STATUS:Referred to the Assembly Government Operations Committee; Public hearing held 10/7/97; Executive session scheduled 2/25/98

ANALYSIS:The executive session will be held on Assembly Substitute Amendment 1 (ASA 1) to AB 479, authored by State Representative Peggy Krusick (D-Milwaukee), who authored the original bill as well. ASA 1 to AB 479 would do the following:

1. Require the Department of Health and Family Services (DHFS) to suspend new admissions to a nursing home if the facility has received notices of violation (NOV) for a Class “A” violation or 3 or more Class “B” violations during both the previous 12 months and any 12-month period during the 3 years preceding the previous 12 months. The suspension of new admissions remains in effect until all Class “A” and Class “B” violations have been corrected.
   

2. Initiate a suspension of admissions either 90 days after a nursing home received its last NOV for a Class “A” or a Class “B” violation or at the time of a return visit to the facility where the DHFS determines there is an uncorrected Class “A” or Class “B” violation, whichever comes first. Admission of a new resident during the period for which admissions have been suspended constitutes a Class “B” violation.
   

3. Increase forfeiture levels. Under current law, a Class “A” violation may be subject (at the DHFS’ discretion) to a forfeiture of not more than $5,000; under ASA 1 to AB 479, a Class “A” violation is subject (no discretion) to a forfeiture of not less than $5,000 nor more than $10,000. Under current law, a Class “B” violation may be subject to a forfeiture of not more than $1,000; under ASA 1 to AB 479, a Class “B” violation may be subject (at the DHFS’ discretion) to a forfeiture of not more than $5,000. Under current law, a Class “C” violation may be subject to a forfeiture of not more than $100; under ASA 1 to AB 479, a Class “C” violation may be subject to a forefeiture of not more than $500. Similar changes are made in the statute that provides for a separate forfeiture for a Class “A” or Class “B” violation if the licensee fails to correct the violation within a specified time period.
   

4. Under current law, a nursing home that violates a statute or rule and that has received a NOV of the same statute or rule on one or more prior occasions within the prior 2-year period may be subject (based on DHFS discretion) to a forfeiture that is three times the amount authorized for the class of violation involved. ASA 1 to AB 479 amends current law to use a 3-year period, rather than a 2-year period, to determine repeat violations. In addition, ASA 1 to AB 479 makes changes with regard to the discretionary nature of tripling forfeitures and with regard to the nature of the repeat violation and its relationship to the prior violation. The following table shows the circumstances in which a triple forfeiture may or must be assessed:
   
   
   

   Prior Violation	Current Violation	Triple Forfeiture
   Class "A"	Class "A" or "B" (same or different statute or rule)	Mandatory
   Class "B"	Class "A" (same or different statutue or rule)	Mandatory
   Class "B"	Class "B" (same statutue or rule)	Mandatory
   Class "B"	Class "B" (different statutue or rule)	Discretionary

   
   
   

5. If a nursing home does not contest a NOV and an assessment of forfeiture for a Class “A” or “B” violation and pays the forfeiture to the DHFS within 10 days of receipt of the notice of assessment, ASA 1 to AB 479 requires the DHFS to reduce the amount of the assessment by 35%.
   

6. ASA 1 to AB 479 expands the authority of the Nursing Home Administrator Examining Board to take disciplinary action against an administrator if proof is submitted that while the licensee was the administrator of the nursing home, that nursing home received an excessive number of violations that were not reversed on appeal.
   

7. Require the DHFS to publish a Class 1 notice in a newspaper likely to give notice in the area where a nursing home is located if that facility has had its admissions suspended.
   

WAHSA POSITION: Oppose

WAHSA supports the elimination of the dual state/federal nursing home regulatory systems through the elimination of the State system and the retention of the federal system. While the federal system promotes compliance, it has at its disposal sanctions that are much harsher than those contained in ASA 1 to AB 479 to be used against poor performing facilities.

The Wisconsin Association of Homes and Services for the Aging (WAHSA) is a statewide membership organization of not-for-profit cor- porations principally serving the elderly and disabled. Membership is comprised of 195 religious, fraternal, private and governmental organizations which own, operate and/or sponsor 145 not-for-profit and 47 county-operated nursing homes, 23 facilities for the devel- opmentally disabled, 56 community-based residential facilities, 10 licensed home health agencies, 91 independent living facilities, 40 adult day care programs and over 300 community service agencies which provide programs ranging from Alzheimer’s support, child day care, hospice and home care to Meals on Wheels. For more information, please contact the WAHSA staff at (608) 255-7060: John Sauer, Executive Director; Tom Ramsey, director of Government Relations; Brian Schoeneck, Financial Services Director.

Wisconsin Association of Homes and Services for the Aging
204 South Hamilton Street
Madison, WI 53703
Telephone: (608)255-7060 FAX:(608)255-7064