S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1856
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 23, 2023
                                ___________
 
 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.
                                                            LBD06040-01-3
              

 A. 1856                             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;
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   (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.
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   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, 2023, and shall expire
 and be deemed repealed 2 years after such date.