§ 2803. Commissioner and council; powers and duties. 1. (a) The
commissioner shall have the power to inquire into the operation of
hospitals and to conduct periodic inspections of facilities with respect
to the fitness and adequacy of the premises, equipment, personnel, rules
and by-laws, standards of medical care, hospital service, including
health-related service, system of accounts, records, and the adequacy of
financial resources and sources of future revenues. The commissioner or
persons designated by him shall conduct at least one unannounced
comprehensive inspection of each residential health care facility not
later than fifteen months after the previous such inspection to
determine the adequacy of care being rendered. Such comprehensive
inspection shall include, but not be limited to, a survey to determine
compliance by the facility with applicable statutes and regulations, and
observation of a representative sample of all patients or residents and
their medical records to determine the quality and adequacy of the care
and treatment provided. Additional visits shall be made to facilities as
needed to determine whether violations or deficiencies have been
corrected, to investigate any report made pursuant to section
twenty-eight hundred three-d of this article or any other complaint, and
for any other purpose deemed necessary and appropriate by the
commissioner. Any employee of the department who gives or causes to be
given advance notice of such unannounced inspection to any unauthorized
person shall, in addition to any other penalty provided by law, be
suspended by the commissioner from all duties without pay for at least
five days or for such greater period of time as the commissioner shall
determine. Any such suspension shall be made by the commissioner in
accordance with all other applicable provisions of law.

(b) The purpose of such inspection shall be to determine compliance by
residential health care facilities with statutes, and with regulations
promulgated under the provisions of those statutes, governing minimum
standards of construction, quality and adequacy of care, rights of
patients, rates of payment and reimbursement. At least one such
inspection every fifteen months shall include, but shall not be limited
to, full on-site examination of the medical, nursing care, dietary and
social services records of the facility.

(c) The commissioner shall establish, in consultation with the state
office for the aging, a consumer information system for residential
health care facilities with respect to their compliance with the
standards set forth in this section designed to provide accurate and
comprehensible information to consumers on the quality of facilities
which shall incorporate a summary of the findings and results of the
inspections conducted pursuant to the provisions of this section. Such
summary of results and findings shall include, but need not be limited
to, a listing of areas in which items were found at the time of such
inspections to be not in compliance with such standards and the nature
of such non-compliance. Each residential health care facility shall be
issued a summary of the findings of inspections of such facility
conducted since the issuance of the previous summary of findings, which
shall be posted conspicuously within such facility, and any other
information relating to the facility available through the consumer
information system. The commissioner shall promulgate rules and
regulations necessary to implement the provisions of this paragraph. A
facility may appeal the accuracy of a summary findings to the
commissioner within twenty days after receipt of such summary. The
results and findings of any prior inspections, and any penalties thereby
assessed, which have not been previously appealed and overruled, shall
not be subject to review.

(d) (i) Notwithstanding any inconsistent provision of law, the
commissioner or his designee shall determine the necessity and
appropriateness of care and services provided by hospitals to patients
eligible for medical assistance pursuant to title eleven of article five
of the social services law and shall further determine whether a general
hospital has taken an action that results in the admission of patients
unnecessarily, unnecessary multiple admissions of the same patients,
inappropriate discharge of patients, inappropriate transfer of patients
between hospitals or between distinct units of a hospital, inappropriate
diagnosis-related group coding, or other inappropriate medical or other
practices with respect to hospitalized inpatients eligible for medical
assistance pursuant to title eleven of article five of the social
services law. In making such determinations the commissioner may utilize
the services of department personnel or other authorized
representatives. The hospitals shall provide such information,
facilities and services as may be required by the commissioner to make
such determinations. The commissioner, in implementing this paragraph,
shall adopt necessary rules and regulations including but not limited to
those for determining the necessity or appropriate level of admission,
controlling the length of stay, the provision of surgery and other
services, and the methods and procedures for making such determinations.

