constitute a class A violation. For each such violation, a civil penalty of not more than three thousand dollars may be imposed.
Sec. 16. Section 19a-528 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
In imposing the civil penalties [which] that shall become due under sections 19a-524 to 19a-528, inclusive, as amended by this act, the commissioner may consider all factors [which he] that the commissioner deems relevant, including, but not limited to, the following:
(1) The amount of assessment necessary to insure immediate and continued compliance;
(2) The character and degree of impact of the violation on the health, safety and welfare of any patient in the nursing home facility or residential care home;
(3) The conduct of the person against whom the citation is issued in taking all feasible steps or procedures necessary or appropriate to comply or to correct the violation;
(4) Any prior violations by the nursing home facility or residential care home of statutes, regulations or orders administered, adopted or issued by the Commissioner of Public Health.
Sec. 17. Section 19a-529 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
Any person aggrieved by a final order pursuant to sections 19a-524 to 19a-528, inclusive, as amended by this act, may appeal such order to the superior court for the judicial district in which the nursing home facility or residential care home is situated in accordance with section 4-183. Such appeal shall have precedence in the order of trial to the same extent as provided in section 52-191. This section shall provide the exclusive procedure for appealing any such order.
Sec. 18. Section 19a-531 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
Any employee of the Department of Public Health or the Department of Social Services or any regional ombudsman who gives or causes to be given any advance notice to any nursing home facility or residential care home, directly or indirectly, that an investigation or inspection is under consideration or is impending or gives any information regarding any complaint submitted pursuant to section 17b-408[,] or 19a-523, as amended by this act, prior to an on-the-scene investigation or inspection of such facility, unless specifically mandated by federal or state regulations to give advance notice, shall be guilty of a class B misdemeanor and may be subject to dismissal, suspension or demotion in accordance with chapter 67.
Sec. 19. Section 19a-532 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
No nursing home facility or residential care home shall discharge or in any manner discriminate or retaliate against any patient in any nursing home facility or residential care home, or any relative, guardian, conservator or sponsoring agency thereof or against any employee of any nursing home facility or residential care home or against any other person because such patient, relative, guardian, conservator, sponsoring agency, employee or other person has filed any complaint or instituted or caused to be instituted any proceeding under sections 17b-406, 17b-408, 19a-531 to 19a-534, inclusive, as amended by this act, 19a-536 to 19a-539, inclusive, as amended by this act, 19a-550, as amended by this act, 19a-553, as amended by this act, and 19a-554, or has testified or is about to testify in any such proceeding or because of the exercise by such patient, relative, guardian, conservator, sponsoring agency, employee or other person on behalf of himself, herself or others of any right afforded by said sections. Notwithstanding any other provision of the general statutes, any nursing home facility or residential care home [which] that violates any provision of this section shall be liable to the injured party for treble damages.
Sec. 20. Section 19a-534 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
If the commissioner determines that there is imminent danger to the health, safety or welfare of any patient in any nursing home facility or residential care home, said commissioner may transfer or cause to be transferred such patient to another nursing home facility, residential care home or hospital, provided the commissioner promptly notifies the spouse, relative, guardian or conservator or sponsoring agency of such patient of the transfer and indicates the nursing home facility, residential care home or hospital to which such patient has been transferred.
Sec. 21. Section 19a-534a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
If the commissioner finds that the health, safety or welfare of any patient or patients in any nursing home facility or residential care home imperatively requires emergency action and incorporates a finding to that effect in the order, the commissioner may issue a summary order to the holder of a license issued pursuant to section 19a-493 pending completion of any proceedings conducted pursuant to section 19a-494. Such proceedings shall be promptly instituted and determined. The orders [which] that the commissioner may issue shall include, but not be limited to: (1) Revoking or suspending the license; (2) prohibiting the nursing home facility or residential care home from admitting new patients or discharging current patients; (3) limiting the license of a nursing home facility or residential care home in any respect, including reducing the licensed patient capacity; and (4) compelling compliance with the applicable statutes or regulations administered or adopted by the department.
Sec. 22. Section 19a-538 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
On or before January 1, 1977, and annually thereafter, the Department of Public Health shall publish a report, available to the public, [which] that shall include, but not be limited to, a list of all nursing home facilities and residential care homes in this state; whether such nursing home facilities and residential care homes are proprietary or nonproprietary; the classification of each such nursing home facility and residential care home; the name of the owner or owners, including the name of any partnership, corporation, trust, individual proprietorship or other legal entity [which] that owns or controls, directly or indirectly, such facility or residential care homes; the total number of beds; the number of private and semiprivate rooms; the religious affiliation, and religious services offered, if any, in the nursing home facility or residential care home; the cost per diem for private patients; the languages spoken by the administrator and staff of such nursing home facility or residential care home; the number of full-time employees and their professions; whether or not such nursing home facility or residential care home accepts Medicare and Medicaid patients; recreational and other programs available and the number and nature of any class A or class B citation issued against such nursing home facility or residential care home in the previous year.
