2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2803 - Commissioner and Council; Powers and Duties.

§  2803.  Commissioner  and  council;  powers  and  duties. 1. (a) The
commissioner shall have the power  to  inquire  into  the  operation  of
hospitals and to conduct periodic inspections of facilities with respect
to the fitness and adequacy of the premises, equipment, personnel, rules
and  by-laws,  standards  of  medical  care, hospital service, including
health-related service, system of accounts, records, and the adequacy of
financial resources and sources of future revenues. The commissioner  or
persons  designated  by  him  shall  conduct  at  least  one unannounced
comprehensive inspection of each residential health  care  facility  not
later  than  fifteen  months  after  the  previous  such  inspection  to
determine the  adequacy  of  care  being  rendered.  Such  comprehensive
inspection  shall  include, but not be limited to, a survey to determine
compliance by the facility with applicable statutes and regulations, and
observation of a representative sample of all patients or residents  and
their  medical records to determine the quality and adequacy of the care
and treatment provided. Additional visits shall be made to facilities as
needed  to  determine  whether  violations  or  deficiencies  have  been
corrected,   to   investigate   any  report  made  pursuant  to  section
twenty-eight hundred three-d of this article or any other complaint, and
for  any  other  purpose  deemed  necessary  and  appropriate   by   the
commissioner.  Any  employee of the department who gives or causes to be
given advance notice of such unannounced inspection to any  unauthorized
person  shall,  in  addition  to  any  other penalty provided by law, be
suspended by the commissioner from all duties without pay for  at  least
five  days  or for such greater period of time as the commissioner shall
determine. Any such suspension shall be  made  by  the  commissioner  in
accordance with all other applicable provisions of law.
(b) The purpose of such inspection shall be to determine compliance by
residential  health  care facilities with statutes, and with regulations
promulgated under the provisions of those  statutes,  governing  minimum
standards  of  construction,  quality  and  adequacy  of care, rights of
patients,  rates  of  payment  and  reimbursement.  At  least  one  such
inspection  every fifteen months shall include, but shall not be limited
to, full on-site examination of the medical, nursing care,  dietary  and
social services records of the facility.
(c)  The  commissioner shall establish, in consultation with the state
office for the aging, a  consumer  information  system  for  residential
health  care  facilities  with  respect  to  their  compliance  with the
standards set forth in this section designed  to  provide  accurate  and
comprehensible  information  to  consumers  on the quality of facilities
which shall incorporate a summary of the findings  and  results  of  the
inspections  conducted  pursuant to the provisions of this section. Such
summary of results and findings shall include, but need not  be  limited
to,  a  listing  of  areas in which items were found at the time of such
inspections to be not in compliance with such standards and  the  nature
of  such  non-compliance. Each residential health care facility shall be
issued a summary  of  the  findings  of  inspections  of  such  facility
conducted  since the issuance of the previous summary of findings, which
shall be posted  conspicuously  within  such  facility,  and  any  other
information  relating  to  the  facility  available through the consumer
information  system.  The  commissioner  shall  promulgate   rules   and
regulations  necessary  to implement the provisions of this paragraph. A
facility  may  appeal  the  accuracy  of  a  summary  findings  to   the
commissioner  within  twenty  days  after  receipt  of such summary. The
results and findings of any prior inspections, and any penalties thereby
assessed, which have not been previously appealed and  overruled,  shall
not be subject to review.
(d)  (i)  Notwithstanding  any  inconsistent  provision  of  law,  the
commissioner  or  his  designee  shall  determine  the   necessity   and
appropriateness  of  care and services provided by hospitals to patients
eligible for medical assistance pursuant to title eleven of article five
of the social services law and shall further determine whether a general
hospital  has  taken an action that results in the admission of patients
unnecessarily, unnecessary multiple admissions  of  the  same  patients,
inappropriate  discharge of patients, inappropriate transfer of patients
between hospitals or between distinct units of a hospital, inappropriate
diagnosis-related group coding, or other inappropriate medical or  other
practices  with  respect to hospitalized inpatients eligible for medical
assistance pursuant to title  eleven  of  article  five  of  the  social
services law. In making such determinations the commissioner may utilize
the    services    of   department   personnel   or   other   authorized
representatives.  The  hospitals   shall   provide   such   information,
facilities  and  services as may be required by the commissioner to make
such determinations. The commissioner, in implementing  this  paragraph,
shall adopt necessary rules and regulations including but not limited to
those  for  determining the necessity or appropriate level of admission,
controlling the length of stay,  the  provision  of  surgery  and  other
services, and the methods and procedures for making such determinations.
