An Act to Support Continuity in Perinatal and Emergency Care by Requiring Notice of a Voluntary Hospital or Facility Closure or Reduction in Services
Maine Legislature, Session 131, LD 1131
Committee: Health and Human Services
Sponsors: STOVER
Amends: 22 MRSA §1822

Legislative Document
No. 1131
H.P. 716
House of Representatives, March 9, 2023
An Act to Support Continuity in Perinatal and Emergency Care by 
Requiring Notice of a Voluntary Hospital or Facility Closure or 
Reduction in Services
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative STOVER of Boothbay.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1822, as amended by PL 2019, c. 501, §11, is repealed and the 
following enacted in its place:
§1822.  Notice of voluntary closure or reduction in services of hospital, sanatorium, 
convalescent home, rest home, nursing home or similar institution
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "Closure plan monitor" means a person whose purpose is to ensure that a facility or 
hospital is following its closure or reduction plan under subsection 3 and that patient 
needs and preferences are being considered and honored whenever possible.
B. "Emergency department" means the unit of a hospital licensed in accordance with 
this chapter that provides 24-hour emergency medical care services to an unscheduled 
patient population.
C. "Facility" means a sanatorium, convalescent home, rest home, nursing home or 
similar institution.
D. "Hospital" means a hospital licensed in accordance with this chapter and any unit 
or facility of a hospital providing specialized care services, including, but not limited 
to, perinatal care services.
E. "Perinatal care services" means maternal and infant health improvement services 
and ancillary services that are appropriate for women and infants during the perinatal 
period.
F. "Perinatal period" means the period of time that begins before conception and ends 
on an infant's first birthday.
2.  Notice; timeline.  This subsection governs the required notice of a voluntary closing 
of a facility or hospital or reduction in services provided by the facility or hospital governed 
by this section.
A. Except as provided in paragraph B, a person, including a county or local government 
unit, that is licensed in accordance with this chapter to conduct, manage or operate a 
facility shall give to the patients and governmental units or institutions that are 
primarily responsible for the welfare of those patients at least 60 days' notice of the 
voluntary closing of the facility or reduction in services provided by the facility so that 
adequate preparation may be made for the orderly transfer of the patients to another 
qualified facility.
B. A person, including a county or local government unit, that is licensed in accordance 
with this chapter to conduct, manage or operate a hospital shall give the following 
notice of the voluntary closing of the hospital or reduction in services provided by the 
hospital so that adequate preparation may be made for the orderly transfer of the 
patients to another qualified hospital:
(1) To the department and the Emergency Medical Services' Board under Title 32, 
section 88, 180 days' notice; and
(2) To the patients and governmental units or institutions that are primarily 
responsible for the welfare of those patients, including emergency services 
agencies that regularly serve the hospital, 135 days' notice.
3.  Notice; requirements.  Notice provided pursuant to subsection 2 must include the 
following information:
A. A credible root cause analysis of the factors contributing to the decision to close the 
facility or hospital or reduce the services provided by the facility or hospital, including:
(1) Interventions considered or implemented by the facility or hospital to prevent 
its closure or reduction in services;
(2) Analysis of why the interventions implemented were not effective;
(3) The rationale for a decision that identified interventions that were considered 
but not implemented; and
(4) Evidence of what the facility or hospital considered before reaching a decision 
regarding whether to contract with a closure plan monitor; and
B. A copy of the closure or reduction plan for the services provided by the facility or 
hospital that addresses the facility's or hospital's plan to:
(1) Make referrals to other facilities or hospitals or other providers in a manner that 
includes patient choice and preferences and continuity of care;
(2) Monitor and assist patients and their guardians, legal representatives and 
families with the psychosocial effect of the closure or reduction in services on 
patients;
(3) Transfer patients' medical records and pending tests in a manner that includes 
continuity of care and procedures to ensure no undue delay in patient care;
(4) Address the effect on inpatients relating to transportation to a new facility or 
hospital in a manner that promotes appropriate and timely continuity of care and 
minimizes the psychosocial effect of the transportation;
(5) Notify and coordinate with other facilities and hospitals and other providers 
that could be affected by the closure or reduction in services;
(6) Notify the public emergency services agencies that regularly serve the hospital 
and governmental units or institutions of the planned closure or reduction in 
services; and
(7) If the closure or reduction in services affects perinatal care services, address 
emergencies related to the perinatal period by developing policies and procedures 
regarding emergency perinatal care services and training for emergency 
department and family practice staff on emergency perinatal care services that 
incorporates teaching with examples and simulations.
SUMMARY
This bill requires a sanatorium, convalescent home, rest home, nursing home or similar 
institution or hospital to give notice of the voluntary closure of the facility or hospital or 
reduction in services provided by the facility or hospital.  The bill requires the facility or 
hospital to engage in a root cause analysis for the decision and to develop a closure or 
reduction plan.