(ii) In the event the commissioner or his designee makes a
determination pursuant to this paragraph that a general hospital or
physician has taken an inappropriate action resulting in a denial or
adjustment of payment determined in accordance with section twenty-eight
hundred seven-c of this article, the general hospital or physician which
is the subject of such determination shall be entitled to a review
before the commissioner or an appeal agent designated for such purposes
by the commissioner at which such hospital or physician may challenge
such determination. In order to be entitled to such review, such
hospital or physician must provide the commissioner or his designee, as
appropriate, with a written request for such review within thirty days
of receipt of the written determination. During such review, the
hospital or physician may present documentation or evidence in support
of its challenge to the determination, and representatives of the
commissioner or his designee may present documentation or evidence in
support of the determination. In the event that the determination is
sustained, the hospital or physician may seek judicial review of the
decision pursuant to article seventy-eight of the civil practice law and
rules.

(iii) The commissioner shall certify to the social services officials
responsible for making payments for authorized hospital services that
specified items of care and services for specified individuals eligible
for medical assistance pursuant to title eleven of article five of the
social services law are inappropriate or unnecessary and are not
authorized for payment or are authorized for payment at the appropriate
level of care under the medical assistance program and, for general
hospitals, for rate periods beginning on or after January first,
nineteen hundred eighty-eight through March thirty-first, nineteen
hundred ninety-seven, at the appropriate case based rate of payment
determined pursuant to section twenty-eight hundred seven-c of this
article.

(e) Notwithstanding any inconsistent provision of law, the
commissioner or his designee shall, not later than July first, nineteen
hundred seventy-six, determine on an individual patient basis whether
identifiable periods of in-patient care in a general hospital are
required beyond the maximum length of stay established pursuant to
section three hundred sixty-five-a of the social services law, and
whether deferral of surgical procedures specified by such commissioner
in accordance with paragraph (c) of subdivision five of such section may
jeopardize life or essential function, or cause severe pain. In making
such determinations the commissioner may utilize the services of
department personnel or other authorized representatives. The hospitals
shall provide such information, facilities and services as may be
required by the commissioner to make such determinations. The
commissioner, in implementing this paragraph, shall adopt necessary
rules and regulations including but not limited to the methods and
procedures for making such determinations and the utilization of any
department staff or other authorized representatives located at such
hospital in performing other functions relating to assuring that public
funds for medical assistance are utilized exclusively to provide items
of care and services in amount, duration and scope specifically
authorized under the medical assistance program. The commissioner shall
certify to the social services officials responsible for making payments
for authorized hospital services that specified items of care and
services for specified individuals are not authorized for payment under
the medical assistance program.

(f) Notwithstanding any inconsistent provision of law, the
commissioner shall establish standards for determining the necessity of
care and service for alcoholism and alcohol abuse provided by hospitals.
In implementing this paragraph the commissioner, in consultation with
the director of the division of alcoholism and alcohol abuse, shall
adopt necessary rules and regulations including but not limited to those
for determining the necessity or appropriate level of admission,
controlling the length of stay, the provision of services and
establishing the methods and procedures for making such determinations.

(g) The commissioner shall require that every general hospital adopt
and make public an identical statement of the rights and
responsibilities of patients, in accordance with applicable law,
including, but not limited to:

(i) a patient complaint and quality of care review process;

(ii) a right to receive all information necessary to give informed
consent for any proposed intervention, procedure, or treatment,
including information regarding the foreseeable and clinically
significant risks and benefits of the proposed intervention, procedure,
or treatment;

(iii) a right to receive complete information regarding the patient's
condition, prognosis, and clinical indications for the proposed
intervention, procedure, or treatment;

(iv) a right to receive information regarding alternative treatment
options including the foreseeable and clinically significant risks and
benefits of such alternative treatment options, taking into
consideration any known preconditions;

(v) a right to be informed of the name, position, and functions of any
persons, including medical students and physicians exempt from New York
state licensure pursuant to section sixty-five hundred twenty-six of the
education law, who provide face-to-face care to or direct observation of
the patient;

