S T A T E O F N E W Y O R K
________________________________________________________________________
8168
2021-2022 Regular Sessions
I N A S S E M B L Y
July 7, 2021
___________
Introduced by M. of A. KIM -- read once and referred to the Committee on
Health
AN ACT to amend the public health law, in relation to creating a nursing
home resident quality and safety study; and providing for the repeal
of such provisions upon expiration thereof
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The public health law is amended by adding a new section
2804-b to read as follows:
§ 2804-B. NURSING HOME RESIDENT QUALITY AND SAFETY STUDY. 1. DEFI-
NITIONS. FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL
HAVE THE FOLLOWING MEANINGS:
(A) "FRAILTY INDEX" MEANS A GLOBALLY RECOGNIZED METHODOLOGY USED TO
MEASURE THE HEALTH STATUS OF ELDERLY INDIVIDUALS.
(B) "FRAILTY SCORE" MEANS A SCORE GIVEN TO AN INDIVIDUAL ANALYZED
USING THE FRAILTY INDEX.
(C) "THE STUDY" MEANS THE NURSING HOME RESIDENT QUALITY AND SAFETY
STUDY CONDUCTED PURSUANT TO THIS SECTION.
(D) "MINIMUM DATA SET" MEANS A FEDERALLY MANDATED PROCESS FOR CLINICAL
ASSESSMENT OF ALL RESIDENTS IN MEDICARE OR MEDICAID CERTIFIED NURSING
HOMES.
(E) "THE DEMONSTRATION TEAM" MEANS A PRIVATE BUSINESS APPOINTED BY THE
COMMISSIONER THAT HAS THE RESOURCES AND TECHNOLOGY AVAILABLE TO COLLECT
MINIMUM DATA SET DATA FOR ALL NURSING HOMES IN NEW YORK STATE FOR ANALY-
SIS, AND TO PERFORM ALL TASKS NECESSARY FOR THE COMPLETION OF THE STUDY.
(F) "NURSING HOME" OR "FACILITY" MEANS A NURSING HOME AS DEFINED BY
SECTION TWENTY-EIGHT HUNDRED ONE OF THIS ARTICLE.
(G) "APPLICANT" MEANS A NURSING HOME THAT HAS SUBMITTED AN APPLICATION
TO PARTICIPATE IN THE STUDY.
(H) "PARTICIPATING FACILITY" MEANS AN APPLICANT THAT HAS BEEN APPROVED
BE THE COMMISSIONER TO PARTICIPATE IN THE STUDY.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11746-01-1
A. 8168 2
(I) "CONTROL GROUP" MEANS THE GROUP OF PARTICIPATING FACILITIES ACTING
AS A CONTROL DURING THE STUDY BY NOT IMPLEMENTING THE USE OF FRAILTY
INDEX METHODOLOGY.
(J) "INTERVENTION GROUP" MEANS THE GROUP OF PARTICIPATING FACILITIES
IMPLEMENTING THE USE OF FRAILTY INDEX METHODOLOGY.
(K) "RESIDENTIAL HEALTH CARE FACILITY QUALITY INCENTIVE PAYMENT
PROGRAM" MEANS THE PROGRAM ESTABLISHED PURSUANT TO SECTION TWENTY-EIGHT
HUNDRED ONE-F OF THIS ARTICLE.
2. NURSING HOME RESIDENT QUALITY AND SAFETY STUDY ESTABLISHED. THE
COMMISSIONER SHALL UNDERTAKE A STUDY ON THE ADOPTION OF THE FRAILTY
INDEX METHODOLOGY TO IMPROVE THE QUALITY OF CARE IN NURSING HOMES,
ACHIEVE BETTER OUTCOMES FOR NURSING HOME RESIDENTS, AND HELP NEW YORK
STATE MORE APPROPRIATELY DIRECT PAYMENTS TO PROVIDERS BASED ON QUALITY
PERFORMANCE, PURSUANT TO THIS SECTION.
3. APPLICATION AND ACCEPTANCE FOR PARTICIPATION. (A) THE COMMISSIONER
SHALL MAKE AVAILABLE A METHOD FOR NURSING HOMES TO APPLY FOR PARTIC-
IPATION IN THE STUDY. THE STUDY SHALL RECEIVE SUCH APPLICANTS ON A
FIRST-COME FIRST-SERVE BASIS.
(B) THE COMMISSIONER SHALL ACCEPT AN EQUAL NUMBER OF NURSING HOME
APPLICANTS FOR PARTICIPATION IN THE STUDY FROM EACH DEPARTMENT REGION.
