GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1999

H	1 

HOUSE BILL 977*

Short Title:  Long-Term Care Facilities/Disclosure.	(Public)

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Sponsors: Representatives Clary; and Mosley.

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Referred to:  Select Committee on Health Care Delivery.

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April 12, 1999

A BILL TO BE ENTITLED
AN ACT TO REQUIRE THAT ADULT CARE HOMES, NURSING HOMES, AND ADULT DAY CARE PROGRAMS PROVIDING SPECIAL CARE FOR PERSONS WITH ALZHEIMER'S DISEASE OR OTHER DEMENTIAS DISCLOSE CERTAIN INFORMATION.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 143B-181.50 reads as rewritten:
"§ 143B-181.50. Definition of special care unit.
As used in this Part, the term 'special care unit' means a wing or hallway within a nursing home or adult care home, or a program provided by a nursing home or adult care home, that is designated especially for residents with Alzheimer's disease or other dementias."
Section 2. G.S. 143B-181.51 reads as rewritten:
"§ 143B-181.51.  Rules required – North Carolina Medical Care Commission.
The North Carolina Medical Care Commission shall develop rules containing State standards for special care units in nursing homes for patients with Alzheimer's disease or other dementias.  These standards shall include guidelines concerning the type of care provided in a special care unit, the type of resident who can be served on the unit, the ratio of residents to staff members, and the requirements for the training of staff members. The rules shall also provide for compliance with the disclosure requirements under G.S. 131E-112."
Section 3. G.S. 143B-181.52 reads as rewritten:
"§ 143B-181.52.  Rules required – Social Services Commission.
The Social Services Commission shall develop rules containing State standards for special care units in adult care homes for patients with Alzheimer's disease or other dementias.  These standards shall include guidelines concerning the type of care provided in a special care unit, the type of resident who can be served on the unit, the ratio of residents to staff members, and the requirements for the training of staff members. The rules shall also provide for compliance with the disclosure requirements under G.S. 131D-6(b1)	and G.S. 131D-7."
Section 4. Part A of Article 6 of Chapter 131E of the General Statutes is amended by adding the following new section to read:
"§ 131E-112.  Special care units; disclosure of information required.
(a)	A nursing home or combination home licensed under this Part that provides special care for persons with Alzheimer's disease or other dementias in a special care unit shall make the following disclosures pertaining to the special care provided that distinguishes the special care unit as being especially designed for residents with Alzheimer's disease or other dementias.  The disclosure shall be made annually, in writing, to all of the following:
(1)	The Department, as part of its licensing procedures.
(2)	Each person seeking placement within a special care unit, or the person's authorized representative, prior to entering into an agreement with the person to provide special care.
(b)	Information that must be disclosed in writing shall include, but is not limited to, all of the following:
(1)	A statement of the overall philosophy and mission of the licensed facility and how it reflects the special needs of residents with dementia.
(2)	The process and criteria for placement, transfer, or discharge to or from the special care unit.
(3)	The process used for assessment and establishment of the plan of care and its implementation, as required under State and federal law.
(4)	Typical staffing patterns and how the patterns reflect the resident's need for increased care and supervision.
(5)	Dementia-specific staff training.
(6)	Physical environment features designed specifically for the special care unit.
(7)	Alzheimer's disease and other dementia-specific programming.
(8)	Opportunities for family involvement.
(9)	Additional costs or fees to the resident for special care.
(c)	As part of its license renewal procedures and inspections, the Department shall examine for accuracy the written disclosures made by each licensed facility subject to this section.
(d)	Nothing in this section shall be construed as prohibiting a nursing home or combination home that does not offer a special care unit from admitting a person with Alzheimer's disease or other dementias.  The disclosures required by this section apply only to a nursing home or combination home that advertises, markets, or otherwise promotes itself as providing a special care unit for persons with Alzheimer's disease or other dementias.
(e)	As used in this section, the term 'special care unit' has the same meaning as applied under G.S. 143B-181.50."
Section 5. Article 1 of Chapter 131D of the General Statutes is amended by adding the following new section to read:
"§ 131D-7.  Adult care home special care units; disclosure of information required.
(a)	An adult care home licensed under this Part that provides special care for persons with Alzheimer's disease or other dementias in a special care unit shall make the following disclosures pertaining to the special care provided that distinguishes the special care unit as being especially designed for residents with Alzheimer's disease or other dementias.  The disclosure shall be made annually, in writing, to all of the following:
(1)	The Department, as part of its licensing procedures.
(2)	Each person seeking placement within a special care unit, or the person's authorized representative, prior to entering into an agreement with the person to provide special care.
(b)	Information that must be disclosed in writing shall include, but is not limited to, all of the following:
(1)	A statement of the overall philosophy and mission of the licensed facility and how it reflects the special needs of residents with dementia.
(2)	The process and criteria for placement, transfer, or discharge to or from the special care unit.
(3)	The process used for assessment and establishment of the plan of care and its implementation, including methods by which the plan of care evolves and is responsive to changes in the resident's condition.
(4)	Typical staffing patterns and how the patterns reflect the resident's need for increased care and supervision.
(5)	Dementia-specific staff training.
(6)	Physical environment features designed specifically for the special care unit.
(7)	Alzheimer's disease and other dementia-specific programming.
(8)	Opportunities for family involvement.
(9)	Additional costs or fees to the resident for special care.
(c)	As part of its license renewal procedures and inspections, the Department shall examine for accuracy the written disclosures made by each adult care home subject to this section.
(d)	Nothing in this section shall be construed as prohibiting an adult care home that does not offer a special care unit from admitting a person with Alzheimer's disease or other dementias.  The disclosures required by this section apply only to an adult care home that advertises, markets, or otherwise promotes itself as providing a special care unit for persons with Alzheimer's disease or other dementias.
(e)	As used in this section, the term 'special care unit' has the same meaning as applied under G.S. 143B-181.50."
Section 6. G.S. 131D-6 is amended by adding the following new subsections to read:
"( b1)	An adult day care program that provides or that advertises, markets, or otherwise promotes itself as providing special care services to persons with Alzheimer's disease or other dementias shall provide the following written disclosures to the Department and to persons seeking adult day care program special care services:
(1)	A statement of the overall philosophy and mission of the adult day care program and how it reflects the special needs of residents with dementia.
(2)	The process and criteria for providing or discontinuing special care services.
(3)	The process used for assessment and establishment of the plan of special care and its implementation, including methods by which the plan of special care evolves and is responsive to changes in the participant's condition.
(4)	Typical staffing patterns and how the patterns meet the participant's need for increased special care and supervision.
(5)	Dementia-specific training.
(6)	Physical environment features designed specifically for participants with Alzheimer's disease or other dementias.
(7)	Frequency and type of participant activities provided to recipients of special care services.
(8)	Opportunities for involvement of families in special care and availability of family support programs.
(9)	Additional costs or fees to the participant for special care.
(c)	As part of its certification renewal procedures and inspections, the Department shall examine for accuracy the written disclosure of each adult day care program subject to this section.
(d)	Nothing in this section shall be construed as prohibiting an adult day care program that does not advertise, market, or otherwise promote itself as providing special care services for persons with Alzheimer's disease or other dementias from providing adult day care services to persons with Alzheimer's disease or other dementias."
Section 7. This act becomes effective January 1, 2000.