(ii)   In   the  event  the  commissioner  or  his  designee  makes  a
determination pursuant to this paragraph  that  a  general  hospital  or
physician  has  taken  an  inappropriate action resulting in a denial or
adjustment of payment determined in accordance with section twenty-eight
hundred seven-c of this article, the general hospital or physician which
is the subject of such determination  shall  be  entitled  to  a  review
before  the commissioner or an appeal agent designated for such purposes
by the commissioner at which such hospital or  physician  may  challenge
such  determination.  In  order  to  be  entitled  to  such review, such
hospital or physician must provide the commissioner or his designee,  as
appropriate,  with  a written request for such review within thirty days
of receipt  of  the  written  determination.  During  such  review,  the
hospital  or  physician may present documentation or evidence in support
of its challenge  to  the  determination,  and  representatives  of  the
commissioner  or  his  designee may present documentation or evidence in
support of the determination.  In the event that  the  determination  is
sustained,  the  hospital  or  physician may seek judicial review of the
decision pursuant to article seventy-eight of the civil practice law and
rules.
(iii) The commissioner shall certify to the social services  officials
responsible  for  making  payments for authorized hospital services that
specified items of care and services for specified individuals  eligible
for  medical  assistance pursuant to title eleven of article five of the
social services  law  are  inappropriate  or  unnecessary  and  are  not
authorized  for payment or are authorized for payment at the appropriate
level of care under the medical  assistance  program  and,  for  general
hospitals,  for  rate  periods  beginning  on  or  after  January first,
nineteen  hundred  eighty-eight  through  March  thirty-first,  nineteen
hundred  ninety-seven,  at  the  appropriate  case based rate of payment
determined pursuant to section  twenty-eight  hundred  seven-c  of  this
article.
(e)   Notwithstanding   any   inconsistent   provision   of  law,  the
commissioner or his designee shall, not later than July first,  nineteen
hundred  seventy-six,  determine  on an individual patient basis whether
identifiable periods of  in-patient  care  in  a  general  hospital  are
required  beyond  the  maximum  length  of  stay established pursuant to
section three hundred sixty-five-a  of  the  social  services  law,  and

whether  deferral  of surgical procedures specified by such commissioner
in accordance with paragraph (c) of subdivision five of such section may
jeopardize life or essential function, or cause severe pain.  In  making
such  determinations  the  commissioner  may  utilize  the  services  of
department personnel or other authorized representatives. The  hospitals
shall  provide  such  information,  facilities  and  services  as may be
required  by  the  commissioner  to  make   such   determinations.   The
commissioner,  in  implementing  this  paragraph,  shall adopt necessary
rules and regulations including but  not  limited  to  the  methods  and
procedures  for  making  such  determinations and the utilization of any
department staff or other authorized  representatives  located  at  such
hospital  in performing other functions relating to assuring that public
funds for medical assistance are utilized exclusively to  provide  items
of  care  and  services  in  amount,  duration  and  scope  specifically
authorized under the medical assistance program. The commissioner  shall
certify to the social services officials responsible for making payments
for  authorized  hospital  services  that  specified  items  of care and
services for specified individuals are not authorized for payment  under
the medical assistance program.
(f)   Notwithstanding   any   inconsistent   provision   of  law,  the
commissioner shall establish standards for determining the necessity  of
care and service for alcoholism and alcohol abuse provided by hospitals.
In  implementing  this  paragraph the commissioner, in consultation with
the director of the division of  alcoholism  and  alcohol  abuse,  shall
adopt necessary rules and regulations including but not limited to those
for  determining  the  necessity  or  appropriate  level  of  admission,
controlling  the  length  of  stay,  the  provision  of   services   and
establishing the methods and procedures for making such determinations.
(g)  The  commissioner shall require that every general hospital adopt
and  make  public   an   identical   statement   of   the   rights   and
responsibilities   of  patients,  in  accordance  with  applicable  law,
including, but not limited to:
(i) a patient complaint and quality of care review process;
(ii) a right to receive all information  necessary  to  give  informed
consent   for   any  proposed  intervention,  procedure,  or  treatment,
including  information  regarding   the   foreseeable   and   clinically
significant  risks and benefits of the proposed intervention, procedure,
or treatment;
(iii) a right to receive complete information regarding the  patient's
condition,   prognosis,   and  clinical  indications  for  the  proposed
intervention, procedure, or treatment;
(iv) a right to receive information  regarding  alternative  treatment
options  including  the foreseeable and clinically significant risks and
benefits  of   such   alternative   treatment   options,   taking   into
consideration any known preconditions;
(v) a right to be informed of the name, position, and functions of any
persons,  including medical students and physicians exempt from New York
state licensure pursuant to section sixty-five hundred twenty-six of the
education law, who provide face-to-face care to or direct observation of
the patient;
(vi) a right  to  refuse  the  proposed  intervention,  procedure,  or
treatment and to be informed of the clinical effects of such refusal;
(vii)  a  right to meaningfully engage and participate in the informed
consent process, which shall mean, but not be limited to, affording  the
patient  or  their  representative  time  to ask questions and have them
answered satisfactorily to the extent reasonable;
(viii) a right to be informed of any human subjects research that  the
attending  physician  taking care of the patient participates in and may

directly affect a procedure or treatment to be received by the  patient,
and to provide voluntary written informed consent to participate, should
the patient be an appropriate candidate for such human subjects research
in  the  clinical  judgment  of  the  attending  physician. The informed
consent  referred  to  here  shall  conform  with  federal  requirements
regarding   protection  for  human  research  subjects,  and  any  other
applicable laws or regulations;
(ix) a right to an appropriate patient discharge plan; and
(x) for patients other  than  beneficiaries  of  title  XVIII  of  the
federal social security act (medicare), a right to a discharge review in
accordance  with  section  twenty-eight hundred three-i of this article.
