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A08168 Summary:

BILL NOA08168
 
SAME ASSAME AS S07219
 
SPONSORKim
 
COSPNSR
 
MLTSPNSR
 
Add §2804-b, Pub Health L
 
Relates to creating a nursing home resident quality and safety study to study the implementation of a globally recognized frailty index score methodology in nursing homes in New York state.
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A08168 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          8168
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                      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:
 
     1    Section  1.  The  public health law is amended by adding a new section
     2  2804-b to read as follows:
     3    § 2804-b. Nursing home resident quality and safety study.  1.    Defi-
     4  nitions.    For  the purposes of this section, the following terms shall
     5  have the following meanings:
     6    (a) "Frailty index" means a globally recognized  methodology  used  to
     7  measure the health status of elderly individuals.
     8    (b)  "Frailty  score"  means  a  score given to an individual analyzed
     9  using the frailty index.
    10    (c) "The study" means the nursing home  resident  quality  and  safety
    11  study conducted pursuant to this section.
    12    (d) "Minimum data set" means a federally mandated process for clinical
    13  assessment  of  all  residents in Medicare or Medicaid certified nursing
    14  homes.
    15    (e) "The demonstration team" means a private business appointed by the
    16  commissioner that has the resources and technology available to  collect
    17  minimum data set data for all nursing homes in New York state for analy-
    18  sis, and to perform all tasks necessary for the completion of the study.
    19    (f)  "Nursing  home"  or "facility" means a nursing home as defined by
    20  section twenty-eight hundred one of this article.
    21    (g) "Applicant" means a nursing home that has submitted an application
    22  to participate in the study.
    23    (h) "Participating facility" means an applicant that has been approved
    24  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
 
     1    (i) "Control group" means the group of participating facilities acting
     2  as a control during the study by not implementing  the  use  of  frailty
     3  index methodology.
     4    (j)  "Intervention  group" means the group of participating facilities
     5  implementing the use of frailty index methodology.
     6    (k)  "Residential  health  care  facility  quality  incentive  payment
     7  program"  means the program established pursuant to section twenty-eight
     8  hundred one-f of this article.
     9    2. Nursing home resident quality and  safety  study  established.  The
    10  commissioner  shall  undertake  a  study  on the adoption of the frailty
    11  index methodology to improve the  quality  of  care  in  nursing  homes,
    12  achieve  better  outcomes  for nursing home residents, and help New York
    13  state more appropriately direct payments to providers based  on  quality
    14  performance, pursuant to this section.
    15    3.  Application and acceptance for participation. (a) The commissioner
    16  shall make available a method for nursing homes  to  apply  for  partic-
    17  ipation  in  the  study.  The  study  shall receive such applicants on a
    18  first-come first-serve basis.
    19    (b) The commissioner shall accept an  equal  number  of  nursing  home
    20  applicants for participation in the study from each department region.
    21    (c)  Applicants  accepted for participation in the study shall, at the
    22  time of submission of an application, have an occupancy rate of  seventy
    23  percent or greater.
    24    (d)  At  least twenty percent of applicants accepted for participation
    25  in the study shall be a non-profit or public facility.
    26    4. Categorization of data. Data from participating facilities shall be
    27  categorized as follows:
    28    (a) Facilities having:
    29    (i) three hundred beds or more;
    30    (ii) one hundred to two hundred ninety-nine beds; and
    31    (iii) ninety-nine beds or fewer;
    32    (b) Facilities operating:
    33    (i) as part of a hospital; and
    34    (ii) independently from a hospital; and
    35    (c) Facilities having a rating of:
    36    (i) one to two stars; and
    37    (ii) three to five stars.
    38    5. Control and intervention groups. Participating facilities shall  be
    39  divided  evenly into a control group and an intervention group.  Partic-
    40  ipating facilities in the control group shall  make  no  changes,  other
    41  than  reporting  data  as  directed by the commissioner.   Participating
    42  facilities in the intervention group shall implement frailty index meth-
    43  odology pursuant to this section.
    44    6. Demonstration team. (a) The  commissioner  shall  contract  with  a
    45  demonstration team, to perform all tasks necessary for the completion of
    46  the  study,  under  the direction of the commissioner. The demonstration
    47  team shall:
    48    (i) Train and provide certification in the frailty  index  methodology
    49  to staff in the intervention group, including but not limited to nurses'
    50  aides, nurses, physicians, therapists, dietary staff, recreation, social
    51  workers, managers, and administrative leaders;
    52    (ii)  Collect  minimum data set data for all participating facilities,
    53  and collect frailty score  data  from  facilities  in  the  intervention
    54  group;