(vi) a right to refuse the proposed intervention, procedure, or
treatment and to be informed of the clinical effects of such refusal;

(vii) a right to meaningfully engage and participate in the informed
consent process, which shall mean, but not be limited to, affording the
patient or their representative time to ask questions and have them
answered satisfactorily to the extent reasonable;

(viii) a right to be informed of any human subjects research that the
attending physician taking care of the patient participates in and may
directly affect a procedure or treatment to be received by the patient,
and to provide voluntary written informed consent to participate, should
the patient be an appropriate candidate for such human subjects research
in the clinical judgment of the attending physician. The informed
consent referred to here shall conform with federal requirements
regarding protection for human research subjects, and any other
applicable laws or regulations;

(ix) a right to an appropriate patient discharge plan; and

(x) for patients other than beneficiaries of title XVIII of the
federal social security act (medicare), a right to a discharge review in
accordance with section twenty-eight hundred three-i of this article.
The form and content of such statement shall be determined in accordance
with rules and regulations adopted by the council and approved by the
commissioner. A patient who requires continuing health care services in
accordance with such patient's discharge plan may not be discharged
until such services are secured or determined by the hospital to be
reasonably available to the patient. Each general hospital shall give a
copy of the statement to each patient, or the appointed personal
representative of the patient at or prior to the time of admission to
the general hospital, as long as the patient or the appointed personal
representative of the patient receives such notice no earlier than
fourteen days before admission. Such statement shall also be
conspicuously posted by the hospital and shall be a part of the
patient's admission package. Nothing herein contained shall be construed
to limit any authority vested in the commissioner pursuant to this
article related to the operation of hospitals and care and services
provided to patients.

* (h) Every hospital providing treatment to alleged victims of family
offenses as defined in article eight of the family court act and section
530.11 of the criminal procedure law shall be responsible for providing
a copy of a notice to victims of family offenses as described in section
eight hundred twelve of the family court act and subdivision six of
section 530.11 of the criminal procedure law. The commissioner shall
promulgate such rules and regulations as may be necessary and proper to
carry out effectively the provisions of this paragraph.

* NB There are 2 (h)'s

* (h) The statement regarding patient rights and responsibilities
which the commissioner shall approve as provided under paragraph (g) of
this subdivision shall include a provision stating that every patient
shall have the right to authorize those family members and other adults
who will be given priority to visit consistent with the patient's
ability to receive visitors.

* NB There are 2 (h)'s

(i) The statement regarding patient rights and responsibilities,
required pursuant to paragraph (g) of this subdivision, shall include
provisions informing the patient of his or her right to make organ,
tissue or whole body donations, and the means by which the patient may
make such a donation. The commissioner shall promulgate any rules and
regulations necessary to implement the provisions of this paragraph.

* (j) As used with regard to applicable regulations issued by the
department implementing the statement regarding patient rights and
responsibilities required pursuant to paragraph (g) of this subdivision,
the term "itemized bill" shall, for all periods on and after January
first, two thousand eleven, be defined as reflecting a charges schedule
developed by each hospital for all ancillary patient services, which
schedule shall set forth separate charges for each ancillary service
provided.

* NB There are 2 (j)'s

* (j) The commissioner shall require that the statement regarding
patient rights and responsibilities, described in paragraph (g) of this
subdivision, shall include a provision informing the patient of his or
her right to not be discriminated against on account of age.

* NB There are 2 (j)'s

(k) The statement regarding patient rights and responsibilities,
required pursuant to paragraph (g) of this subdivision, shall include
provisions informing the patient of his or her right to choose to submit
surprise bills or bills for emergency services to the independent
dispute process established in article six of the financial services
law, and informing the patient of his or her right to view a list of the
hospital's standard charges and the health plans the hospital
participates with consistent with section twenty-four of this chapter.

(l) The statement regarding patient rights and responsibilities,
required pursuant to paragraph (g) of this subdivision, shall include
provisions informing the patient of his or her right to choose to
identify a caregiver pursuant to article twenty-nine-cccc of this
chapter.