The form and content of such statement shall be determined in accordance
with rules and regulations adopted by the council and  approved  by  the
commissioner.  A patient who requires continuing health care services in
accordance with such patient's discharge  plan  may  not  be  discharged
until  such  services  are  secured  or determined by the hospital to be
reasonably available to the patient. Each general hospital shall give  a
copy  of  the  statement  to  each  patient,  or  the appointed personal
representative of the patient at or prior to the time  of  admission  to
the  general  hospital, as long as the patient or the appointed personal
representative of the patient  receives  such  notice  no  earlier  than
fourteen   days   before   admission.   Such  statement  shall  also  be
conspicuously posted by  the  hospital  and  shall  be  a  part  of  the
patient's admission package. Nothing herein contained shall be construed
to  limit  any  authority  vested  in  the commissioner pursuant to this
article related to the operation of  hospitals  and  care  and  services
provided to patients.
* (h)  Every hospital providing treatment to alleged victims of family
offenses as defined in article eight of the family court act and section
530.11 of the criminal procedure law shall be responsible for  providing
a copy of a notice to victims of family offenses as described in section
eight  hundred  twelve  of  the  family court act and subdivision six of
section 530.11 of the criminal procedure  law.  The  commissioner  shall
promulgate  such rules and regulations as may be necessary and proper to
carry out effectively the provisions of this paragraph.
* NB There are 2 (h)'s
* (h) The statement  regarding  patient  rights  and  responsibilities
which  the commissioner shall approve as provided under paragraph (g) of
this subdivision shall include a provision stating  that  every  patient
shall  have the right to authorize those family members and other adults
who will be given  priority  to  visit  consistent  with  the  patient's
ability to receive visitors.
* NB There are 2 (h)'s
(i)  The  statement  regarding  patient  rights  and responsibilities,
required pursuant to paragraph (g) of this  subdivision,  shall  include
provisions  informing  the  patient  of  his or her right to make organ,
tissue or whole body donations, and the means by which the  patient  may
make  such  a  donation. The commissioner shall promulgate any rules and
regulations necessary to implement the provisions of this paragraph.
* (j) As used with regard to  applicable  regulations  issued  by  the
department  implementing  the  statement  regarding  patient  rights and
responsibilities required pursuant to paragraph (g) of this subdivision,
the term "itemized bill" shall, for all periods  on  and  after  January
first,  two thousand eleven, be defined as reflecting a charges schedule
developed by each hospital for all  ancillary  patient  services,  which
schedule  shall  set  forth  separate charges for each ancillary service
provided.
* NB There are 2 (j)'s
* (j) The commissioner shall  require  that  the  statement  regarding
patient  rights and responsibilities, described in paragraph (g) of this
subdivision, shall include a provision informing the patient of  his  or
her right to not be discriminated against on account of age.
* NB There are 2 (j)'s
(k)  The  statement  regarding  patient  rights  and responsibilities,
required pursuant to paragraph (g) of this  subdivision,  shall  include
provisions informing the patient of his or her right to choose to submit
surprise  bills  or  bills  for  emergency  services  to the independent
dispute process established in article six  of  the  financial  services
law, and informing the patient of his or her right to view a list of the
hospital's   standard   charges   and  the  health  plans  the  hospital
participates with consistent with section twenty-four of this chapter.
(l) The  statement  regarding  patient  rights  and  responsibilities,
required  pursuant  to  paragraph (g) of this subdivision, shall include
provisions informing the patient of  his  or  her  right  to  choose  to
identify  a  caregiver  pursuant  to  article  twenty-nine-cccc  of this
chapter.
