PRIOR PRINTER'S NO. 3114 PRINTER'S NO. 4025
No. 2182 Session of 2008
INTRODUCED BY STABACK, BELFANTI, BIANCUCCI, BLACKWELL, BOBACK,
CURRY, FABRIZIO, FREEMAN, GEORGE, GIBBONS, GOODMAN, GRUCELA,
HORNAMAN, JAMES, JOSEPHS, KOTIK, KULA, LEACH, McGEEHAN,
McILVAINE SMITH, MOUL, MOYER, MUNDY, M. O'BRIEN, PARKER,
PASHINSKI, PRESTON, SHIMKUS, SIPTROTH, K. SMITH, WALKO,
WANSACZ, WATSON, WOJNAROSKI, YOUNGBLOOD, YUDICHAK AND
CALTAGIRONE, JANUARY 22, 2008
AS RE-REPORTED FROM COMMITTEE ON AGING AND OLDER ADULT SERVICES,
HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 24, 2008
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," further providing for
4 onsite complaint investigations and plans of correction.
5 The General Assembly of the Commonwealth of Pennsylvania
6 hereby enacts as follows:
7 Section 1. The act of June 13, 1967 (P.L.31, No.21), known
8 as the Public Welfare Code, is amended by adding a section to
9 read:
10 Section 211.1. Onsite Complaint Investigations and Plans of
11 Correction.--(a) The department shall initiate onsite
12 investigations of complaints at personal care homes and assisted
13 living residences as follows:
14 (1) If the complaint is a Level 1 complaint with a high <--
15 regulatory risk, including, but not limited to, incidents
16 related to immediate fire safety, physical assault or abuse, no
1 food or water, no heat in winter, no staff or serious illness
2 outbreak, the onsite inspection shall be initiated within
3 twenty-four hours of the complaint intake.
4 (2) If the complaint is a Level 2 complaint with a medium <--
5 regulatory risk, including, but not limited to, incidents
6 related to inadequate staffing, quality of care issues,
7 nutrition, sanitation or medication administration, the onsite
8 inspection shall be initiated within seven calendar days of the
9 complaint intake.
10 (3) If the complaint is a Level 3 complaint with a low <--
11 regulatory risk, including, but not limited to, incidents
12 related to menus, policies, assessments, support plans,
13 financial management or contracts, the onsite inspection shall
14 be initiated within twenty-one calendar days of the complaint
15 intake.
16 (b) The department shall contact and coordinate the
17 investigation with appropriate local agencies, including the
18 Area Agency on Aging, specifically the Protective Services or
19 Long-Term Care Ombudsman Program, County Mental Health/Mental
20 Retardation, local or Pennsylvania State Police, local code
21 enforcement or fire officials.
22 (c) The department shall conduct an unannounced onsite
23 inspection of the personal care home or assisted living
24 residence within the time frame established under subsection
25 (a)(1), (2) or (3). The complaint investigation shall include
26 the following components and adhere to the following time
27 frames:
28 (1) Conduct an entrance interview with administrator or
29 designee, providing general information regarding the complaint,
30 but maintaining confidentiality of residents and complainant.
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1 (2) Interview relevant subjects to the complaint such as
2 residents, families, staff or other witnesses.
3 (3) Preserve evidence by obtaining signed witness
4 statements, making copies of documents and taking photographs.
5 (4) Review relevant documents such as resident, staff and
6 facility records.
7 (5) Observe physical site conditions related to the
8 complaint.
9 (6) Contact the appropriate manager in the department
10 regarding Level 1 high-risk issues.
11 (7) Ensure that immediate threats are resolved before
12 leaving the personal care home or assisted living residence.
13 (8) Record all relevant information, including violations,
14 as directed by department policies and procedures.
15 (9) Conduct an exit interview with the administrator or the
16 most appropriate employe onsite and provide an opportunity to
17 respond to preliminary findings, unless the disclosure may
18 jeopardize ongoing aspects of the investigation.
19 (10) Determine and discuss findings with the appropriate
20 manager in the department and determine if each allegation is
21 founded, unfounded or requires further investigation.
22 (11) Additional collateral contacts, interviews and site
23 inspections shall be made as indicated by the seriousness of the
24 complaint allegation and based on the initial onsite inspection.
25 (12) The complaint investigation, including all collateral
26 contacts, interviews and onsite inspections, must be concluded
27 within fifteen days following the onsite inspection. An <--
28 exception to this time line may be granted by the appropriate
29 manager in the department.