2. (a) The council, by a majority vote of its members, shall adopt and
amend rules and regulations, subject to the approval of the
commissioner, to effectuate the provisions and purposes of this article,
including, but not limited to:

(i) the establishment of requirements for a uniform statewide system
of reports and audits relating to the quality of medical and physical
care provided, hospital utilization, and costs in accordance with
section twenty-eight hundred three-b of this article,

(ii) establishment by the department of schedules of rates, payments,
reimbursements, grants and other charges for hospital and health-related
services as provided in sections twenty-eight hundred seven,
twenty-eight hundred seven-a, twenty-eight hundred seven-c and
twenty-eight hundred eight of this article. The schedules established
shall be reasonable and adequate to meet the costs which must be
incurred by efficiently and economically operated facilities. In
adopting regulations related to the computation of general hospital
inpatient payments, the council shall take into consideration the
elements of cost, geographical differentials in the elements of cost
considered, economic factors in the area in which the hospital is
located, costs of hospitals of comparable size, and the need for
incentives to improve services and institute economies. The council
shall exclude from consideration in the regulations adopted nonallowable
costs such as the costs for research and those parts of the costs for
educational salaries which the council determines to be not directly
related to hospital service,

(iii) the identification of appropriate and reasonable standards for
the development of acceptable collection procedures used by general
hospitals in an effort to collect unpaid bills prior to the
determination that the unpaid bill is a bad debt eligible for
reimbursement consideration pursuant to paragraphs (e) and (f) of
subdivision eight of section twenty-eight hundred seven-a or paragraph
(b) of subdivision fourteen of section twenty-eight hundred seven-c and
twenty-eight hundred seven-k of this article,

(iv) subject to the provisions of paragraph (e) of subdivision eleven
of section twenty-eight hundred seven-a of this article or subdivision
nine of section twenty-eight hundred seven-c of this article, the
establishment of guidelines regarding the time to resolve appeals
submitted by general hospitals. The council may consider different
periods depending upon whether the basis for the appeal is related to a
general hospital's existing costs or anticipated future costs,

(v) standards and procedures relating to hospital operating
certificates, provided however, that the council shall establish minimum
acceptable standards and procedures equal to the standards and
procedures which federal law and regulation require for hospitals to
qualify as providers pursuant to titles XVIII and XIX of the federal
social security act. The existing state standards and procedures in
effect on the date that this subdivision becomes effective shall be
deemed to constitute maximum standards and procedures for purposes of
limiting medical assistance reimbursement pursuant to the social
services law. Such standards and procedures may thereafter be changed or
added to by the council only upon the recommendation of the
commissioner. For the purposes of ensuring that the health and safety of
the residents of hospitals are not endangered, the council may
promulgate changes in the minimum acceptable standards and procedures
referred to herein upon recommendation of the commissioner, and

(vi) the establishment of a system of accounts and cost findings to be
used by hospitals, including a classification of such hospitals and the
prescription of a system of accounts and cost finding for each class in
accordance with sections twenty-eight hundred three-b and twenty-eight
hundred five-a of this article.

(b) The commissioner may propose rules and regulations and amendments
thereto for consideration by the council.

3. The commissioner may enter into contracts with any political
subdivision, voluntary non-profit agency or health systems agency and
such entities are authorized to enter into contracts with the
commissioner to effectuate the purposes of this article, however,
contracts with voluntary non-profit agencies may not provide for payment
for general hospital out-patient and emergency services or for treatment
or diagnostic center services unless the commissioner is satisfied that
the costs incurred for such services are approvable pursuant to the
provisions of section twenty-eight hundred seven of this article.

4. At the request of the commissioner, hospitals shall furnish to the
department such reports and information as it may require to effectuate
the provisions of this article.

5. The commissioner may institute or cause to be instituted in a court
of competent jurisdiction proceedings to compel compliance with the
provisions of this article or the determinations, rules, regulations and
orders of the commissioner or the council.