2. (a) The council, by a majority vote of its members, shall adopt and
amend  rules  and  regulations,  subject  to   the   approval   of   the
commissioner, to effectuate the provisions and purposes of this article,
including, but not limited to:
(i)  the  establishment of requirements for a uniform statewide system
of reports and audits relating to the quality of  medical  and  physical
care  provided,  hospital  utilization,  and  costs  in  accordance with
section twenty-eight hundred three-b of this article,
(ii) establishment by the department of schedules of rates,  payments,
reimbursements, grants and other charges for hospital and health-related
services   as   provided   in   sections   twenty-eight  hundred  seven,
twenty-eight  hundred  seven-a,   twenty-eight   hundred   seven-c   and
twenty-eight  hundred  eight  of this article. The schedules established
shall be reasonable and  adequate  to  meet  the  costs  which  must  be
incurred   by  efficiently  and  economically  operated  facilities.  In
adopting regulations related to  the  computation  of  general  hospital
inpatient  payments,  the  council  shall  take  into  consideration the
elements of cost, geographical differentials in  the  elements  of  cost
considered,  economic  factors  in  the  area  in  which the hospital is
located, costs of  hospitals  of  comparable  size,  and  the  need  for
incentives  to  improve  services  and  institute economies. The council
shall exclude from consideration in the regulations adopted nonallowable
costs such as the costs for research and those parts of  the  costs  for
educational  salaries  which  the  council determines to be not directly
related to hospital service,
(iii) the identification of appropriate and reasonable  standards  for
the  development  of  acceptable  collection  procedures used by general
hospitals  in  an  effort  to  collect  unpaid  bills   prior   to   the
determination   that  the  unpaid  bill  is  a  bad  debt  eligible  for
reimbursement consideration  pursuant  to  paragraphs  (e)  and  (f)  of
subdivision  eight  of section twenty-eight hundred seven-a or paragraph
(b) of subdivision fourteen of section twenty-eight hundred seven-c  and
twenty-eight hundred seven-k of this article,
(iv)  subject to the provisions of paragraph (e) of subdivision eleven
of section twenty-eight hundred seven-a of this article  or  subdivision
nine  of  section  twenty-eight  hundred  seven-c  of  this article, the
establishment of  guidelines  regarding  the  time  to  resolve  appeals
submitted  by  general  hospitals.  The  council  may consider different
periods depending upon whether the basis for the appeal is related to  a
general hospital's existing costs or anticipated future costs,
(v)   standards   and   procedures   relating  to  hospital  operating
certificates, provided however, that the council shall establish minimum
acceptable  standards  and  procedures  equal  to  the   standards   and
procedures  which  federal  law  and regulation require for hospitals to
qualify  as  providers  pursuant  to titles XVIII and XIX of the federal
social security act. The existing  state  standards  and  procedures  in
effect  on  the  date  that  this subdivision becomes effective shall be
deemed to constitute maximum standards and procedures  for  purposes  of
limiting   medical  assistance  reimbursement  pursuant  to  the  social
services law. Such standards and procedures may thereafter be changed or
added  to  by  the  council  only  upon  the   recommendation   of   the
commissioner. For the purposes of ensuring that the health and safety of
the   residents  of  hospitals  are  not  endangered,  the  council  may
promulgate changes in the minimum acceptable  standards  and  procedures
referred to herein upon recommendation of the commissioner, and
(vi) the establishment of a system of accounts and cost findings to be
used  by hospitals, including a classification of such hospitals and the
prescription of a system of accounts and cost finding for each class  in
accordance  with  sections twenty-eight hundred three-b and twenty-eight
hundred five-a of this article.
(b) The commissioner may propose rules and regulations and  amendments
thereto for consideration by the council.
3.  The  commissioner  may  enter  into  contracts  with any political
subdivision, voluntary non-profit agency or health  systems  agency  and
such   entities   are  authorized  to  enter  into  contracts  with  the
commissioner to  effectuate  the  purposes  of  this  article,  however,
contracts with voluntary non-profit agencies may not provide for payment
for general hospital out-patient and emergency services or for treatment
or  diagnostic center services unless the commissioner is satisfied that
the costs incurred for such services  are  approvable  pursuant  to  the
provisions of section twenty-eight hundred seven of this article.
4.  At the request of the commissioner, hospitals shall furnish to the
department such reports and information as it may require to  effectuate
the provisions of this article.
5. The commissioner may institute or cause to be instituted in a court
of  competent  jurisdiction  proceedings  to  compel compliance with the
provisions of this article or the determinations, rules, regulations and
orders of the commissioner or the council.
6. The council, by a majority vote of its members and subject  to  the
approval  of  the  commissioner,  shall  adopt  rules and regulations to
establish (a) a system of penalties of up to one  thousand  dollars  per
day  for  continuing  violations  of  rules  and regulations promulgated
pursuant to article twenty-eight  of  this  chapter  and  pertaining  to
patient  care  by  residential  health  care  facilities, specifying the
violations and the amount of the penalty to be  assessed  in  connection
with  each such violation, and (b) a system by which the rate of payment
approved for a residential health  care  facility  pursuant  to  section
twenty-eight  hundred  seven  of  this  chapter  and  certified  to  the
department of social services  for  purposes  of  reimbursement  in  the
medical  assistance  program, is reduced in sufficient amount to collect
such penalties. Any reduction of rate  to  collect  penalties  shall  be
limited  to  five  percent of the otherwise established per diem rate or
that portion of the per diem rate which represents the owner's return on
equity, as defined by regulation, whichever is less.
