2010 Reform Law

The 2010 Reform Law

The 2010 nursing home reform law did the following 


1. It increased nursing home staffing. By January 1, 2014, nursing homes will be requried to have enough nursing staff (licensed nurses and certified nursing assistants) to provide 3.8 hours of care for every resident needing skiled care. The new law increases the previous requirement by a half. For more information,  see Minimum Staffing.  


2. Increased the number of Public Health surveyors (nursing home inspectors.) Public Health had so few surveyors, they could not enforce even existing laws, much less new ones. The number of Public Health surveyors is scheduled to more than double by 2013, although it will take years before the new surveyors are able to do their jobs without a lot of supervision. 


3. Changed the penalty structure and nursing home fines.  There is a new violation level and fine amount for nursing homes where violations cause the death of a resident, and higher amounts for other violations. Fines are doubled for violations deemed "high risk," and if nursing home staff lie to a surveyor or otherwise impede an investigation. It is also easier to deny new nursing home licenses to owners of bad nursing homes. Finally, the law strengthens the ability of the State to discipline nursing home administrators. 


4. Required Public Health to publish a quarterly list of really, really bad nursing homes. (The law calls them "distressed facilities."). The Department has not done this, yet. 


5. Required Public Health to establish a protocol for getting informed consent for psychotropic medications, and an informed consent form. The Department has not done this yet. They have asked for ICBC's help, and we are doing the research necessary to get this done. The law also requires prior approval from the state for Medicaid to pay for drugs that appear to violate the standards set by the federal government for     "unnecessary drugs" given to nursing home residents.  The state Medicaid agency has taken one step toward enforcing this requirement. 


6. Requires state oversight and permission before doing "experimental treatment" on a nursing home resident. 


7. Improves criminal background checks for nursing home residents. Improves the "dangerousness" assessment process for residents with felony convictions. 


8. Improves pre-screening for persons with a serious mental illness entering a nursing home, and requires periodic reassessment to see if nursing home care is needed. Requires improvements in nursing home care for these persons. There are still no rules implementing this requirement. 


9.  Requires Public Health to create a de-identified database of injuries inflicted by residents on other residents, staff or visitors, to enable an analysis of causes and possible preventive actions by nursing homes and the Department.  The Department did not want to do this, and has not created the database. 


10. Requires Public Health to create a protocol for caring for residents who have been sexually assaulted. This has been done. 


11. Creates "whistle-blower" protection for nursing home employees who report violations to a supervisor or to any public agency.