Sec. 23. Section 19a-541 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
As used in this section and sections 19a-542 to 19a-549, inclusive, unless the context otherwise requires:
(1) "Nursing home facility" shall have the same meaning as provided in section 19a-521, as amended by this act;
(2) "Emergency" means a situation, physical condition or one or more practices, methods or operations which presents imminent danger of death or serious physical or mental harm to residents of a nursing home facility;
(3) "Transfer trauma" means the medical and psychological reactions to physical transfer that increase the risk of death, or grave illness, or both, in elderly persons; [and]
(4) "Substantial violation" means a violation of law [which] that presents a reasonable likelihood of serious physical or mental harm to residents of a nursing home facility or residential care home; and
(5) "Residential care home" shall have the same meaning as provided in section 19a-521, as amended by this act.
Sec. 24. Section 19a-542 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) An application to appoint a receiver for a nursing home facility or residential care home may be filed in the Superior Court by the Commissioner of Social Services, the Commissioner of Public Health or the director of the Office of Protection and Advocacy for Persons with Disabilities. A resident of [a facility] such facility or home, or such resident's legally liable relative, conservator or guardian may file a written complaint with the Commissioner of Public Health specifying conditions at [the] such facility [which] or home that warrant an application to appoint a receiver. If the Commissioner of Public Health fails to resolve such complaint [within] not later than forty-five days [of] after its receipt or, in the case of a nursing home facility [which] or residential care home that intends to close, [within] not later than seven days [of] after its receipt, the person who filed the complaint may file an application in the Superior Court for the appointment of a receiver for such facility or home. Said court shall immediately notify the Attorney General of such application. The court shall hold a hearing not later than ten days after the date the application is filed. Notice of such hearing shall be given to the owner of such facility or residential care home, or such owner's agent for service of process, not less than five days prior to such hearing. Such notice shall be posted by the court in a conspicuous place inside such facility for not less than three days prior to such hearing.
(b) A resident of a nursing home facility or residential care home for which an application to appoint a receiver has been filed or such resident's legally liable relative, conservator or guardian may appear as a party to the proceedings.
(c) Notwithstanding the provisions of subsection (a) of this section the court may appoint a receiver upon an ex parte motion when affidavits, testimony or any other evidence presented indicates that there is a reasonable likelihood an emergency exists in such facility [which must] or home that shall be remedied immediately to insure the health, safety and welfare of the patients of such facility or home. Notice of the application and order shall be served on the owner or [his] or the owner's agent for service of process and shall be posted in a conspicuous place inside [the] such facility or home not later than twenty-four hours after issuance of such order. A hearing on the application shall be held not later than five days after the issuance of such order unless the owner consents to a later date.
Sec. 25. Section 19a-543 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
The court shall grant an application for the appointment of a receiver for a nursing home facility or residential care home upon a finding of any of the following: (1) Such facility or home is operating without a license issued pursuant to this chapter or such facility's or home's license has been suspended or revoked pursuant to section 19a-494; (2) such facility or home intends to close and adequate arrangements for relocation of its residents have not been made at least thirty days prior to closing; (3) such facility or home has sustained a serious financial loss or failure which jeopardizes the health, safety and welfare of the patients or there is a reasonable likelihood of such loss or failure; or (4) there exists in such facility a condition in substantial violation of the Public Health Code, or any other applicable state statutes, or Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended, or any regulation adopted pursuant to such state or federal laws.
Sec. 26. Section 19a-544 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
It shall be a sufficient defense to a receivership application if any owner of a nursing home facility or residential care home establishes that, (1) [he] the owner did not have knowledge or could not reasonably have known that any conditions in violation of section 19a-543 existed, or (2) [he] the owner did not have a reasonable time in which to correct such violations, or (3) the violations listed in the application do not, in fact, exist or, in the event the grounds upon which the petition is based are those set forth in subdivision (2) of section 19a-543, as amended by this act, [the] such facility or home does not intend to close.