7. The commissioner shall  have  the  power  to  assess  penalties  in
accordance  with the system of penalties adopted pursuant to subdivision
six of this section and pursuant to a hearing  conducted  in  accordance
with  section  twelve-a  of  this  chapter. No penalty shall be assessed

pursuant to subdivision six of this  section  unless  the  facility  has
received  at  least  thirty  days written notice of the existence of the
violation, the amount of the penalty for which it may become liable  and
the  steps which must be taken to rectify the violation. If the facility
fails to rectify the violation within said thirty day period,  it  shall
thereafter  be  liable  for  such  penalty.  Any such penalties shall be
subject to release and compromise by the commissioner in the same manner
as a penalty provided by subdivision  one  of  section  twelve  of  this
chapter.  Any  penalty  assessed  pursuant  to  subdivision  six of this
section shall be subject to recovery in the same  manner  as  a  penalty
provided  by  subdivision  one  of  section  twelve  of  this chapter or
pursuant to the system for reduction of  the  rate  of  payment  to  the
facility  adopted  pursuant  to  clause  (b)  of subdivision six of this
section. Any such penalty assessed pursuant to subdivision six  of  this
section  shall  be  additional  and cumulative to all other penalties or
remedies existing for violations of rules  and  regulations  promulgated
pursuant to article twenty-eight of this chapter. The provisions of this
subdivision  shall  not  be  applicable to nor limit any power to assess
penalties pursuant to section twelve of this chapter; provided, however,
that if  a  penalty  is  assessed  for  a  violation  pursuant  to  this
subdivision, no penalty shall be assessed for such violation pursuant to
section  twelve  of  this  chapter,  and  if a penalty is assessed for a
violation pursuant to section twelve of this chapter, no  penalty  shall
be assessed for such violation pursuant to this subdivision.
8.   (a)  Notwithstanding  any  inconsistent  provision  of  law,  the
commissioner shall establish procedures to be followed by hospitals  for
notification  to  mothers  and  reporting  under  section  three hundred
sixty-six-g of the social services law.
(b) Notwithstanding any inconsistent provision of  section  twelve  of
this  chapter  or  any  other  law,  the commissioner may impose a civil
penalty of up to three thousand five hundred dollars for each  violation
of  the  requirements  of  subdivision  one  of  section  three  hundred
sixty-six-g of the social services law  or  the  rules  and  regulations
promulgated  pursuant  to  such  section, pertaining to reporting to the
department, or such other entity designated by the department,  of  each
live  birth  to  a  woman  receiving  medical assistance. Any such civil
penalties shall be assessed subject  to  the  applicable  provisions  of
sections twelve and twelve-a of this chapter.
8-a.   Notwithstanding  any  inconsistent  provision  of  law  to  the
contrary, the commissioner shall develop a program to facilitate the use
of a triage system of care in emergency  rooms  of  hospitals  that  are
subject  to  the  provisions of this article. In developing such program
the commissioner shall consider the manner in which such a system  would
be  coordinated,  how  such  a  system would provide greater efficiency,
provide cost savings to public health programs and a higher  quality  of
care.    Within  one  year  from  the  enactment  of  such  program, the
commissioner shall submit a report to the  temporary  president  of  the
senate  and  the speaker of the assembly regarding: the impact of such a
system on the cost of Medicaid covered services in the hospital setting;
quality of care in facilities; along with  any  other  data  as  may  be
appropriate.
9.  (a)  General  hospitals  shall,  no  later  than  April first, two
thousand, submit to the commissioner a plan  for  compliance  with  part
four  hundred  five  of  the  official  compilation  of codes, rules and
regulations of the state of New York regarding the working conditions of
and limits on working hours for certain members of a hospital's  medical
staff  and postgraduate trainees in such form and manner as specified by
the commissioner.
(b) The commissioner shall audit each hospital for compliance with its
plan and the applicable regulation on an annual  basis.  Based  upon  an
initial  written  audit  finding of noncompliance the commissioner shall
assess a civil penalty of six thousand  dollars  for  each  instance  of
noncompliance identified in such initial audit.
