HF 1869

as introduced - 91st Legislature (2019 - 2020) Posted on 02/28/2019 02:31pm

A bill for an act
relating to health; requiring preadmission screening for any patient admitted to a
swing bed in a critical access hospital; amending Minnesota Statutes 2018, sections
144.562, subdivision 3; 256.975, subdivision 7a.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 144.562, subdivision 3, is amended to read:

Subd. 3.

Approval of license condition.

(a) The commissioner of health shall approve
a license condition for swing beds if the hospital meets all of the criteria of this subdivision.

(b) The hospital must meet the eligibility criteria in subdivision 2.

(c) The hospital must be in compliance with the Medicare conditions of participation
for swing beds under Code of Federal Regulations, title 42, section 482.66.

(d) The hospital must agree, in writing, to limit the length of stay of a patient receiving
services in a swing bed to not more than 40 days, or the duration of Medicare eligibility,
unless the commissioner of health approves a greater length of stay in an emergency situation.
To determine whether an emergency situation exists, the commissioner shall require the
hospital to provide documentation that continued services in the swing bed are required by
the patient; that no skilled nursing facility beds are available within 25 miles from the
patient's home, or in some more remote facility of the resident's choice, that can provide
the appropriate level of services required by the patient; and that other alternative services
are not available to meet the needs of the patient. If the commissioner approves a greater
length of stay, the hospital shall develop a plan providing for the discharge of the patient
upon the availability of a nursing home bed or other services that meet the needs of the
patient. Permission to extend a patient's length of stay must be requested by the hospital at
least ten days prior to the end of the maximum length of stay.

(e) The hospital must agree, in writing, to limit admission to a swing bed only to (1)
patients who have been hospitalized and not yet discharged from the facility, or (2) patients
who are transferred directly from an acute care hospital.

(f) The hospital must agree, in writing, to report to the commissioner of health by
December 1, 1985, and annually thereafter, in a manner required by the commissioner (1)
the number of patients readmitted to a swing bed within 60 days of a patient's discharge
from the facility, (2) the hospital's charges for care in a swing bed during the reporting
period with a description of the care provided for the rate charged, and (3) the number of
beds used by the hospital for transitional care and similar subacute inpatient care.

(g) The hospital must agree, in writing, to report statistical data on the utilization of the
swing beds on forms supplied by the commissioner. The data must include the number of
swing beds, the number of admissions to and discharges from swing beds, Medicare
reimbursed patient days, total patient days, and other information required by the
commissioner to assess the utilization of swing beds.

new text begin (h) For critical access hospitals established under section 144.1483, clause (9), and
United States Code, title 42, section 1395i-4, the hospital must agree, in writing, to limit
admission to a swing bed only to patients who have received a preadmission screening as
provided under section 256.975, subdivisions 7a to 7d.
new text end

Sec. 2.

Minnesota Statutes 2018, section 256.975, subdivision 7a, is amended to read:

Subd. 7a.

Preadmission screening activities related to nursing facility admissions.

(a)
All individuals seeking admission to Medicaid-certified nursing facilities, including certified
boarding care facilities, new text begin or to a swing bed located in a critical access hospital established
under section 144.1483, clause (9), with a valid license condition for swing beds granted
under section 144.562, new text end must be screened prior to admission regardless of income, assets,
or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs
(a) and (b). The purpose of the screening is to determine the need for nursing facility level
of care as described in section 256B.0911, subdivision 4e, and to complete activities required
under federal law related to mental illness and developmental disability as outlined in
paragraph (b).

(b) A person who has a diagnosis or possible diagnosis of mental illness or developmental
disability must receive a preadmission screening before admission regardless of the
exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further
evaluation and specialized services, unless the admission prior to screening is authorized
by the local mental health authority or the local developmental disabilities case manager,
or unless authorized by the county agency according to Public Law 101-508.

(c) The following criteria apply to the preadmission screening:

(1) requests for preadmission screenings must be submitted via an online form developed
by the commissioner;

(2) the Senior LinkAge Line must use forms and criteria developed by the commissioner
to identify persons who require referral for further evaluation and determination of the need
for specialized services; and

(3) the evaluation and determination of the need for specialized services must be done
by:

(i) a qualified independent mental health professional, for persons with a primary or
secondary diagnosis of a serious mental illness; or

(ii) a qualified developmental disability professional, for persons with a primary or
secondary diagnosis of developmental disability. For purposes of this requirement, a qualified
developmental disability professional must meet the standards for a qualified developmental
disability professional under Code of Federal Regulations, title 42, section 483.430.

(d) The local county mental health authority or the state developmental disability authority
under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the
individual does not meet the nursing facility level of care criteria or needs specialized
services as defined in Public Laws 100-203 and 101-508. For purposes of this section,
"specialized services" for a person with developmental disability means active treatment as
that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1).

(e) In assessing a person's needs, the screener shall:

(1) use an automated system designated by the commissioner;

(2) consult with care transitions coordinators or physician; and

(3) consider the assessment of the individual's physician.

Other personnel may be included in the level of care determination as deemed necessary
by the screener.