Sec. 27. Subsection (a) of section 19a-545 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) A receiver appointed pursuant to the provisions of sections 19a-541 to 19a-549, inclusive, as amended by this act, in operating [such] a nursing home facility or residential care home, shall have the same powers as a receiver of a corporation under section 52-507, except as provided in subsection (c) of this section and shall exercise such powers to remedy the conditions [which] that constituted grounds for the imposition of receivership, assure adequate health care for the residents and preserve the assets and property of the owner. If [a] such facility or home is placed in receivership it shall be the duty of the receiver to notify each resident and each resident's guardian or conservator, if any, or legally liable relative or other responsible party, if known. Such receiver may correct or eliminate any deficiency in the structure or furnishings of [the] such facility or home [which] that endangers the safety or health of the residents while they remain in [the] such facility or home, provided the total cost of correction does not exceed three thousand dollars. The court may order expenditures for this purpose in excess of three thousand dollars on application from such receiver. If any resident is transferred or discharged such receiver shall provide for: (1) Transportation of the resident and such resident's belongings and medical records to the place where such resident is being transferred or discharged; (2) aid in locating an alternative placement and discharge planning in accordance with section 19a-535; (3) preparation for transfer to mitigate transfer trauma, including but not limited to, participation by the resident or the resident's guardian in the selection of the resident's alternative placement, explanation of alternative placements and orientation concerning the placement chosen by the resident or the resident's guardian; and (4) custodial care of all property or assets of residents [which] that are in the possession of an owner of [the] such facility or home. The receiver shall preserve all property, assets and records of residents [which] that the receiver has custody of and shall provide for the prompt transfer of the property, assets and records to the alternative placement of any transferred resident. In no event may the receiver transfer all residents and close [a] such facility or home without a court order and without complying with the notice and discharge plan requirements for each resident in accordance with section 19a-535.
Sec. 28. Subsection (a) of section 19a-546 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) A receiver may not be required to honor any lease, mortgage, secured transaction or other contract entered into by the owner of [the] a nursing home facility or residential care home if, upon application to the Superior Court, said court determines that: (1) The person seeking payment under the agreement was an owner or controlling stockholder of [the] such facility or home or was an affiliate of such owner or controlling stockholder at the time the agreement was made; or (2) the rental, price or rate of interest required to be paid under the agreement was substantially in excess of a reasonable rental, price or rate of interest at the time the contract was entered into.
Sec. 29. Section 19a-547 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) The court may appoint any responsible individual whose name is proposed by the Commissioner of Public Health and the Commissioner of Social Services to act as a receiver. Such individual shall be a nursing home facility or residential care home administrator licensed in the state of Connecticut with substantial experience in operating Connecticut nursing homes. [On or before July 1, 2004, the] The Commissioner of Social Services shall adopt regulations governing qualifications for proposed receivers consistent with this subsection. No state employee or owner, administrator or other person with a financial interest in the [facility] nursing home facility or residential care home may serve as a receiver for that [facility] nursing home facility or residential care home. No person appointed to act as a receiver shall be permitted to have a current financial interest in the [facility] nursing home facility or residential care home; nor shall such person appointed as a receiver be permitted to have a financial interest in the [facility] nursing home facility or residential care home for a period of five years from the date the receivership ceases.
(b) The court may remove such receiver in accordance with section 52-513. A nursing home facility or residential care home receiver appointed pursuant to this section shall be entitled to a reasonable receiver's fee as determined by the court. The receiver shall be liable only in [his] the receiver's official capacity for injury to person and property by reason of the conditions of the nursing home facility or residential care home. [He] The receiver shall not be personally liable, except for acts or omissions constituting gross, wilful or wanton negligence.
(c) The court, in its discretion, may require a bond of such receiver in accordance with section 52-506.
(d) The court may require the Commissioner of Public Health to provide for the payment of any receiver's fees authorized in subsection (a) of this section upon a showing by such receiver to the satisfaction of the court that (1) the assets of the nursing home facility or residential care home are not sufficient to make such payment, and (2) no other source of payment is available, including the submission of claims in a bankruptcy proceeding. The state shall have a claim for any court-ordered fees and expenses of the receiver [which] that shall have priority over all other claims of secured and unsecured creditors and other persons whether or not [the] such nursing home facility or residential care home is in bankruptcy, to the extent allowed under state or federal law.
Sec. 30. Section 19a-548 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
Each receiver shall, during the first week in January, April, July and October in each year, sign, swear to and file with the clerk of the court by which [he] the receiver was appointed a full and detailed account of his or her doings as such receiver for the three months next preceding, together with a statement of all court orders passed during such three months and the present condition and prospects of the nursing home facility or residential care home in [his] the receiver's charge, and cause a motion for a hearing and approval of the same to be placed on the short calendar.
Sec. 31. Section 19a-549 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
The Superior Court, upon a motion by the receiver or the owner of [such] the nursing home facility or residential care home, may terminate the receivership if it finds that such facility or home has been rehabilitated so that the violations complained of no longer exist or if such receivership was instituted pursuant to subdivision (2) of section 19a-543, as amended by this act, the orderly transfer of the patients has been completed and such facility or home is ready to be closed. Upon such finding, the court may terminate the receivership and return such facility or home to its owner. In its termination order the court may include such terms as it deems necessary to prevent the conditions complained of from recurring.