        A. 8168                             3
 
     1    (iii)  Collect  performance  data  on  New York state quality measures
     2  included in the  residential  health  care  facility  quality  incentive
     3  payment program for all participating facilities; and
     4    (iv)  Track  nursing  home  resident information for all participating
     5  facilities including hospital transfers and  readmissions,  polypharmacy
     6  use,  falls, pain, pressure ulcers, and other information as directed by
     7  the commissioner.
     8    (b) The commissioner shall be authorized  to  pay  reasonable  compen-
     9  sation to the demonstration team within the limits provided by appropri-
    10  ation.
    11    7. Frailty index methodology training. (a) Staff certified and trained
    12  in  the  frailty index methodology pursuant to subparagraph (i) of para-
    13  graph (a) of subdivision six of this  section  shall  be  authorized  to
    14  train  staff  in nursing homes throughout the state in the frailty index
    15  methodology after the completion of the study.
    16    (b) Such training shall be conducted during off-hours, and participat-
    17  ing facilities shall cover the cost for such training. Such  participat-
    18  ing  facilities  shall  be reimbursed by the state for training expenses
    19  upon the completion of the study.
    20    (c) All participating facilities that complete the study shall receive
    21  a twenty-five percent discount from the state that shall be  applied  to
    22  frailty index methodology training of future employees.
    23    8.  Timeline  of the study. The study shall follow the following time-
    24  line:
    25    (a) Upon the effective date of this section,  the  commissioner  shall
    26  begin  accepting applications from nursing homes applying to participate
    27  in a study pursuant to subdivision three of this section;
    28    (b) On or before the thirtieth day after the effective  date  of  this
    29  section,  the commissioner shall have selected all participating facili-
    30  ties from applicants pursuant to subdivision three of this section,  and
    31  shall have appointed a demonstration team pursuant to subdivision six of
    32  this section;
    33    (c)  Beginning  the  sixtieth  day  after  the  effective date of this
    34  section, the demonstration team shall begin collecting minimum data  set
    35  data  from  participating  facilities from the prior year to establish a
    36  baseline performance for participating facilities;
    37    (d) On or before the one hundred twentieth  day  after  the  effective
    38  date  of this section, the demonstration team shall complete the frailty
    39  index  methodology  training  pursuant  to  subdivision  seven  of  this
    40  section;
    41    (e)  Beginning  on  the  one hundred twentieth day after the effective
    42  date of this section, participating facilities in the intervention group
    43  shall begin implementing the frailty index methodology;
    44    (f) Upon the  fourteenth  month  after  the  effective  date  of  this
    45  section,  the  demonstration  team  shall issue a report on the year-one
    46  results of the study to the governor, the speaker of the  assembly,  the
    47  temporary  president  of  the  senate,  and the chairs of the senate and
    48  assembly health and aging committees;
    49    (g) The study shall end upon the eighteenth month after the  effective
    50  date of this section; and
    51    (h)  Upon  the  twenty-first  month  after  the effective date of this
    52  section, the demonstration team shall issue a final report including the
    53  findings of  the  study  and  recommendations  for  future  legislative,
    54  program,  provider,  and  other stakeholder actions to the governor, the
    55  speaker of the assembly, the temporary president of the senate, and  the
    56  chairs of the senate and assembly health and aging committees.

        A. 8168                             4
 
     1    9.  Use  of  funds.  The commissioner shall be authorized to use funds
     2  received from the federal civil money penalty reinvestment  program  for
     3  the purposes of this section.
     4    §  2.  This  act shall take effect September 1, 2021, and shall expire
     5  and be deemed repealed 2 years after such date.
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