(c)  Within thirty days after the hospital's receipt of written notice
of noncompliance the hospital shall submit a plan of correction in  such
form   and  manner  as  specified  by  the  commissioner  for  achieving
compliance with its  plan  and  with  the  applicable  regulations.  The
commissioner shall audit each such hospital for compliance with its plan
and the applicable regulations within a reasonable time after submission
of  such  plan of correction. Upon a written finding by the commissioner
within  one  hundred  eighty  days  of  the  initial  audit  finding  of
noncompliance  that  the  hospital has failed to substantially adhere to
its plan of correction the commissioner  shall  assess  the  hospital  a
civil penalty of twenty-five thousand dollars. Upon a further subsequent
written  finding  by  the commissioner within one hundred eighty days of
the initial audit finding of noncompliance that the hospital has  failed
to substantially adhere to its plan of correction the commissioner shall
assess the hospital a civil penalty of fifty thousand dollars. Upon each
and  every  subsequent  written finding by the commissioner within three
hundred sixty days of the initial audit finding  of  noncompliance  that
the  hospital  has  failed  to  substantially  adhere  to  its  plan  of
correction the commissioner shall assess the hospital a civil penalty of
fifty thousand dollars.
(d)  The  penalties  assessed  pursuant  to  paragraph  (c)  of   this
subdivision  shall  be  subject to the provisions of section twelve-a of
this chapter.
(e) Hospitals shall submit to the commissioner any data  necessary  to
perform audits pursuant to this subdivision. Any hospital which fails to
produce  data  or  documentation  requested in furtherance of such audit
within thirty days of such request may be assessed by the commissioner a
civil penalty of ten thousand dollars.
10. (a) All civil penalties assessed and collected pursuant to section
twelve of this chapter for violations of this  article  and  regulations
promulgated  thereunder  related  to the operation of residential health
care facilities,  and  all  civil  monetary  penalties  related  to  the
operation  of nursing facilities received from the federal government in
accordance with subdivision (h) of section nineteen hundred nineteen  of
the  federal social security act, shall be deposited by the commissioner
and credited to the quality of care improvement account which  shall  be
established by the comptroller in the special revenue fund-other. To the
extent  of funds appropriated therefor, funds shall be made available to
the department for expenditures related to the protection of the  health
or  property of residents of residential health care facilities that are
found to be deficient.
(b) Any funds available pursuant to paragraph (a) of this subdivision,
not used for the purposes of paragraph (a) of this subdivision, shall be
used, at  the  commissioner's  discretion,  to  support  activities  and
initiatives  intended to improve resident quality of care at residential
health care facilities found to be deficient, as well as for such  other
purposes  as  are  described  in  this  paragraph.  Such  activities may
include, but are not  limited  to,  relocation  of  residents  to  other
facilities  and  the  maintenance  and  operation  of a facility pending
correction of deficiencies or closure. The commissioner  may  also  make
grants  to  residential  health care facilities that support facilities'
activities and initiatives intended to improve  residential  quality  of
care pursuant to a request for proposals process.
* 11.   (a)  The  commissioner  shall  make  regulations  relating  to
midwifery  birth   centers,   including   relating   to   establishment,
construction,  and  operation,  considering  the  standards of state and
national  professional  associations  of  midwifery  birth  centers,  in
consultation  with representatives of midwives, midwifery birth centers,
and general hospitals providing obstetric services.
(b) (i) As used in this subdivision, "accrediting organization"  means
a  national  accrediting  organization  that  provides  accreditation to
midwifery birth centers, recognized by the commissioner in  consultation
with  representatives  of midwives, midwifery birth centers, and general
hospitals providing  obstetric  services.  The  commissioner  shall  not
unreasonably  withhold  recognition  of  an  organization  seeking to be
recognized under this paragraph.
(ii) Where a proposed midwifery birth center demonstrates  the  intent
and  capability  to  obtain and maintain accreditation by an accrediting
organization, and fully completes and  files  an  application  with  the
public  health  and  health  planning  council  on forms provided by the
department, it shall be deemed upon approval of the  public  health  and
health  planning  council to meet the requirements of this article for a
midwifery birth center for approval of a certificate  of  incorporation,
articles  of organization and establishment, contingent on obtaining and
maintaining that accreditation. Notwithstanding any other  provision  of
this  article to the contrary, such application to the public health and
health planning council shall include information to:  (A)  satisfy  the
character  and competence criteria found in subdivision three of section
twenty-eight hundred one-a of this article;  (B)  demonstrate  that  the
legal  structure  of the proposed operator of the midwifery birth center
complies with the requirements  for  establishment  of  hospitals  under
section  twenty-eight  hundred  one-a  of this article; (C) evidence the
capability to fund any acquisition, renovations, and construction costs;
and (D) demonstrate that the premises and equipment comply with required
life safety and building standards necessary to protect the life, safety
and  welfare  of  patients  and  staff.  Upon  receipt  of  a  completed
application,   the   department  shall  schedule  such  application  for
consideration at the next available and appropriate committee meeting by
the public  health  and  health  planning  council.  If  the  department
receives  an  incomplete  application,  the department shall communicate
with the applicant until such time as the application is  completed  and
filed  with  the  public  health  and  health  planning  council for its
approval or disapproval, or the applicant withdraws the application.