6. The council, by a majority vote of its members and subject to the
approval of the commissioner, shall adopt rules and regulations to
establish (a) a system of penalties of up to one thousand dollars per
day for continuing violations of rules and regulations promulgated
pursuant to article twenty-eight of this chapter and pertaining to
patient care by residential health care facilities, specifying the
violations and the amount of the penalty to be assessed in connection
with each such violation, and (b) a system by which the rate of payment
approved for a residential health care facility pursuant to section
twenty-eight hundred seven of this chapter and certified to the
department of social services for purposes of reimbursement in the
medical assistance program, is reduced in sufficient amount to collect
such penalties. Any reduction of rate to collect penalties shall be
limited to five percent of the otherwise established per diem rate or
that portion of the per diem rate which represents the owner's return on
equity, as defined by regulation, whichever is less.

7. The commissioner shall have the power to assess penalties in
accordance with the system of penalties adopted pursuant to subdivision
six of this section and pursuant to a hearing conducted in accordance
with section twelve-a of this chapter. No penalty shall be assessed
pursuant to subdivision six of this section unless the facility has
received at least thirty days written notice of the existence of the
violation, the amount of the penalty for which it may become liable and
the steps which must be taken to rectify the violation. If the facility
fails to rectify the violation within said thirty day period, it shall
thereafter be liable for such penalty. Any such penalties shall be
subject to release and compromise by the commissioner in the same manner
as a penalty provided by subdivision one of section twelve of this
chapter. Any penalty assessed pursuant to subdivision six of this
section shall be subject to recovery in the same manner as a penalty
provided by subdivision one of section twelve of this chapter or
pursuant to the system for reduction of the rate of payment to the
facility adopted pursuant to clause (b) of subdivision six of this
section. Any such penalty assessed pursuant to subdivision six of this
section shall be additional and cumulative to all other penalties or
remedies existing for violations of rules and regulations promulgated
pursuant to article twenty-eight of this chapter. The provisions of this
subdivision shall not be applicable to nor limit any power to assess
penalties pursuant to section twelve of this chapter; provided, however,
that if a penalty is assessed for a violation pursuant to this
subdivision, no penalty shall be assessed for such violation pursuant to
section twelve of this chapter, and if a penalty is assessed for a
violation pursuant to section twelve of this chapter, no penalty shall
be assessed for such violation pursuant to this subdivision.

8. (a) Notwithstanding any inconsistent provision of law, the
commissioner shall establish procedures to be followed by hospitals for
notification to mothers and reporting under section three hundred
sixty-six-g of the social services law.

(b) Notwithstanding any inconsistent provision of section twelve of
this chapter or any other law, the commissioner may impose a civil
penalty of up to three thousand five hundred dollars for each violation
of the requirements of subdivision one of section three hundred
sixty-six-g of the social services law or the rules and regulations
promulgated pursuant to such section, pertaining to reporting to the
department, or such other entity designated by the department, of each
live birth to a woman receiving medical assistance. Any such civil
penalties shall be assessed subject to the applicable provisions of
sections twelve and twelve-a of this chapter.

8-a. Notwithstanding any inconsistent provision of law to the
contrary, the commissioner shall develop a program to facilitate the use
of a triage system of care in emergency rooms of hospitals that are
subject to the provisions of this article. In developing such program
the commissioner shall consider the manner in which such a system would
be coordinated, how such a system would provide greater efficiency,
provide cost savings to public health programs and a higher quality of
care. Within one year from the enactment of such program, the
commissioner shall submit a report to the temporary president of the
senate and the speaker of the assembly regarding: the impact of such a
system on the cost of Medicaid covered services in the hospital setting;
quality of care in facilities; along with any other data as may be
appropriate.

9. (a) General hospitals shall, no later than April first, two
thousand, submit to the commissioner a plan for compliance with part
four hundred five of the official compilation of codes, rules and
regulations of the state of New York regarding the working conditions of
and limits on working hours for certain members of a hospital's medical
staff and postgraduate trainees in such form and manner as specified by
the commissioner.

