Rule-Making Notices (Hearing Notices)

Sec. 10. The board of managers shall appoint a commandant for the home, who shall be an ex-officer, soldier, sailor, or marine, whose salary shall be such amount as shall be appropriated by the legislature, and who shall nominate, for the action of the board of managers, all necessary subordinate officers, who shall also be ex-officers, soldiers, sailors, or marines, who may be dismissed by the commandant for inefficiency or misconduct. In case of every removal, a detailed statement of the case shall be reported to the board of managers by the commandant. No member or former member of the board of managers shall be eligible to election or appointment as commandant of the facility until the expiration of at least 1 year from the date of the end of his term as member of the board of managers or the date of his resignation as such member.

Mich. Admin. Code R 325.20111(2) (Licensing of Nursing Homes)

(2) The governing body shall appoint a licensed nursing home administrator and shall delegate to the administrator the responsibility for operating the home in accordance with policies established by the governing body. An administrator and all other persons in supervisory positions shall be not less than 18 years of age.

Minnesota:

Minn. R. 9050.0030(A) (Veterans Homes)

The commissioner of veterans affairs shall ensure compliance by the facility and staff with applicable statutes, with applicable rules of the Minnesota Department of Health and the Minnesota Department of Human Services, and with applicable health, safety, sanitation, building, zoning, and operations codes, including the following:

A.   Minnesota Department of Health licensure and operations requirements in chapters 4655 and 4660 and Minnesota Statutes, sections 144.50 to 144.56 and 144A.02 to 144A.10.

Minn. R. 4655.1200 (Boarding Care Homes)

Subpart 1. The licensee in each nursing home or boarding care home shall be responsible for its management, control, and operation.

Subp. 2. The licensee shall develop written bylaws and/or policies which shall be available to all members of the governing body and shall assume full legal responsibility for matters under its control, for the quality of care rendered and for compliance with applicable laws and rules of legally authorized agencies. The responsibilities of the licensee shall include:

A.   Full disclosure of each person having an interest of ten percent or more of the ownership of the home to the commissioner of health with any changes promptly reported in writing. In case of corporate ownership, the name and address of each officer and director shall be made known. If the home is organized as a partnership, the name and address of each partner shall be furnished. In the case of a home operated by a lessee, the persons or business entities having an interest in the lessee organization shall be reported and an executed copy of the lease agreement furnished. If the home is operated by the holder of a franchise, disclosure as specified above shall be made as to the franchise holder who shall also furnish an executed copy of the franchise agreement.

B.   Appointment of a licensed nursing home administrator or a person in charge who shall be responsible for the operation of the home in accordance with law and established policies.

C.   The authority to serve as administrator or person in charge shall be delegated in writing.

D.   The administrator of a hospital with a convalescent and nursing care unit may serve both units. See the Nursing Home Administrator Licensing Law, Laws of Minnesota 1969, chapter 770.

E.   Notification of the termination of service of the administrator or the person in charge as well as the appointment of a replacement shall be given within five days in writing to the commissioner of health by the governing body of the home. If a licensed nursing home administrator or person in charge of the boarding care home is not available to assume the position immediately, such notification to the commissioner of health shall include the name of the person temporarily in charge of the home. The governing body of a nursing home shall not employ an individual as the permanent administrator until it is determined that the administrator qualifies for licensure as a nursing home administrator in Minnesota. See the Nursing Home Administrator Licensing Law, Laws of Minnesota 1969, chapter 770.

F.   Provision of a competent staff and maintenance of professional standards in the care of patients and residents.

G.   Employment of qualified personnel. There shall be sufficient personnel to provide the basic services such as food service, housekeeping, laundry, and plant maintenance. Employees or volunteers under 18 years of age shall be under direct supervision.

H.   Provision of facilities, equipment, and supplies for care consistent with the needs of the patients and residents.

I.   Provision of evidence of adequate financing, proper administration of funds, and the maintenance of required statistics.

Only a licensee is responsible for the management, control and operation of a nursing home.

Summary of factual data and analytical methodologies

The department commissioned a report on the operation of its skilled nursing facilities by an independent consulting group, Pathways Health Services, Inc. The report reviewed the supervision of both facilities, as well as the supervision provided by the Administrator, Division of Homes. The report identified issues ensuring compliance with health care requirements, interaction with health care inspectors and advocacy for appropriate budget and staffing based on the current organizational structure. The report made recommendations that all commandants and the Administrator, Division of Homes be licensed. The Board has also received testimony from a member of its Long Term Care Committee who is a licensed nursing home administrator in Wisconsin. The testimony identified similar concerns and concurred with the solutions offered in the Pathways report. The Board has adopted the recommendation related to commandants and the Administrator, Division of Homes being licensed as nursing home administrators.

Analysis and supporting documents used to determine effect on small business

No analysis was performed regarding an economic impact statement.

Small Business Impact

These rules do not appear to have any effect upon small businesses, nor any significant fiscal impact upon the private sector.

Fiscal Estimate

Assumptions used in arriving at fiscal estimate

The proposed amendment will require that any individual employed as a commandant or as the administrator for the division of the Wisconsin Veterans Homes (WVH), shall be licensed under chapter 456 of the Wisconsin Statues or secure such licensure within 90 days of initiating employment. The proposed repeal will realign the direction of commandants from direct supervision by the secretary to direct supervision by the WVH's division administrator.

The proposed changes will have no fiscal effect on the department.

Please contact James A. Stewart, 30 West Mifflin Street, P.O. Box 7843, Madison, WI 53707-7843 or Phone: [phone] or E-Mail: [e-mail] to request a copy of the fiscal estimate.

State fiscal effect

None.

Text of Proposed Rules

SECTION 1. VA 1.11 (1) is amended to read:

VA 1.11 (1) Employ a commandant s for the Wisconsin veterans homes, designate an employee of the department as deputy secretary, and appoint such persons as may be necessary to carry out the functions of the department. Any individual employed as a commandant or as the administrator for the division of homes, after January 1, 2011, shall be licensed under Chapter 456 of the Wisconsin Statutes or secure such licensure within 90 days of initiating employment as a commandant or administrator of the division of homes.

SECTION 2. VA 1.11 (8) is repealed.

Agency Contact Person

James A. Stewart, Chief Legal Counsel

30 West Mifflin Street, P.O. Box 7843

Madison, WI 53707-7843

Phone: [phone]

EMail: [e-mail]