Sec. 32. Section 19a-550 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a)(1) As used in this section, (A) "nursing home facility" shall have the same meaning as provided in section 19a-521, as amended by this act, [and] (B) "residential care home" shall have the same meaning as provided in section 19a-521, as amended by this act, and (C) "chronic disease hospital" means a long-term hospital having facilities, medical staff and all necessary personnel for the diagnosis, care and treatment of chronic diseases; and (2) for the purposes of subsections (c) and (d) of this section, and subsection (b) of section 19a-537, "medically contraindicated" means a comprehensive evaluation of the impact of a potential room transfer on the patient's physical, mental and psychosocial well-being, which determines that the transfer would cause new symptoms or exacerbate present symptoms beyond a reasonable adjustment period resulting in a prolonged or significant negative outcome that could not be ameliorated through care plan intervention, as documented by a physician in a patient's medical record.
(b) There is established a patients' bill of rights for any person admitted as a patient to any nursing home facility, residential care home or chronic disease hospital. The patients' bill of rights shall be implemented in accordance with the provisions of Sections 1919(b), 1919(c), 1919(c)(2), 1919(c)(2)(D) and 1919(c)(2)(E) of the Social Security Act. The patients' bill of rights shall provide that each such patient: (1) Is fully informed, as evidenced by the patient's written acknowledgment, prior to or at the time of admission and during the patient's stay, of the rights set forth in this section and of all rules and regulations governing patient conduct and responsibilities; (2) is fully informed, prior to or at the time of admission and during the patient's stay, of services available in [the] such facility, home or chronic disease hospital, and of related charges including any charges for services not covered under Titles XVIII or XIX of the Social Security Act, or not covered by basic per diem rate; (3) is entitled to choose the patient's own physician and is fully informed, by a physician, of the patient's medical condition unless medically contraindicated, as documented by the physician in the patient's medical record, and is afforded the opportunity to participate in the planning of the patient's medical treatment and to refuse to participate in experimental research; (4) in a residential care home or a chronic disease hospital is transferred from one room to another within [the facility] such home or chronic hospital only for medical reasons, or for the patient's welfare or that of other patients, as documented in the patient's medical record and such record shall include documentation of action taken to minimize any disruptive effects of such transfer, except a patient who is a Medicaid recipient may be transferred from a private room to a nonprivate room, provided no patient may be involuntarily transferred from one room to another within [the facility] such home or chronic disease hospital if (A) it is medically established that the move will subject the patient to a reasonable likelihood of serious physical injury or harm, or (B) the patient has a prior established medical history of psychiatric problems and there is psychiatric testimony that as a consequence of the proposed move there will be exacerbation of the psychiatric problem [which] that would last over a significant period of time and require psychiatric intervention; and in the case of an involuntary transfer from one room to another within [the facility] such home or chronic disease hospital, the patient and, if known, the patient's legally liable relative, guardian or conservator or a person designated by the patient in accordance with section 1-56r, is given [at least] not less than thirty days' and [no] not more than sixty days' written notice to ensure orderly transfer from one room to another within [the facility] such home or chronic disease hospital, except where the health, safety or welfare of other patients is endangered or where immediate transfer from one room to another within [the facility] such home or chronic disease hospital is necessitated by urgent medical need of the patient or where a patient has resided in [the facility] such home or chronic disease hospital for less than thirty days, in which case notice shall be given as many days before the transfer as practicable; (5) is encouraged and assisted, throughout the patient's period of stay, to exercise the patient's rights as a patient and as a citizen, and to this end, has the right to be fully informed about patients' rights by state or federally funded patient advocacy programs, and may voice grievances and recommend changes in policies and services to nursing home facility, residential care home or chronic disease hospital staff or to outside representatives of the patient's choice, free from restraint, interference, coercion, discrimination or reprisal; (6) shall have prompt efforts made by [the facility] such nursing home facility, residential care home or chronic disease hospital to resolve grievances the patient may have, including those with respect to the behavior of other patients; (7) may manage the patient's personal financial affairs, and is given a quarterly accounting of financial transactions made on the patient's behalf; (8) is free from mental and physical abuse, corporal punishment, involuntary seclusion and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the patient's medical symptoms. Physical or chemical restraints may be imposed only to ensure the physical safety of the patient or other patients and only