CCS/HS/SB 326 - This act extends the expiration date for the nursing facility reimbursement allowance to September 30, 2002 and it modifies the certificate of need (CON) process and the duties of the Division of Aging.

The nursing home CON moratorium is extended to January 1, 2003 and the construction start date is extended to January 1, 2004.

In order to qualify for CON, nursing facilities must exceed ninety percent occupancy for four consecutive calendar quarters. The expenditure minimum termination date is extended to January 1, 2003. Facilities may buy and sell beds or transfer beds if specific conditions are satisfied. A facility is prohibited from expanding for five years following a bed transfer. An applicant is entitled to a de novo hearing, if desired, upon a CON committee decision.

Sections are added regarding licensing of long term care facilities and abuse and neglect of the elderly. This act also includes a provision for facilities which self-report violations.

The pathway to safety law is modified to allow more residents to remain in facilities, based on evaluations of the family, facility and physician. Safety requirements are also revised.

The Division of Aging may provide investigation results to all parties to the complaint, to residents, or to family members. Conflicts of interest between investigators and facilities are prohibited. Facility inspections are required at least twice a year. The Division shall develop flexible assessment procedures to evaluate the continuum of care.

Alzheimer's pilot projects shall be developed throughout the state, with ten such projects using existing licenses and additional newly licensed facilities with no more than thirty beds per project. One project shall be at a stand-alone facility of up to 120 beds in St. Louis county. A total of no more than 300 beds may be newly licensed.

The Division must establish an alternative dispute resolution pilot project for residents, their families, and facilities. It must also establish four aging in place pilot projects to provide a continuum of care for the elderly. One such project shall be at a thirty five bed facility in either Jasper, Newton, or McDonald County.

Facilities that are unable to maintain an occupancy level above thirty percent shall have their number of licensed beds reduced. Uniform regulations should be developed for every long term care facility in the state. The Department must maintain records of facility compliance if it also maintains records of facility inspections and violations.

The Division is required to provide budget allotment tables to each area agency on aging by January 1 of each year. On-site monitoring of each agency will be conducted at least once a year.

This act exempts certain sixty bed stand-alone long term care facilities from CON. In addition, certain not for profit, religiously-owned skilled nursing facilities are also exempted from CON if such facilities are operated as part of a continuing care retirement community.

For reimbursement and recoupment cases only, the Administrative Hearing Commission is required to render a decision within 300 days of appeal. If a decision is not rendered within the time limit, the appellant may appeal to the circuit court of Cole County or to the circuit court where the facility is located. The Circuit court shall be bound to administrative hearing guidelines, except that it will retain authority to make final decisions of law.

There is an emergency clause for portions of the bill relating to the certificate of need program. This act is substantially similar to SB 339 and HB 826(1999)
ERIN MOTLEY