(b) The commissioner shall audit each hospital for compliance with its
plan and the applicable regulation on an annual basis. Based upon an
initial written audit finding of noncompliance the commissioner shall
assess a civil penalty of six thousand dollars for each instance of
noncompliance identified in such initial audit.

(c) Within thirty days after the hospital's receipt of written notice
of noncompliance the hospital shall submit a plan of correction in such
form and manner as specified by the commissioner for achieving
compliance with its plan and with the applicable regulations. The
commissioner shall audit each such hospital for compliance with its plan
and the applicable regulations within a reasonable time after submission
of such plan of correction. Upon a written finding by the commissioner
within one hundred eighty days of the initial audit finding of
noncompliance that the hospital has failed to substantially adhere to
its plan of correction the commissioner shall assess the hospital a
civil penalty of twenty-five thousand dollars. Upon a further subsequent
written finding by the commissioner within one hundred eighty days of
the initial audit finding of noncompliance that the hospital has failed
to substantially adhere to its plan of correction the commissioner shall
assess the hospital a civil penalty of fifty thousand dollars. Upon each
and every subsequent written finding by the commissioner within three
hundred sixty days of the initial audit finding of noncompliance that
the hospital has failed to substantially adhere to its plan of
correction the commissioner shall assess the hospital a civil penalty of
fifty thousand dollars.

(d) The penalties assessed pursuant to paragraph (c) of this
subdivision shall be subject to the provisions of section twelve-a of
this chapter.

(e) Hospitals shall submit to the commissioner any data necessary to
perform audits pursuant to this subdivision. Any hospital which fails to
produce data or documentation requested in furtherance of such audit
within thirty days of such request may be assessed by the commissioner a
civil penalty of ten thousand dollars.

10. (a) All civil penalties assessed and collected pursuant to section
twelve of this chapter for violations of this article and regulations
promulgated thereunder related to the operation of residential health
care facilities, and all civil monetary penalties related to the
operation of nursing facilities received from the federal government in
accordance with subdivision (h) of section nineteen hundred nineteen of
the federal social security act, shall be deposited by the commissioner
and credited to the quality of care improvement account which shall be
established by the comptroller in the special revenue fund-other. To the
extent of funds appropriated therefor, funds shall be made available to
the department for expenditures related to the protection of the health
or property of residents of residential health care facilities that are
found to be deficient.

(b) Any funds available pursuant to paragraph (a) of this subdivision,
not used for the purposes of paragraph (a) of this subdivision, shall be
used, at the commissioner's discretion, to support activities and
initiatives intended to improve resident quality of care at residential
health care facilities found to be deficient, as well as for such other
purposes as are described in this paragraph. Such activities may
include, but are not limited to, relocation of residents to other
facilities and the maintenance and operation of a facility pending
correction of deficiencies or closure. The commissioner may also make
grants to residential health care facilities that support facilities'
activities and initiatives intended to improve residential quality of
care pursuant to a request for proposals process.

* 11. (a) The commissioner shall make regulations relating to
midwifery birth centers, including relating to establishment,
construction, and operation, considering the standards of state and
national professional associations of midwifery birth centers, in
consultation with representatives of midwives, midwifery birth centers,
and general hospitals providing obstetric services.

(b) (i) As used in this subdivision, "accrediting organization" means
a national accrediting organization that provides accreditation to
midwifery birth centers, recognized by the commissioner in consultation
with representatives of midwives, midwifery birth centers, and general
hospitals providing obstetric services. The commissioner shall not
unreasonably withhold recognition of an organization seeking to be
recognized under this paragraph.