upon the written order of a physician that specifies the type of restraint and the duration and circumstances under which the restraints are to be used, except in emergencies until a specific order can be obtained; (9) is assured confidential treatment of the patient's personal and medical records, and may approve or refuse their release to any individual outside the facility, except in case of the patient's transfer to another health care institution or as required by law or third-party payment contract; (10) receives quality care and services with reasonable accommodation of individual needs and preferences, except where the health or safety of the individual would be endangered, and is treated with consideration, respect, and full recognition of the patient's dignity and individuality, including privacy in treatment and in care for the patient's personal needs; (11) is not required to perform services for the nursing home facility, residential care home or chronic disease hospital that are not included for therapeutic purposes in the patient's plan of care; (12) may associate and communicate privately with persons of the patient's choice, including other patients, send and receive the patient's personal mail unopened and make and receive telephone calls privately, unless medically contraindicated, as documented by the patient's physician in the patient's medical record, and receives adequate notice before the patient's room or roommate in [the] such facility, home or chronic disease hospital is changed; (13) is entitled to organize and participate in patient groups in [the] such facility, home or chronic disease hospital and to participate in social, religious and community activities that do not interfere with the rights of other patients, unless medically contraindicated, as documented by the patient's physician in the patient's medical records; (14) may retain and use the patient's personal clothing and possessions unless to do so would infringe upon rights of other patients or unless medically contraindicated, as documented by the patient's physician in the patient's medical record; (15) is assured privacy for visits by the patient's spouse or a person designated by the patient in accordance with section 1-56r and, if the patient is married and both the patient and the patient's spouse are inpatients in the facility, they are permitted to share a room, unless medically contraindicated, as documented by the attending physician in the medical record; (16) is fully informed of the availability of and may examine all current state, local and federal inspection reports and plans of correction; (17) may organize, maintain and participate in a patient-run resident council, as a means of fostering communication among residents and between residents and staff, encouraging resident independence and addressing the basic rights of nursing home facility, residential care home and chronic disease hospital patients and residents, free from administrative interference or reprisal; (18) is entitled to the opinion of two physicians concerning the need for surgery, except in an emergency situation, prior to such surgery being performed; (19) is entitled to have the patient's family or a person designated by the patient in accordance with section 1-56r meet in [the] such facility, residential care home or chronic disease hospital with the families of other patients in the facility to the extent [the] such facility, residential care home or chronic disease hospital has existing meeting space available [which] that meets applicable building and fire codes; (20) is entitled to file a complaint with the Department of Social Services and the Department of Public Health regarding patient abuse, neglect or misappropriation of patient property; (21) is entitled to have psychopharmacologic drugs administered only on orders of a physician and only as part of a written plan of care developed in accordance with Section 1919(b)(2) of the Social Security Act and designed to eliminate or modify the symptoms for which the drugs are prescribed and only if, at least annually, an independent external consultant reviews the appropriateness of the drug plan; (22) is entitled to be transferred or discharged from the facility only pursuant to section 19a-535 or section 19a-535b, as applicable; (23) is entitled to be treated equally with other patients with regard to transfer, discharge and the provision of all services regardless of the source of payment; (24) shall not be required to waive any rights to benefits under Medicare or Medicaid or to give oral or written assurance that the patient is not eligible for, or will not apply for benefits under Medicare or Medicaid; (25) is entitled to be provided information by the nursing home facility, residential care home or chronic disease hospital as to how to apply for Medicare or Medicaid benefits and how to receive refunds for previous payments covered by such benefits; (26) on or after October 1, 1990, shall not be required to give a third-party guarantee of payment to the facility as a condition of admission to, or continued stay in, [the] such facility, home or chronic disease hospital; (27) is entitled to have [the] such facility, home or chronic disease hospital not charge, solicit, accept or receive any gift, money, donation, third-party guarantee or other consideration as a precondition of admission or expediting the admission of the individual to [the] such facility, home or chronic disease hospital or as a requirement for the individual's continued stay in [the] such facility, home or chronic disease hospital; and (28) shall not be required to deposit the patient's personal funds in [the] such facility, home or chronic disease hospital.
