MISSISSIPPI LEGISLATURE

2001 Regular Session

To: Public Health and Welfare

By: Senator(s) Huggins

Senate Bill 2350

(COMMITTEE SUBSTITUTE)

AN ACT TO AMEND SECTION 43-11-13, MISSISSIPPI CODE OF 1972, TO PROVIDE CERTAIN MINIMUM REQUIREMENTS RELATING TO THE LICENSURE OF PERSONAL CARE HOMES AND THE LICENSURE OF NURSING FACILITIES DESIGNATED AS ALZHEIMER'S/DEMENTIA CARE UNITS; TO PROVIDE FOR LICENSURE PURPOSES THAT NURSING FACILITIES DESIGNATED AS ALZHEIMER'S/DEMENTIA CARE UNITS SHALL DISCLOSE CERTAIN PROGRAM INFORMATION TO FAMILIES OF RESIDENTS; TO DIRECT THE STATE BOARD OF HEALTH TO ADOPT CERTAIN REGULATIONS REGARDING NURSING FACILITY PATIENT'S PERSONAL DEPOSIT ACCOUNTS AND THE USE OF PATIENT FOOD AND MEDICINE RECORDS IN NURSING FACILITIES; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 43-11-13, Mississippi Code of 1972, is amended as follows:

43-11-13. (1) The licensing agency shall adopt, amend, promulgate and enforce such rules, regulations and standards, including classifications, with respect to all institutions for the aged or infirm to be licensed hereunder as may be designed to further the accomplishment of the purpose of this chapter in promoting adequate care of individuals in such institutions in the interest of public health, safety and welfare. Such rules, regulations and standards shall be adopted and promulgated by the licensing agency and shall be recorded and indexed in a book to be maintained by the licensing agency in its main office in the State of Mississippi, entitled "Rules, Regulations and Minimum Standards for Institutions for the Aged or Infirm" and said book shall be open and available to all institutions for the aged or infirm and the public generally at all reasonable times. Upon the adoption of such rules, regulations and standards, the licensing agency shall mail copies thereof to all such institutions in the state which have filed with said agency their names and addresses for this purpose, but the failure to mail the same or the failure of the institutions to receive the same shall in nowise affect the validity thereof. Said rules, regulations and standards may be amended by the licensing agency from time to time as necessary to promote the health, safety and welfare of persons living in said institutions.

(2) The licensee shall keep posted in a conspicuous place on the licensed premises all current rules, regulations and minimum standards applicable to fire protection measures as adopted by the licensing agency. The licensee shall furnish to the licensing agency at least once each six (6) months a certificate of approval and inspection by state or local fire authorities. Failure to comply with state laws and/or municipal ordinances and current rules, regulations and minimum standards as adopted by the licensing agency, relative to fire prevention measures, shall be prima facie evidence for revocation of license.

(3) The State Board of Health shall promulgate rules and regulations restricting the storage, quantity and classes of drugs allowed in personal care homes. Residents requiring administration of Schedule II Narcotics as defined in the Uniform Controlled Substances Law may be admitted to a personal care home. Schedule drugs may only be allowed in a personal care home if they are administered or stored utilizing proper procedures under the direct supervision of a licensed physician or nurse.

(4) The State Board of Health shall promulgate rules and regulations providing for sufficient staff to meet the needs of residents in personal care homes. Personnel shall be employed and on duty, awake and fully dressed to provide personal care to the residents. The following staffing ratio shall apply: For Level I facilities: (a) one (1) resident attendant per ten (10) or fewer residents for the hours of 7 a.m. until 3 p.m.; (b) one (1) resident attendant per fifteen (15) or fewer residents for the hours of 3 p.m. until 11 p.m.; (c) one (1) resident attendant per twenty-five (25) or fewer residents for the hours of 11 p.m. until 7 a.m.; (d) Level I facilities shall have a licensed nurse on the premises from 7 a.m. until 7 p.m. and may be included in the resident attendant ratio; (e) for instances where a resident is unable to self-administer prescription medication during the 7 p.m. until 7 a.m. timeframe, a licensed nurse must be present to administer the prescription medication; and (f) nursing activities must comply with Mississippi Board of Nursing regulation. For Level II facilities: (a) one (1) resident attendant per ten (10) residents for the hours of 7 a.m. until 6 p.m.; and (b) sufficient staff shall be present to meet the personal care needs of the residents for the hours of 6 p.m. until 7 a.m.

(5) The State Board of Health shall promulgate rules and regulations providing for the designation and licensure of Alzheimer's/dementia care units which shall be no more restrictive than the following:

(a) The maximum number of residents in any freestanding Alzheimer's/dementia care unit shall be seventy-five (75) residents.

(b) The minimum requirements for nursing staff for an Alzheimer's/dementia care unit shall be based on the ratio of three (3.0) hours of nursing care per resident per twenty-four (24) hours.

(c) Admission criteria for residents in an Alzheimer's/dementia care unit shall provide that the resident may not be permanently bedfast, but may require assistance transferring to and from a wheelchair.

(d) Admission criteria for residents in an Alzheimer's/dementia care unit shall not require the resident to be continent; however, the staff shall be sufficiently trained to ensure that a toileting program is provided to maintain the functional ability of continent residents and to assess each resident to determine any additional continence support required.

(e) The nursing staff of an Alzheimer's/dementia care unit shall be authorized to deliver oral medication to residents which has been prescribed, including, but not limited to, the physical act of handing an oral prescription medication to the resident along with liquids to assist the resident in swallowing.

(6) The State Board of Health shall promulgate rules and regulations providing for the designation and licensure of Alzheimer's/dementia care units which shall include, at a minimum, that the following information shall be disclosed to families of residents at the time of admitting:

(a) The philosophy of the care and mission of the Alzheimer's/dementia care program;

(b) The criteria for placement in, and transfer or discharge of, residents from the program;

(c) The process used for assessment and establishment of the plan of care for the resident and its implementation;

(d) The procedures for staff training and continuing education;

(e) The facility design features that are intended to aid Alzheimer's/dementia residents;

(f) The frequency and types of resident activities, as well as family involvement; and

(g) The cost of care for the residents in such Alzheimer's/dementia units.

(7) The State Board of Health shall promulgate rules and regulations restricting the handling of a resident's personal deposits by the director of a nursing facility. Any funds given or provided for the purpose of supplying extra comforts, conveniences or services to any patient in any nursing facility, and any funds otherwise received and held from, for or on behalf of any such resident, shall be deposited by the director or other proper officer of the institution to the credit of that patient in an account which shall be known as the Resident's Personal Deposit Fund. No more than one (1) month charge for the care, support, maintenance and medical attention of the patient shall be applied from such account at any one (1) time. After the death, discharge or transfer of any resident for whose benefit any such fund has been provided, any unexpended balance remaining in his personal deposit fund shall be applied for the payment of care, cost of support, maintenance and medical attention which is accrued. In the event any unexpended balance remains in that resident's personal deposit fund after complete reimbursement has been made for payment of care, support, maintenance and medical attention, and the director or other proper officer of the institution has been or shall be unable to locate the person or persons entitled to such unexpended balance, the director or other proper officer may, after the lapse of one (1) year from the date of such death, discharge or transfer, deposit the unexpended balance to the credit of the institution's operating fund.

(8) The State Board of Health shall promulgate rules and regulations requiring nursing facilities to maintain a daily record of the food intake, diet, health condition, medicine dispensed and administered and any reaction to such medicine. The director of the nursing facility shall be responsible for explaining the availability of such records to the family of the resident at any time upon reasonable request.

SECTION 2. This act shall take effect and be in force from and after July 1, 2001.