(ii) Where a proposed midwifery birth center demonstrates the intent
and capability to obtain and maintain accreditation by an accrediting
organization, and fully completes and files an application with the
public health and health planning council on forms provided by the
department, it shall be deemed upon approval of the public health and
health planning council to meet the requirements of this article for a
midwifery birth center for approval of a certificate of incorporation,
articles of organization and establishment, contingent on obtaining and
maintaining that accreditation. Notwithstanding any other provision of
this article to the contrary, such application to the public health and
health planning council shall include information to: (A) satisfy the
character and competence criteria found in subdivision three of section
twenty-eight hundred one-a of this article; (B) demonstrate that the
legal structure of the proposed operator of the midwifery birth center
complies with the requirements for establishment of hospitals under
section twenty-eight hundred one-a of this article; (C) evidence the
capability to fund any acquisition, renovations, and construction costs;
and (D) demonstrate that the premises and equipment comply with required
life safety and building standards necessary to protect the life, safety
and welfare of patients and staff. Upon receipt of a completed
application, the department shall schedule such application for
consideration at the next available and appropriate committee meeting by
the public health and health planning council. If the department
receives an incomplete application, the department shall communicate
with the applicant until such time as the application is completed and
filed with the public health and health planning council for its
approval or disapproval, or the applicant withdraws the application.

(iii) Regulations and requirements of the commissioner under paragraph
(a) of this subdivision for approval of a certificate of incorporation,
articles of organization, establishment, and operation of a midwifery
birth center established or seeking to be established under this
article, including a determination of public need and compliance with
operational and physical plant standards, shall not be inconsistent
with: (A) article one hundred forty of the education law; (B) the
standards of the accrediting organization from which the midwifery birth
center proposes to seek, seeks or has obtained accreditation; (C) life
safety code or other building standards the commissioner deems necessary
to protect the life, safety and welfare of patients and staff; and (D)
subparagraph (ii) of this paragraph. Regulations, requirements and
guidance under this subparagraph shall be made by the commissioner after
consultation with representatives of midwives, midwifery birth centers,
and general hospitals providing obstetric services. To the extent any of
the standards in this subparagraph conflict, the commissioner shall
accommodate or modify the application of any standard to harmonize and
maximize the intent of the standards.

* NB There are 2 sb 11's

* 11. Notwithstanding any provision of this article, or any rule or
regulation under this article to the contrary, the commissioner shall
allow outpatient clinics of general hospitals and diagnostic and
treatment centers to provide off-site primary care services that are:

(a) primary care services ordinarily provided to patients on-site at
the outpatient clinic or diagnostic and treatment center and are not
home care services defined in subdivision one of section thirty-six
hundred two of this chapter or the professional services enumerated in
subdivision two of such section;

(b) provided by a primary care professional to a patient with a
pre-existing clinical relationship with the outpatient clinic or
diagnosis and treatment center, or with the health care professional
providing the service; and

(c) provided to a patient who is unable to leave his or her residence
to receive services at the outpatient clinic or diagnostic and treatment
center without unreasonable difficulty due to circumstances, including
but not limited to, clinical impairment.

Nothing in this subdivision shall preclude a federally qualified
health center from providing off-site services in accordance with
department regulations.

* NB There are 2 sb 11's

12. (a) Each residential health care facility shall, no later than
ninety days after the effective date of this subdivision and annually
thereafter, or more frequently as may be directed by the commissioner,
prepare and make available to the public on the facility's website, and
immediately upon request, in a form acceptable to the commissioner, a
pandemic emergency plan which shall include but not be limited to:

(i) a communication plan:

(A) to update authorized family members and resident representatives
of infected residents at least once per day and upon a change in a
resident's condition and at least once a week to update all residents
and authorized families and resident representatives on the number of
infections and deaths at the facility, and to update all residents,
authorized family members, and resident representatives at the facility
not later than five o'clock p.m. the next calendar day following the
detection of a confirmed infection of a resident or staff member, or at
such earlier time as guidance from the federal centers for Medicaid and
medicare services or centers for disease control and prevention may
provide, by electronic or such other means as may be selected by each
resident, authorized family member or resident representative; and

(B) that includes a method to provide all residents with daily access,
at no cost, to remote videoconference or equivalent communication
methods with family members and guardians; and