(c) The patients' bill of rights shall provide that a patient in a rest home with nursing supervision or a chronic and convalescent nursing home may be transferred from one room to another within [a facility] such home only for the purpose of promoting the patient's well-being, except as provided pursuant to subparagraph (C) or (D) of this subsection or subsection (d) of this section. Whenever a patient is to be transferred, [the facility] such home shall effect the transfer with the least disruption to the patient and shall assess, monitor and adjust care as needed subsequent to the transfer in accordance with subdivision (10) of subsection (b) of this section. When a transfer is initiated by [the facility] such and the patient does not consent to the transfer, [the facility] such home shall establish a consultative process that includes the participation of the attending physician, a registered nurse with responsibility for the patient and other appropriate staff in disciplines as determined by the patient's needs, and the participation of the patient, the patient's family, a person designated by the patient in accordance with section 1-56r or other representative. The consultative process shall determine: (1) What caused consideration of the transfer; (2) whether the cause can be removed; and (3) if not, whether [the facility] such home has attempted alternatives to transfer. The patient shall be informed of the risks and benefits of the transfer and of any alternatives. If subsequent to the completion of the consultative process a patient still does not wish to be transferred, the patient may be transferred without the patient's consent, unless medically contraindicated, only (A) if necessary to accomplish physical plant repairs or renovations that otherwise could not be accomplished; provided, if practicable, the patient, if the patient wishes, shall be returned to the patient's room when the repairs or renovations are completed; (B) due to irreconcilable incompatibility between or among roommates, which is actually or potentially harmful to the well-being of a patient; (C) if [the facility] such home has two vacancies available for patients of the same sex in different rooms, there is no applicant of that sex pending admission in accordance with the requirements of section 19a-533 and grouping of patients by the same sex in the same room would allow admission of patients of the opposite sex, [which] that otherwise would not be possible; (D) if necessary to allow access to specialized medical equipment no longer needed by the patient and needed by another patient; or (E) if the patient no longer needs the specialized services or programming that is the focus of the area of [the facility] such home in which the patient is located. In the case of an involuntary transfer, [the facility] such home shall, subsequent to completion of the consultative process, provide the patient and the patient's legally liable relative, guardian or conservator if any or other responsible party if known, with at least fifteen days' written notice of the transfer, which shall include the reason for the transfer, the location to which the patient is being transferred, and the name, address and telephone number of the regional long-term care ombudsman, except that in the case of a transfer pursuant to subparagraph (A) of this subsection at least thirty days' notice shall be provided. Notwithstanding the provisions of this subsection, a patient may be involuntarily transferred immediately from one room to another within [a facility] such home to protect the patient or others from physical harm, to control the spread of an infectious disease, to respond to a physical plant or environmental emergency that threatens the patient's health or safety or to respond to a situation that presents a patient with an immediate danger of death or serious physical harm. In such a case, disruption of patients shall be minimized; the required notice shall be provided [within] not later than twenty-four hours after the transfer; if practicable, the patient, if the patient wishes, shall be returned to the patient's room when the threat to health or safety [which] that prompted the transfer has been eliminated; and, in the case of a transfer effected to protect a patient or others from physical harm, the consultative process shall be established on the next business day.
(d) Notwithstanding the provisions of subsection (c) of this section, unless medically contraindicated, a patient who is a Medicaid recipient may be transferred from a private to a nonprivate room. In the case of such a transfer, the nursing home facility, residential care home or chronic disease hospital shall (1) give [at least] not less than thirty days' written notice to the patient and the patient's legally liable relative, guardian or conservator, if any, a person designated by the patient in accordance with section 1-56r or other responsible party, if known, which notice shall include the reason for the transfer, the location to which the patient is being transferred and the name, address and telephone number of the regional long-term care ombudsman; and (2) establish a consultative process to effect the transfer with the least disruption to the patient and assess, monitor and adjust care as needed subsequent to the transfer in accordance with subdivision (10) of subsection (b) of this section. The consultative process shall include the participation of the attending physician, a registered nurse with responsibility for the patient and other appropriate staff in disciplines as determined by the patient's needs, and the participation of the patient, the patient's family, a person designated by the patient in accordance with section 1-56r or other representative.
(e) Any nursing home facility, residential care home or chronic disease hospital that negligently deprives a patient of any right or benefit created or established for the well-being of the patient by the provisions of this section shall be liable to such patient in a private cause of action for injuries suffered as a result of such deprivation. Upon a finding that a patient has been deprived of such a right or benefit, and that the patient has been injured as a result of such deprivation, damages shall be assessed in the amount sufficient to compensate such patient for such injury. The rights or benefits specified in subsections (b) to (d), inclusive, of this section may not be reduced, rescinded or abrogated by contract. In addition, where the deprivation of any such right or benefit is found to have been wilful or in reckless disregard of the rights of the patient, punitive damages may be assessed. A patient may also maintain an action pursuant to this section for any other type of relief, including injunctive and declaratory relief, permitted by law. Exhaustion of any available administrative remedies shall not be required prior to commencement of suit under this section.
(f) In addition to the rights specified in subsections (b), (c) and (d) of this section, a patient in a nursing home facility or residential care home is entitled to have the facility manage the patient's funds as provided in section 19a-551, as amended by this act.