30 (d) Within two FOUR business days of the conclusion of the <--
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1 complaint investigation for Level 1 high-risk complaints and, <--
2 within five TEN business days of the conclusion of the complaint <--
3 investigation for Levels 2 and 3 LEVEL 2 COMPLAINTS AND WITHIN <--
4 15 BUSINESS DAYS OF THE CONCLUSION OF THE COMPLAINT
5 INVESTIGATION FOR LEVEL 3 COMPLAINTS, the department shall
6 prepare a violation report if applicable, review the violation
7 report with the appropriate manager in the department and
8 transmit the violation report to the personal care home or
9 assisted living residence for corrective action.
10 (e) If a violation report is filed PROVIDED by the <--
11 department, the personal care home or assisted living residence
12 must file SUBMIT a plan of correction within seven calendar days <--
13 of receipt of the violation report.
14 (f) Within five TEN business days of receiving the plan of <--
15 correction from the personal care home or assisted living
16 residence, the department shall review the plan of correction
17 and refer the plan to the appropriate manager in the department
18 for plan approval or denial.
19 (g) If the personal care home or assisted living residence
20 does not submit a plan of correction within the required seven-
21 day time frame, the department may suspend, revoke or limit a
22 license, or may issue a ban on admissions for the personal care
23 home or assisted living residence.
24 (h) Once the plan of correction has been approved by the
25 department, the follow-up complaint inspection of the personal
26 care home or assisted living residence shall be conducted onsite
27 after the longest target date for compliance has been reached as
28 noted on the plan of correction, but no later than ninety days
29 after the initial onsite complaint inspection by the department
30 to ensure compliance with the plan of correction.
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1 (i) If the plan of correction is denied DISAPPROVED, the <--
2 department shall contact the personal care home or assisted
3 living residence within twenty-four hours of the denial FORTY- <--
4 EIGHT HOURS OF THE DISAPPROVAL decision and require an alternate
5 plan within forty-eight hours OF CORRECTION WITHIN FOUR BUSINESS <--
6 DAYS. If the personal care home or assisted living residence
7 returns an approved plan of correction within the required time
8 frame, the department shall conduct a follow-up onsite
9 inspection of the personal care home or assisted living
10 residence as outlined under subsection (h).
11 (j) If the alternate plan of correction is not resubmitted
12 by the personal care home or assisted living residence within
13 the required time frame, the department may suspend, revoke or
14 limit a license, or may issue a ban on admissions for the
15 personal care home or assisted living residence.
16 (k) Within ten BUSINESS days of the conclusion of the <--
17 investigation and determination on each of the complaint
18 allegations, the department shall send a complaint response
19 letter to the complainant.
20 (L) THE DEPARTMENT MAY EXCEED THE TIMELINES RELATING TO A <--
21 LEVEL 3 COMPLAINT IF IT DETERMINES THAT RESOURCES ARE OTHERWISE
22 NECESSARY TO ADDRESS RISKS TO THE HEALTH AND SAFETY OF OTHER
23 RESIDENTS IN THE PERSONAL CARE HOME OR ASSISTED LIVING
24 RESIDENCE.
25 (M) FOR PURPOSES OF THIS SECTION:
26 "LEVEL 1 COMPLAINT" SHALL MEAN A COMPLAINT WITH A HIGH RISK,
27 INCLUDING, BUT NOT LIMITED TO, INCIDENTS RELATED TO IMMEDIATE
28 FIRE SAFETY, PHYSICAL ASSAULT OR ABUSE, NO FOOD OR WATER, NO
29 HEAT IN WINTER, NO STAFF OR SERIOUS ILLNESS OUTBREAK.
30 "LEVEL 2 COMPLAINT" SHALL MEAN A COMPLAINT WITH A MEDIUM
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1 RISK, INCLUDING, BUT NOT LIMITED TO, INCIDENTS RELATED TO
2 INADEQUATE STAFFING, QUALITY OF CARE ISSUES, NUTRITION,
3 SANITATION OR MEDICATION ADMINISTRATION.
4 "LEVEL 3 COMPLAINT" SHALL MEAN A COMPLAINT WITH A LOW RISK,
5 INCLUDING, BUT NOT LIMITED TO, INCIDENTS RELATED TO MENUS,
6 POLICIES, ASSESSMENTS, SUPPORT PLANS, FINANCIAL MANAGEMENT OR
7 CONTRACTS.
8 Section 2. This act shall take effect in 60 days.
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