HB 681-FN – FINAL VERSION
HOUSE BILL 681-FN
This bill allows residential care facilities to establish proceedings for a quality assurance program. The bill authorizes the department of health and human services to provide training for persons who own or work in a residential care facility. This bill also grants a one-year waiver from annual inspections to certain facilities under certain conditions.
This bill also authorizes a licensed nurse who is an employee of a licensed medical adult day program facility to assist clients with medication.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [
in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Five
AN ACT relative to training, quality assurance, and licensing of assisted living facilities.
Be it Enacted by the Senate and House of Representatives in General Court convened:
274:1 Statement of Purpose. The general court acknowledges the need to adopt a quality assurance program for certain residential care facilities and a waiver of the annual inspection requirement for a 2-year period if a residential care facility is found deficiency-free during an annual inspection. The general court further recognizes the need to give the department of health and human services authority to train and qualify residential care professionals as trainers in a resident assessment course for those owning or working in residential care facilities.
274:2 New Paragraph; Residential Care Facilities; Training. Amend RSA 151:5-a by inserting after paragraph II the following new paragraph:
III. The department of health and human services may train, and shall approve, provider members of the New Hampshire Association of Residential Care Homes, the New Hampshire Health Care Association, or the Northern New England Association of Homes and Services for the Aging as trainers in a resident assessment course for those owning or working in licensed residential care facilities, so that such trained individuals can satisfactorily meet the provisions of this section.
274:3 Annual Inspections; Waiver. Amend RSA 151:6-a to read as follows:
151:6-a Annual Inspection. The department of health and human services shall make at least one annual unannounced inspection of every facility licensed under this chapter, unless exempted by rules as authorized by RSA 151:9, I(b). For residential care facilities, defined in RSA 151:2, I(e), the inspection shall include a review of the programs and services offered in the facility to assure that the facility is in compliance with its current level of licensure, and a survey of the most recent individual resident needs determinations where such surveys are not done under the survey and certification process for Titles XVIII and XIX of the Social Security Act, as amended, to assure that the facility and its programs and services are appropriate to the needs of the residents. Inspection results shall be provided as a written report which distinguishes between those findings that do, and those which do not, indicate a pattern of care, or which demonstrate over the period of at least 2 inspections, a trend in the care of residents or management of the facility which has the potential for adversely affecting the health of the residents. The results of this inspection and any later inspection shall be posted in a conspicuous place in the facility in the manner determined by the commissioner of the department of health and human services. The results so posted shall indicate the facilities and services inspected and the results for each such facility or service. This section shall not apply to acute care general hospitals and critical access hospitals when the department and the [
joint committee for accreditation of hospitals] Joint Commission on Accreditation of Healthcare Organizations have agreed on joint inspection standards. If a residential care facility, as defined in RSA 151:9, VII(a)(1) or (2), has been inspected and is found to be deficiency-free for 2 consecutive years it shall be granted a one-year waiver from the provisions of this section; provided, that the facility is not the subject of a founded complaint investigation under RSA 151:6, the facility remains under the same administrator who is responsible for the day-to-day operation of the facility, and the facility remains under the same director of nursing if there is a director of nursing.
274:4 New Section; Residential Care Facilities; Quality Assurance Program. Amend RSA 151 by inserting after section 5-b the following new section:
151:5-c Proceedings of Residential Care Facility Quality Assurance Program; Confidentiality.
I. To help assure quality care of residents in licensed residential care facilities, such facilities may voluntarily maintain a quality assurance program for its residents as set forth in this section.
II. In this section:
(a) “Records” means records of interviews, internal reviews and investigations, and all reports, statements, minutes, memoranda, charts, statistics, and other documentation generated during the activities of a quality assurance program. “Records” shall not mean original medical records or other records kept relative to any resident in the course of the business of operating a licensed residential care facility.
(b) “Quality assurance program” means a comprehensive, ongoing, organization-wide system of mechanisms for monitoring and evaluating the quality and appropriateness of the care provided, so that important problems and trends in the delivery of care are identified and that steps are taken to correct problems and to take advantage of opportunities to improve care.
III. Records of a quality assurance program in a licensed residential care facility, including those of its functional components and committees as defined by the facility’s quality assurance plans, organized to evaluate matters relating to the care and treatment of residents and to improve the quality of care provided, and testimony by owners or members, or both, on the board of directors of the residential care facility, medical and clinical staff, employees, or the committee attendees relating to activities of the quality assurance program, shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding. However, information, documents, or records otherwise available from original sources shall not be construed as immune from discovery or use in any such civil or administrative action merely because they were presented to a quality assurance program, and any person who supplies information or testifies as part of a quality assurance program, or who is a member of a quality assurance program committee, shall not be prevented from testifying as to matters within his or her knowledge, but such witness shall not be asked about his or her testimony before such program, or opinions formed by him or her, as a result of committee participation. Further, a program’s records shall be discoverable in either of the following cases:
(a) A judicial or administrative proceeding brought by a licensed residential care facility, its quality assurance program, or owners and/or board of directors, to revoke or restrict the license or certification of a staff member; or
(b) A proceeding alleging repetitive malicious action or personal injury brought against a staff member.
IV. A licensed residential care facility, its owners and/or board of directors, or trustees may waive privileges under this section and release information or present records of the quality assurance program by discovery, subpoena, or admission into evidence in any judicial or administrative proceeding.
V. No owner, directors, trustees, medical or clinical staff, employees, or other attendees of the quality assurance program shall be held liable in any action for damages or other relief arising from the providing of information to a quality assurance program or in any judicial or administrative proceeding.
274:5 New Paragraph; Dealing in or Possessing Prescription Drugs. Amend RSA 318:42 by inserting after paragraph XIII the following new paragraph:
XIV. A nurse, licensed under RSA 326-B, who is an employee of a health facility, licensed by the state of New Hampshire, and acting in the course of his or her employment, from organizing the prescription and non-prescription drugs of clients into containers designed to aid clients in carrying out prescriber’s directions; provided, that the organizing of the drugs is documented in the client’s nursing record and that the original prescriptions will be kept at the facility or client’s home and the medication container is set up on a weekly basis.
274:6 Contingency. If HB 691-FN-LOCAL of the 2005 legislative session becomes law, then section 10 of that act, which amends RSA 318:42, XIII, shall not take effect.
274:7 Effective Date.
I. Section 5 of this act shall take effect 60 days after its passage.
II. Section 6 of this act shall take effect upon its passage.
III. The remainder of this act shall take effect January 1, 2006.
(Approved: July 22, 2005)
(Effective Date: I. Section 5 shall take effect September 20, 2005.
II. Section 6 shall take effect July 22, 2005.
III. Remainder shall take effect January 1, 2006)