(C) APPLICANTS ACCEPTED FOR PARTICIPATION IN THE STUDY SHALL, AT THE
TIME OF SUBMISSION OF AN APPLICATION, HAVE AN OCCUPANCY RATE OF SEVENTY
PERCENT OR GREATER.
(D) AT LEAST TWENTY PERCENT OF APPLICANTS ACCEPTED FOR PARTICIPATION
IN THE STUDY SHALL BE A NON-PROFIT OR PUBLIC FACILITY.
4. CATEGORIZATION OF DATA. DATA FROM PARTICIPATING FACILITIES SHALL BE
CATEGORIZED AS FOLLOWS:
(A) FACILITIES HAVING:
(I) THREE HUNDRED BEDS OR MORE;
(II) ONE HUNDRED TO TWO HUNDRED NINETY-NINE BEDS; AND
(III) NINETY-NINE BEDS OR FEWER;
(B) FACILITIES OPERATING:
(I) AS PART OF A HOSPITAL; AND
(II) INDEPENDENTLY FROM A HOSPITAL; AND
(C) FACILITIES HAVING A RATING OF:
(I) ONE TO TWO STARS; AND
(II) THREE TO FIVE STARS.
5. CONTROL AND INTERVENTION GROUPS. PARTICIPATING FACILITIES SHALL BE
DIVIDED EVENLY INTO A CONTROL GROUP AND AN INTERVENTION GROUP. PARTIC-
IPATING FACILITIES IN THE CONTROL GROUP SHALL MAKE NO CHANGES, OTHER
THAN REPORTING DATA AS DIRECTED BY THE COMMISSIONER. PARTICIPATING
FACILITIES IN THE INTERVENTION GROUP SHALL IMPLEMENT FRAILTY INDEX METH-
ODOLOGY PURSUANT TO THIS SECTION.
6. DEMONSTRATION TEAM. (A) THE COMMISSIONER SHALL CONTRACT WITH A
DEMONSTRATION TEAM, TO PERFORM ALL TASKS NECESSARY FOR THE COMPLETION OF
THE STUDY, UNDER THE DIRECTION OF THE COMMISSIONER. THE DEMONSTRATION
TEAM SHALL:
(I) TRAIN AND PROVIDE CERTIFICATION IN THE FRAILTY INDEX METHODOLOGY
TO STAFF IN THE INTERVENTION GROUP, INCLUDING BUT NOT LIMITED TO NURSES'
AIDES, NURSES, PHYSICIANS, THERAPISTS, DIETARY STAFF, RECREATION, SOCIAL
WORKERS, MANAGERS, AND ADMINISTRATIVE LEADERS;
(II) COLLECT MINIMUM DATA SET DATA FOR ALL PARTICIPATING FACILITIES,
AND COLLECT FRAILTY SCORE DATA FROM FACILITIES IN THE INTERVENTION
GROUP;
A. 8168 3
(III) COLLECT PERFORMANCE DATA ON NEW YORK STATE QUALITY MEASURES
INCLUDED IN THE RESIDENTIAL HEALTH CARE FACILITY QUALITY INCENTIVE
PAYMENT PROGRAM FOR ALL PARTICIPATING FACILITIES; AND
(IV) TRACK NURSING HOME RESIDENT INFORMATION FOR ALL PARTICIPATING
FACILITIES INCLUDING HOSPITAL TRANSFERS AND READMISSIONS, POLYPHARMACY
USE, FALLS, PAIN, PRESSURE ULCERS, AND OTHER INFORMATION AS DIRECTED BY
THE COMMISSIONER.
(B) THE COMMISSIONER SHALL BE AUTHORIZED TO PAY REASONABLE COMPEN-
SATION TO THE DEMONSTRATION TEAM WITHIN THE LIMITS PROVIDED BY APPROPRI-
ATION.
7. FRAILTY INDEX METHODOLOGY TRAINING. (A) STAFF CERTIFIED AND TRAINED
IN THE FRAILTY INDEX METHODOLOGY PURSUANT TO SUBPARAGRAPH (I) OF PARA-
GRAPH (A) OF SUBDIVISION SIX OF THIS SECTION SHALL BE AUTHORIZED TO
TRAIN STAFF IN NURSING HOMES THROUGHOUT THE STATE IN THE FRAILTY INDEX
METHODOLOGY AFTER THE COMPLETION OF THE STUDY.
