STATE OF NEW YORK
2021-2022 Regular Sessions
July 7, 2021
Introduced by M. of A. KIM -- read once and referred to the Committee on
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
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.
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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
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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-
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-
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
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.
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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.