Nursing Home (NH) Transfer and Discharge Rights
NY-ADR
10/8/14 N.Y. St. Reg. HLT-40-14-00017-P
NEW YORK STATE REGISTER
VOLUME XXXVI, ISSUE 40
October 08, 2014
RULE MAKING ACTIVITIES
DEPARTMENT OF HEALTH
PROPOSED RULE MAKING
NO HEARING(S) SCHEDULED
I.D No. HLT-40-14-00017-P
Nursing Home (NH) Transfer and Discharge Rights
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:
Proposed Action:
Amendment of section 415.3 of Title 10 NYCRR.
Statutory authority:
Public Health Law, sections 2801, 2801-a and 2803(2)
Subject:
Nursing Home (NH) Transfer and Discharge Rights.
Purpose:
To clarify requirements governing NH transfers and discharges so that facilities will uniformly comply with Federal regulations.
Substance of proposed rule (Full text is posted at the following State website:www.health.ny.gov):
The amendments to section 415.3 of Title 10 (Health) NYCRR are required to clarify the requirements for transfer and discharge of residents from nursing homes as mandated by federal law. The amendments more clearly define what constitutes a transfer or discharge, specify the elements that must be included in a notice of transfer or discharge to the resident and the deadlines for service of notice, and clarify the rights of a resident at a hearing should one be requested. These amendments do not change existing requirements; they simply ensure that the Department’s regulations clearly reflect the existing federal requirements.
Text of proposed rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Reg. Affairs Unit, Room 2438, ESP Tower Building, Albany, NY 12237, (518) 473-7488, email: [email protected]
Data, views or arguments may be submitted to:
Same as above.
Public comment will be received until:
45 days after publication of this notice.
Regulatory Impact Statement
Statutory Authority:
The statutory authority for this rule is Public Health Law, Sections 2801, 2801-a and 2803(2), which require the Public Health and Health Planning Council to promulgate regulations, subject to the Commissioner’s approval, governing the standards and procedures followed by nursing homes. Those standards and procedures must, at a minimum, meet federal standards.
Legislative Objectives:
To clarify, in accordance with a Stipulation of Settlement in Gautam, et. al. v. Novello, et. al., SDNY 03 Civ. 2473(THK), the requirements that must be met by nursing homes in connection with the transfer or discharge of residents. The state’s regulations governing transfer and discharge must meet, at a minimum, federal standards.
Needs and Benefits:
Since July 2005, transfer and discharge of nursing home residents has been in accordance with an interim policy that clarifies state requirements in a way that ensures compliance with federal requirements. Amending 10 NYCRR 415.3 in accordance with the interim policy will permanently clarify the requirements that must be met by nursing homes prior to transferring and discharging patients and will ensure that all required policies and procedures are clearly included in the Department’s regulations.
Costs:
Costs to Regulated Parties for the Implementation of and Continuing Compliance with the Rule:
Nursing homes are already required to comply with federal regulations prior to transferring and discharging residents. These regulations do not expand upon already existing requirements.
Costs to the Agency, the State and Local Governments for the Implementation and Continuation of the Rule:
The amendments to 10 NYCRR 415.3 will not increase any costs currently borne by the Department or state and local governments. The amendments clarify existing requirements that all facilities are required to follow.
The information, including the source(s) of such information and the methodology upon which the cost analysis is based:
Cost analysis is based on the substance of the regulations and the interim policy clarifying those regulations. There has been no change in the requirements that must be met by all affected entities.
Local Government Mandates:
Local governments that operate nursing homes are already complying with the requirements clarified by these amendments.
Paperwork:
The paperwork required by these amendments has not changed.
Duplication:
These amendments do not duplicate existing regulations or requirements.
Alternatives:
None. The amendments simply clarify state requirements by ensuring the Department’s regulations clearly incorporate existing federal mandates.
Federal Standards:
Federal requirements, upon which these amendments are based, are located at 42 CFR Parts 431 and 483. These amendments do not expand upon these requirements.
Compliance Schedule:
Affected entities are already required to comply with the proposed amendments.
Regulatory Flexibility Analysis
Effect of Rule:
Local governments will not be affected by this rule except to the extent that they operate a nursing home. There are 34 counties that operate nursing homes. The Department does not have information regarding the number of small business nursing homes in NYS readily available. As the amendments do not add to or change existing requirements, and are mandated by federal law, small businesses and local governments will not be affected.
Compliance Requirements:
There are no new reporting and record keeping requirements. The regulations simply clarify state requirements by ensuring the Department’s regulations clearly incorporate existing federal mandates.
Professional Services:
No additional professional staff is expected to be needed as a result of the regulations.
Compliance Costs:
There are no new or additional costs associated with these proposed rules.
Economic and Technological Feasibility:
These regulations simply clarify existing requirements. They do not require any new technology and should not affect the routine cost of doing business.
Minimizing Adverse Impact:
The Department has no flexibility with respect to these regulations as all requirements are mandated by federal law. Nonetheless, the rule will have no adverse economic impact on small businesses or local governments since it simply clarifies state requirements by ensuring the Department’s regulations clearly incorporate existing federal mandates.
Small Business and Local Government Participation:
The Department will meet the requirements of SAPA § 202-b(6) in part by publishing a notice of proposed rulemaking in the State Register with a comment period. Input was not requested with respect to these amendments since they reflect federal mandates. The proposed rules are not expected to have a deleterious effect on small businesses and local governments, since these requirements are already in effect. Accordingly, opposition is not expected.
Rural Area Flexibility Analysis
Types and Estimated Numbers of Rural Areas:
Rural areas are defined as counties with a population less than 200,000 and, for counties with a population greater than 200,000, includes towns with population densities of 150 persons or less per square mile. The proposed amendment will apply statewide, including the 43 rural counties with less than 200,000 inhabitants, and the 10 urban counties with a population density of 150 per square mile or less.
Reporting, Recordkeeping and Other Compliance Requirements and Professional Services:
There are no new or additional requirements as a result of this rule. The regulations simply clarify state requirements by ensuring the Department’s regulations clearly incorporate existing federal mandates.
Costs:
There are no capital costs associated with these rules. There are no additional operational costs as providers are currently required to have policies and procedures in place to implement existing transfer and discharge requirements. Any administrative costs associated with transfer or discharge are mandated by federal law.
Minimizing Adverse Impact:
The Department has no flexibility with respect to these regulations as all requirements are mandated by federal law. Nonetheless, the rule will have no adverse economic impact on rural area providers since it simply clarifies state requirements by ensuring the Department’s regulations clearly incorporate existing federal mandates.
Rural Area Participation:
The Department will meet the requirements of SAPA Section 202-bb(7), in part, by publishing a notice of proposed rulemaking in the State Register with a comment period. The Department did not solicit input regarding these amendments since they reflect federal mandates. The proposed rules are not expected to have a deleterious effect on rural areas, since these requirements are already in effect. Accordingly, opposition is not expected.
Job Impact Statement
A Job Impact Statement is not required because it is apparent, from the nature and purpose of the proposed rule, that it will not have a substantial adverse impact on jobs and employment opportunities.
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