(iii) Regulations and requirements of the commissioner under paragraph
(a) of this subdivision for approval of a certificate of  incorporation,
articles  of  organization,  establishment, and operation of a midwifery
birth center  established  or  seeking  to  be  established  under  this
article,  including  a  determination of public need and compliance with
operational and physical plant  standards,  shall  not  be  inconsistent
with:  (A)  article  one  hundred  forty  of  the education law; (B) the
standards of the accrediting organization from which the midwifery birth
center proposes to seek, seeks or has obtained accreditation;  (C)  life
safety code or other building standards the commissioner deems necessary
to  protect  the life, safety and welfare of patients and staff; and (D)
subparagraph (ii)  of  this  paragraph.  Regulations,  requirements  and
guidance under this subparagraph shall be made by the commissioner after
consultation  with representatives of midwives, midwifery birth centers,
and general hospitals providing obstetric services. To the extent any of
the standards in this  subparagraph  conflict,  the  commissioner  shall
accommodate  or  modify the application of any standard to harmonize and
maximize the intent of the standards.
* NB There are 2 sb 11's
* 11.  Notwithstanding  any  provision of this article, or any rule or
regulation under this article to the contrary,  the  commissioner  shall
allow  outpatient  clinics  of  general  hospitals  and  diagnostic  and
treatment centers to provide off-site primary care services that are:
(a) primary care services ordinarily provided to patients  on-site  at
the  outpatient  clinic  or  diagnostic and treatment center and are not
home care services defined in  subdivision  one  of  section  thirty-six
hundred  two  of this chapter or the professional services enumerated in
subdivision two of such section;
(b) provided by a primary  care  professional  to  a  patient  with  a
pre-existing   clinical  relationship  with  the  outpatient  clinic  or
diagnosis and treatment center, or with  the  health  care  professional
providing the service; and
(c)  provided to a patient who is unable to leave his or her residence
to receive services at the outpatient clinic or diagnostic and treatment
center without unreasonable difficulty due to  circumstances,  including
but not limited to, clinical impairment.
Nothing  in  this  subdivision  shall  preclude  a federally qualified
health center  from  providing  off-site  services  in  accordance  with
department regulations.
* NB There are 2 sb 11's
12.  (a)  Each  residential  health care facility shall, no later than
ninety days after the effective date of this  subdivision  and  annually
thereafter,  or  more frequently as may be directed by the commissioner,
prepare and make available to the public on the facility's website,  and
immediately  upon  request,  in a form acceptable to the commissioner, a
pandemic emergency plan which shall include but not be limited to:
(i) a communication plan:
(A) to update authorized family members and  resident  representatives
of  infected  residents  at  least  once  per day and upon a change in a
resident's condition and at least once a week to  update  all  residents
and  authorized  families  and resident representatives on the number of
infections and deaths at the facility,  and  to  update  all  residents,
authorized  family members, and resident representatives at the facility
not later than five o'clock p.m. the next  calendar  day  following  the
detection  of a confirmed infection of a resident or staff member, or at
such earlier time as guidance from the federal centers for Medicaid  and
medicare  services  or  centers  for  disease control and prevention may
provide, by electronic or such other means as may be  selected  by  each
resident, authorized family member or resident representative; and
(B) that includes a method to provide all residents with daily access,
at  no  cost,  to  remote  videoconference  or  equivalent communication
methods with family members and guardians; and
(C)  that  includes  a  method,  consistent  with  any  guidance   and
regulations  issued  by  the commissioner, to provide all residents with
access, at no cost, to state long-term care ombudsman program staff  and
volunteers,  and  that  provides  state long-term care ombudsman program
staff and volunteers with access to the facility; and
(ii) protection plans  against  infection  for  staff,  residents  and
families, including:
(A)  a  plan  for  hospitalized  residents  to  be  readmitted to such
residential health care facility after treatment, in accordance with all
applicable laws and regulations; and
(B) a plan for such residential health care facility  to  maintain  or
contract  to  have  at  least  a two-month supply of personal protective
equipment; and
(C) a plan or procedure, consistent with any guidance  issued  by  the
federal  centers  for  Medicaid  and  medicare  services  or centers for
disease control and prevention, for placement or grouping  of  residents
within  a facility to reduce transmission of the pandemic disease during
an  infectious disease outbreak in the residential health care facility;
and
(iii) a plan for preserving a resident's place in a residential health
care facility if such resident is hospitalized, in accordance  with  all
applicable laws and regulations.