Sec. 33. Section 19a-551 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
Each nursing home facility and residential care home shall: (1) On or before the admission of each patient provide such patient or such patient's legally liable relative, guardian or conservator with a written statement explaining such patient's rights regarding the patient's personal funds and listing the charges [which] that may be deducted from such funds. Such statement shall explain that the nursing home facility or residential care home shall on and after October 1, 1992, pay interest at a rate not less than four per cent per annum and on and after October 1, 1994, pay interest at a rate not less than five and one-half per cent per annum on any security deposit or other advance payment required of such patient prior to admission to the nursing home facility or residential care home. In the case of patients receiving benefits under Title XVIII or XIX of the federal Social Security Act the statement shall include a list of charges not covered by said titles and not covered by the basic per diem rate provided by said titles. Upon delivery of such statement the person in charge of the nursing home facility or residential care home shall obtain a signed receipt acknowledging such delivery; (2) upon written consent or request of the patient or the patient's legally liable relative, guardian or conservator, manage such patient's personal funds, provided such consent by a patient shall not be effective unless cosigned by the patient's legally liable relative or guardian if such patient has been determined by a physician to be mentally incapable of understanding and no conservator has been appointed. As manager of such personal funds the nursing home facility or residential care home shall: (A) Either maintain separate accounts for each patient or maintain an aggregate trust account for patients' funds to prevent commingling the personal funds of patients with the funds of [the] such facility or home. [The] Such facility or home shall notify in writing each patient receiving Medicaid assistance or such patient's legally liable relative, guardian or conservator when the amount in the patient's account reaches two hundred dollars less than the dollar amount determined under the Medicaid program as the maximum for eligibility under the program and advise the patient or such patient's legally liable relative, guardian or conservator that if the amount in the account plus the value of the patient's other nonexempt resources reaches the maximum the patient may lose his or her Medicaid eligibility; (B) obtain signed receipts for each expenditure from each patient's personal funds; (C) maintain an individual itemized record of income and expenditures for each patient, including quarterly accountings; and (D) permit the patient or the patient's legally liable relative, guardian or conservator, and the regional long-term care ombudsman, and representatives from the Departments of Social Services and Public Health, access to such record; and (3) (A) refund any overpayment or deposit from a former patient or such patient's legally liable relative, guardian or conservator [within] not later than thirty days [of] after the patient's discharge and (B) refund any deposit from an individual planning to be admitted to [the] such facility [within] or home not later than thirty days of receipt of written notification that the individual is no longer planning to be admitted. A refund issued after thirty days shall include interest at a rate of ten per cent per annum. For the purposes of this section "deposit" shall include liquidated damages under any contract for pending admission.
Sec. 34. Section 19a-552 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) Any person who violates any provision of section 19a-551 shall be guilty of a class A misdemeanor.
(b) Any patient or his legally liable relative, guardian or conservator may bring an action in the Superior Court for any violation of section 19a-551. Any nursing home facility or residential care home determined by the court to be in violation of any provision of said section shall be liable to the injured party for treble damages.
Sec. 35. Section 19a-553 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) Each nursing home and residential care home administrator shall submit or cause to be submitted to the appropriate local law enforcement agency a detailed statement regarding any alleged commission of any crime or criminal action by any patient admitted to or by any person employed or visiting in any nursing home facility [which] or residential care home that is under the general administrative charge of such administrator.
(b) Any person who violates any provision of this section shall be guilty of a class D misdemeanor.
Sec. 36. Subsection (a) of section 20-101a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) A registered nurse, licensed under this chapter, in charge in a hospice, [or] nursing home facility, as defined in section 19a-521, as amended by this act, residential care home, as defined in section 19a-521, as amended by this act, or a registered nurse, licensed under this chapter or a registered nurse employed by a home health care agency licensed by the state of Connecticut, in a home or residence may make the actual determination and pronouncement of death of a patient provided that the following conditions are satisfied: (1) The death is an anticipated death; (2) the registered nurse attests to such pronouncement on the certificate of death; and (3) the registered nurse, an advanced practice registered nurse licensed under this chapter, or a physician licensed under chapter 370 certifies the death and signs the certificate of death [no] not later than twenty-four hours after the pronouncement.
Sec. 37. Subsection (a) of section 45a-644 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) "Conservator of the estate" means a person, a municipal or state official, or a private profit or nonprofit corporation except a hospital, [or] nursing home facility, as defined in section 19a-521, as amended by this act, or residential care home, as defined in section 19a-521, as amended by this act, appointed by the Court of Probate under the provisions of sections 45a-644 to 45a-663, inclusive, as amended by this act, to supervise the financial affairs of a person found to be incapable of managing his or her own affairs or of a person who voluntarily asks the Court of Probate for the appointment of a conservator of the estate, and includes a temporary conservator of the estate appointed under the provisions of section 45a-654.