(B) SUCH TRAINING SHALL BE CONDUCTED DURING OFF-HOURS, AND PARTICIPAT-
ING FACILITIES SHALL COVER THE COST FOR SUCH TRAINING. SUCH PARTICIPAT-
ING FACILITIES SHALL BE REIMBURSED BY THE STATE FOR TRAINING EXPENSES
UPON THE COMPLETION OF THE STUDY.
(C) ALL PARTICIPATING FACILITIES THAT COMPLETE THE STUDY SHALL RECEIVE
A TWENTY-FIVE PERCENT DISCOUNT FROM THE STATE THAT SHALL BE APPLIED TO
FRAILTY INDEX METHODOLOGY TRAINING OF FUTURE EMPLOYEES.
8. TIMELINE OF THE STUDY. THE STUDY SHALL FOLLOW THE FOLLOWING TIME-
LINE:
(A) UPON THE EFFECTIVE DATE OF THIS SECTION, THE COMMISSIONER SHALL
BEGIN ACCEPTING APPLICATIONS FROM NURSING HOMES APPLYING TO PARTICIPATE
IN A STUDY PURSUANT TO SUBDIVISION THREE OF THIS SECTION;
(B) ON OR BEFORE THE THIRTIETH DAY AFTER THE EFFECTIVE DATE OF THIS
SECTION, THE COMMISSIONER SHALL HAVE SELECTED ALL PARTICIPATING FACILI-
TIES FROM APPLICANTS PURSUANT TO SUBDIVISION THREE OF THIS SECTION, AND
SHALL HAVE APPOINTED A DEMONSTRATION TEAM PURSUANT TO SUBDIVISION SIX OF
THIS SECTION;
(C) BEGINNING THE SIXTIETH DAY AFTER THE EFFECTIVE DATE OF THIS
SECTION, THE DEMONSTRATION TEAM SHALL BEGIN COLLECTING MINIMUM DATA SET
DATA FROM PARTICIPATING FACILITIES FROM THE PRIOR YEAR TO ESTABLISH A
BASELINE PERFORMANCE FOR PARTICIPATING FACILITIES;
(D) ON OR BEFORE THE ONE HUNDRED TWENTIETH DAY AFTER THE EFFECTIVE
DATE OF THIS SECTION, THE DEMONSTRATION TEAM SHALL COMPLETE THE FRAILTY
INDEX METHODOLOGY TRAINING PURSUANT TO SUBDIVISION SEVEN OF THIS
SECTION;
(E) BEGINNING ON THE ONE HUNDRED TWENTIETH DAY AFTER THE EFFECTIVE
DATE OF THIS SECTION, PARTICIPATING FACILITIES IN THE INTERVENTION GROUP
SHALL BEGIN IMPLEMENTING THE FRAILTY INDEX METHODOLOGY;
(F) UPON THE FOURTEENTH MONTH AFTER THE EFFECTIVE DATE OF THIS
SECTION, THE DEMONSTRATION TEAM SHALL ISSUE A REPORT ON THE YEAR-ONE
RESULTS OF THE STUDY TO THE GOVERNOR, THE SPEAKER OF THE ASSEMBLY, THE
TEMPORARY PRESIDENT OF THE SENATE, AND THE CHAIRS OF THE SENATE AND
ASSEMBLY HEALTH AND AGING COMMITTEES;
(G) THE STUDY SHALL END UPON THE EIGHTEENTH MONTH AFTER THE EFFECTIVE
DATE OF THIS SECTION; AND
(H) UPON THE TWENTY-FIRST MONTH AFTER THE EFFECTIVE DATE OF THIS
SECTION, THE DEMONSTRATION TEAM SHALL ISSUE A FINAL REPORT INCLUDING THE
FINDINGS OF THE STUDY AND RECOMMENDATIONS FOR FUTURE LEGISLATIVE,
PROGRAM, PROVIDER, AND OTHER STAKEHOLDER ACTIONS TO THE GOVERNOR, THE
SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE, AND THE
CHAIRS OF THE SENATE AND ASSEMBLY HEALTH AND AGING COMMITTEES.
A. 8168 4
9. USE OF FUNDS. THE COMMISSIONER SHALL BE AUTHORIZED TO USE FUNDS
RECEIVED FROM THE FEDERAL CIVIL MONEY PENALTY REINVESTMENT PROGRAM FOR
THE PURPOSES OF THIS SECTION.
§ 2. This act shall take effect September 1, 2021, and shall expire
and be deemed repealed 2 years after such date.