(b) The residential health care facility shall prepare and comply with
the  pandemic  emergency  plan. Failure to do so shall be a violation of
this subdivision and may be  subject  to  civil  penalties  pursuant  to
section  twelve  and  twelve-b  of  this chapter. The commissioner shall
review each residential health care facility  for  compliance  with  its
plan  and  the  applicable regulations in accordance with paragraphs (a)
and (b) of subdivision one of this section.
(c) Within thirty days after the residential  health  care  facility's
receipt  of written notice of noncompliance such residential health care
facility shall submit a plan of correction in such form  and  manner  as
specified by the commissioner for achieving compliance with its plan and
with the applicable regulations. The commissioner shall ensure each such
residential  health  care  facility complies with its plan of correction
and the applicable regulations.
(d) The  commissioner  shall  promulgate  any  rules  and  regulations
necessary to implement the provisions of this subdivision.
* 13.  The  commissioner  shall  require  each residential health care
facility to  provide  residents  and  their  families  with  a  separate
document, as part of an intake application, in no less than twelve-point
font,  that  includes  information on how a potential resident and their
family  members  can  look  up   complaints,   citations,   inspections,
enforcement  actions, and penalties taken against the facility including
the web address for the New York state  nursing  home  profiles  website
that  is  maintained  by  the  department  and  the nursing home compare
website maintained by the United States department of health  and  human
services, if applicable.
* NB There are 2 sb 13's
* 13.  (a)  The commissioner, in consultation with the state long-term
care  ombudsman,  shall  establish  policies  and  procedures  for:  (i)
reporting  to  the  department, by staff and volunteers of the long-term
care ombudsman program, issues identified or witnessed by such staff and
volunteers that relate to  actions,  inactions  or  decisions  that  may
adversely  affect  the  health,  safety  and  welfare  of  residents  at
residential  health  care  facilities  licensed  or  certified  by   the
department  in  this  state. Such policies and procedures shall include,
but not be limited to,  establishing  a  telephone  hotline  number  and
reporting  form  on  the  department's website for use by long-term care
ombudsman program staff and volunteers for the submission of reports;
(ii) timely and regular communications by the department to the  state
long-term  care  ombudsman  regarding  such issues reported by staff and
volunteers pursuant to  subparagraph  (i)  of  this  paragraph  and  the
resolution of such issues; and
(iii) requiring the department to notify the local ombudsman entity as
defined  in  paragraph  (c)  of  subdivision  one of section two hundred
eighteen  of  the  elder   law   after   the   department   conducts   a
recertification survey of a facility.
(b) Nothing in this subdivision shall be construed to limit in any way
a  resident's  right  to  privacy  and  confidentiality  pursuant to the

regulations of the long-term care ombudsman  program  or  the  right  to
refuse to consent to the involvement of the long-term care ombudsman.
* NB There are 2 sb 13's
* NB Effective until June 19, 2024
* 14.  (a)  The commissioner, in consultation with the state long-term
care  ombudsman,  shall  establish  policies  and  procedures  for:  (i)
reporting  to  the  department, by staff and volunteers of the long-term
care ombudsman program, on issues identified or witnessed by such  staff
and  volunteers  that relate to actions, inactions or decisions that may
adversely  affect  the  health,  safety  and  welfare  of  residents  at
residential   health  care  facilities  licensed  or  certified  by  the
department in this state. Such policies and  procedures  shall  include,
but  not  be  limited  to,  establishing  a telephone hotline number and
reporting form on the department's website for  use  by  long-term  care
ombudsman program staff and volunteers for the submission of reports;
(ii)  timely and regular resolution to any such issues reported to the
department pursuant to subparagraph (i) of this paragraph. No later than
sixty days after the receipt of any such  issue,  the  department  shall
provide  the  state  long-term  care ombudsman a report on the status of
such issue. Following the initial report, the department  shall  provide
additional  reports  to  the state long-term care ombudsman no less than
every  ninety  days  thereafter  until  such  issue  is  resolved.  Upon
resolution  of  such issue, the department shall provide a timely report
to the state long-term care ombudsman indicating the manner in which the
issue was resolved; and
(iii) requiring the department to notify the local ombudsman entity as
defined in paragraph (c) of  subdivision  one  of  section  two  hundred
eighteen   of   the   elder   law   after   the  department  conducts  a
recertification survey of a facility.
(b) Nothing in this subdivision shall be construed to limit in any way
a resident's right  to  privacy  and  confidentiality  pursuant  to  the
regulations  of  the  long-term  care  ombudsman program or the right to
refuse to consent to the involvement of the long-term care ombudsman.
(c) As used in this subdivision: (i) "resolution" shall  mean  closure
of  a  complaint  by  the department, whether closed as substantiated or
unsubstantiated; and (ii) "status" shall mean whether the complaint  has
been  assigned  to  department  staff  for  investigation,  whether  the
complaint remains  open  under  active  investigation,  or  whether  the
complaint has reached resolution.
* NB Effective June 19, 2024