Sec. 38. Subsection (a) of section 45a-669 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(a) "Plenary guardian of a person with intellectual disability" means a person, legally authorized state official, or private nonprofit corporation, except a hospital, [or] nursing home facility, as defined in section 19a-521, as amended by this act, or residential care home, as defined in section 19a-521, as amended by this act, appointed by a court of probate pursuant to the provisions of sections 45a-669 to 45a-684, inclusive, as amended by this act, to supervise all aspects of the care of an adult person, as enumerated in subsection (d) of section 45a-677, for the benefit of such adult, who by reason of the severity of his or her intellectual disability, has been determined to be totally unable to meet essential requirements for his physical health or safety and totally unable to make informed decisions about matters related to his or her care.
Sec. 39. Subdivision (6) of section 46a-11a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(6) "Facility" means any public or private hospital, nursing home facility, residential care home, training school, regional facility, group home, community companion home, school or other program serving persons with intellectual disability;
Sec. 40. Subdivision (4) of section 19a-17b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013):
(4) "Medical review committee" shall include any committee of a state or local professional society or a committee of any health care [institution] provider established pursuant to written bylaws, and any utilization review committee established pursuant to Public Law 89-97, and a professional standards review organization or a state-wide professional standards review council, established pursuant to Public Law 92-603, engaging in peer review, to gather and review information relating to the care and treatment of patients for the purposes of (A) evaluating and improving the quality of health care rendered; (B) reducing morbidity or mortality; or (C) establishing and enforcing guidelines designed to keep within reasonable bounds the cost of health care. It shall also mean any hospital board or committee reviewing the professional qualifications or activities of its medical staff or applicants for admission thereto.
This act shall take effect as follows and shall amend the following sections: | ||
Section 1 |
July 1, 2013 |
19a-521 |
Sec. 2 |
July 1, 2013 |
19a-490(c) |
Sec. 3 |
July 1, 2013 |
17b-451(a) |
Sec. 4 |
July 1, 2013 |
19a-491b |
Sec. 5 |
July 1, 2013 |
19a-491c |
Sec. 6 |
July 1, 2013 |
19a-497 |
Sec. 7 |
July 1, 2013 |
19a-498(d) |
Sec. 8 |
July 1, 2013 |
19a-502(b) |
Sec. 9 |
July 1, 2013 |
19a-521c |
Sec. 10 |
July 1, 2013 |
19a-522 |
Sec. 11 |
July 1, 2013 |
19a-523 |
Sec. 12 |
July 1, 2013 |
19a-524 |
Sec. 13 |
July 1, 2013 |
19a-525 |
Sec. 14 |
July 1, 2013 |
19a-526 |
Sec. 15 |
July 1, 2013 |
19a-527 |
Sec. 16 |
July 1, 2013 |
19a-528 |
Sec. 17 |
July 1, 2013 |
19a-529 |
Sec. 18 |
July 1, 2013 |
19a-531 |
Sec. 19 |
July 1, 2013 |
19a-532 |
Sec. 20 |
July 1, 2013 |
19a-534 |
Sec. 21 |
July 1, 2013 |
19a-534a |
Sec. 22 |
July 1, 2013 |
19a-538 |
Sec. 23 |
July 1, 2013 |
19a-541 |
Sec. 24 |
July 1, 2013 |
19a-542 |
Sec. 25 |
July 1, 2013 |
19a-543 |
Sec. 26 |
July 1, 2013 |
19a-544 |
Sec. 27 |
July 1, 2013 |
19a-545(a) |
Sec. 28 |
July 1, 2013 |
19a-546(a) |
Sec. 29 |
July 1, 2013 |
19a-547 |
Sec. 30 |
July 1, 2013 |
19a-548 |
Sec. 31 |
July 1, 2013 |
19a-549 |
Sec. 32 |
July 1, 2013 |
19a-550 |
Sec. 33 |
July 1, 2013 |
19a-551 |
Sec. 34 |
July 1, 2013 |
19a-552 |
Sec. 35 |
July 1, 2013 |
19a-553 |
Sec. 36 |
July 1, 2013 |
20-101a(a) |
Sec. 37 |
July 1, 2013 |
45a-644(a) |
Sec. 38 |
July 1, 2013 |
45a-669(a) |
Sec. 39 |
July 1, 2013 |
46a-11a(6) |
Sec. 40 |
July 1, 2013 |
19a-17b(4) |
Statement of Purpose:
To clarify the definitions of "nursing home facility" and "residential care home" and statutory references to such terms and to change the definition of "medical review committee".
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]