The Senate Wednesday passed the first outlining the future or nursing home care and enacts into law major components of legislation necessary to implement the state health and mental hygiene budget for the 2016-2017 state fiscal year.
§ 24. Restorative care unit demonstration program. 1. Notwithstanding 52 any law, rule or regulation to the contrary, the commissioner of health, 53 within amounts appropriated, shall implement a restorative care unit 54 demonstration program within one year of the effective date of this 55 section to reduce hospital admissions and readmissions from residential 56 health care facilities established pursuant to article 28 of the public S. 6407--C 11 A. 9007--C
1 health law, through the establishment of restorative care units. Such 2 units shall provide higher-intensity treatment services for residents 3 who are at risk of hospitalization upon an acute change in condition, 4 and seek to improve the capacity of nursing facilities to identify and 5 treat higher acuity patients with multiple co-morbidities as effectively 6 as possible in-situ, rather than through admission to an acute care 7 facility. The unit shall utilize evidence based tools, as well as: (a) a 8 critical indicator monitoring system to evaluate performance indicators; 9 (b) patient-focused education to support advanced care planning and 10 palliative care decisions; and (c) protocols to effect care monitoring 11 practices designed to reduce the likelihood of change in patient status 12 conditions that may require acute care evaluation. A residential health 13 care facility, established pursuant to article 28 of the public health 14 law, wishing to establish restorative care units must contract with an 15 eligible applicant. 16 2. For the purposes of this section, an eligible applicant must at a 17 minimum meet the following criteria: (a) be a New York state entity in 18 good standing; and (b) have demonstrated experience and capacity in 19 developing and implementing a similar unit as described herein. An 20 eligible applicant for this demonstration program shall contract with a 21 residential health care facility, established pursuant to article 28 of 22 the public health law, with a license in good standing that: (i) employs 23 a nursing home administrator with at least two years operational experi- 24 ence; (ii) has a minimum of 160 certified beds; (iii) accepts reimburse- 25 ment pursuant to title XVIII and title XIX of the federal social securi- 26 ty act; (iv) has achieved at least a three star overall nursing home 27 compare rating from the Center for Medicare and Medicaid Services five- 28 star quality rating system; and (v) operates a discreet dedicated 29 restorative care unit with a minimum of 18 beds. Additionally, the 30 contracting facility must have at the time of application, and maintain 31 during the course of the demonstration, functional wireless internet 32 connectivity throughout the facility, including backup, with sufficient 33 bandwidth to support technological monitoring. 34 3. Restorative care units; requirements. Restorative care units shall 35 provide on-site healthcare services, including, but not limited to: (a) 36 radiology; (b) peripherally inserted central catheter insertion; (c) 37 blood sugar, hemoglobin/hematocrit, electrolytes and blood gases moni- 38 toring; (d) 12-lead transmissible electrocardiograms; (e) specialized 39 cardiac services, including rapid response teams, crash carts, and defi- 40 brillators; (f) telemedicine and telemetry which shall have the capabil- 41 ity to notify the user, in real time, when an urgent or emergent physio- 42 logical change has occurred in a patient's condition requiring 43 intervention, and to generate reports that can be accessed by any 44 provider, in real time, in any location to allow for immediate clinical 45 intervention. 46 4. Electronic health records. For the duration of the demonstration, 47 the restorative care unit shall utilize and maintain an electronic 48 health record system that connects to the local regional health informa- 49 tion organization to facilitate the exchange of health information. 50 5. The department of health shall monitor the quality and effective- 51 ness of the demonstration program in reducing hospital admissions and 52 readmissions over a three year period and shall report to the legisla- 53 ture, within one year of implementation, on the demonstration program's 54 effectiveness in providing a higher level of care at lower cost, and 55 include recommendations regarding the utilization of the restorative 56 care unit model in the state.