(C) that includes a method, consistent with any guidance and
regulations issued by the commissioner, to provide all residents with
access, at no cost, to state long-term care ombudsman program staff and
volunteers, and that provides state long-term care ombudsman program
staff and volunteers with access to the facility; and

(ii) protection plans against infection for staff, residents and
families, including:

(A) a plan for hospitalized residents to be readmitted to such
residential health care facility after treatment, in accordance with all
applicable laws and regulations; and

(B) a plan for such residential health care facility to maintain or
contract to have at least a two-month supply of personal protective
equipment; and

(C) a plan or procedure, consistent with any guidance issued by the
federal centers for Medicaid and medicare services or centers for
disease control and prevention, for placement or grouping of residents
within a facility to reduce transmission of the pandemic disease during
an infectious disease outbreak in the residential health care facility;
and

(iii) a plan for preserving a resident's place in a residential health
care facility if such resident is hospitalized, in accordance with all
applicable laws and regulations.

(b) The residential health care facility shall prepare and comply with
the pandemic emergency plan. Failure to do so shall be a violation of
this subdivision and may be subject to civil penalties pursuant to
section twelve and twelve-b of this chapter. The commissioner shall
review each residential health care facility for compliance with its
plan and the applicable regulations in accordance with paragraphs (a)
and (b) of subdivision one of this section.

(c) Within thirty days after the residential health care facility's
receipt of written notice of noncompliance such residential health care
facility shall submit a plan of correction in such form and manner as
specified by the commissioner for achieving compliance with its plan and
with the applicable regulations. The commissioner shall ensure each such
residential health care facility complies with its plan of correction
and the applicable regulations.

(d) The commissioner shall promulgate any rules and regulations
necessary to implement the provisions of this subdivision.

13. The commissioner shall require each residential health care
facility to provide residents and their families with a separate
document, as part of an intake application, in no less than twelve-point
font, that includes information on how a potential resident and their
family members can look up complaints, citations, inspections,
enforcement actions, and penalties taken against the facility including
the web address for the New York state nursing home profiles website
that is maintained by the department and the nursing home compare
website maintained by the United States department of health and human
services, if applicable.

14. (a) The commissioner, in consultation with the state long-term
care ombudsman, shall establish policies and procedures for: (i)
reporting to the department, by staff and volunteers of the long-term
care ombudsman program, on issues identified or witnessed by such staff
and volunteers that relate to actions, inactions or decisions that may
adversely affect the health, safety and welfare of residents at
residential health care facilities licensed or certified by the
department in this state. Such policies and procedures shall include,
but not be limited to, establishing a telephone hotline number and
reporting form on the department's website for use by long-term care
ombudsman program staff and volunteers for the submission of reports;

(ii) timely and regular resolution to any such issues reported to the
department pursuant to subparagraph (i) of this paragraph. No later than
sixty days after the receipt of any such issue, the department shall
provide the state long-term care ombudsman a report on the status of
such issue. Following the initial report, the department shall provide
additional reports to the state long-term care ombudsman no less than
every ninety days thereafter until such issue is resolved. Upon
resolution of such issue, the department shall provide a timely report
to the state long-term care ombudsman indicating the manner in which the
issue was resolved; and

(iii) requiring the department to notify the local ombudsman entity as
defined in paragraph (c) of subdivision one of section two hundred
eighteen of the elder law after the department conducts a
recertification survey of a facility.

(b) Nothing in this subdivision shall be construed to limit in any way
a resident's right to privacy and confidentiality pursuant to the
regulations of the long-term care ombudsman program or the right to
refuse to consent to the involvement of the long-term care ombudsman.

(c) As used in this subdivision: (i) "resolution" shall mean closure
of a complaint by the department, whether closed as substantiated or
unsubstantiated; and (ii) "status" shall mean whether the complaint has
been assigned to department staff for investigation, whether the
complaint remains open under active investigation, or whether the
complaint has reached resolution.