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PA Bulletin, Doc. No. 99-597


Requirements for Temporary Managers in Long-Term Care Facilities

[29 Pa.B. 1949]

   Under section 814(b) of the Health Care Facilities Act (35 P. S. § 448.814(b)), the Department of Health (Department) may petition the Commonwealth Court or Court of Common Pleas to appoint temporary management designated as qualified by the Department to assume operation of a facility.

   Temporary management is employed at the facility's expense to assure the health and safety of the residents until corrections are made to bring the facility into compliance with the laws and regulations for licensure or until there is an orderly closure of the facility. Applicants must not have any direct or indirect ownership interests, or controlling interest separately or in combination amounting to an ownership interest in the facility to which they are seeking appointment as a temporary manager.

   To be considered as a temporary manager, all applicants must provide the following evidence of their ability to successfully manage long-term care nursing facilities:

   1.  Professional credentials.

   a.  Licenses for all individuals providing management services, including nursing home administrators, registered nurses and other licensed professionals.

   b.  Information regarding the education and experience of principals and agents of the applicant.

   c.  FBI and Pennsylvania criminal history reports (Act 169) on all principals and agents.

   2.  Relevant experience.

   a.  A nursing home administrator must have at least 3 years of experience as a full-time administrator of a licensed long-term care nursing facility with an established history of substantial compliance with State and Federal requirements during the administrator's tenure at the facility.

   b.  A director of nursing services must have at least 3 years of experience in nursing services administration and supervision in a long-term care setting.

   c.  Representatives of other disciplines that may be used by the temporary manager, such as the dietitian, social worker, activities coordinator or medical records practitioner, must have at least 2 years of experience in a long-term care setting.

   d.  Professional persons must have no record of professional disciplinary action affecting licensure and must have no action pending against licensure in Pennsylvania or any other state at the time of application for, or involvement in, temporary management.

   3.  Applicant must provide the following:

   a.  Records of management of long-term care nursing facilities, or other health care facilities which might provide relevant experience, which are owned or operated by the applicant. Include compliance history with particular reference to any periods in which State or Federal adverse action recommendations were made, whether or not the adverse action became final. The compliance history should include: provisional licenses, bans on admissions and readmissions, civil monetary penalties (Federal and State) reports to licensing boards (substantiated or unsubstantiated).

   b.  A complete rationale for periods of noncompliance and the measures that were used to prevent future noncompliance.

   c.  An explanation of how management experience will be used to implement systems which will return a facility to substantial compliance.

   d.  Names, addresses and telephone numbers of state survey agencies, Medicaid agencies or other regulatory agencies that are familiar with the applicant's experience in bringing long-term care nursing facilities into compliance and maintaining compliance.

   4.  Description of the scope of services which the applicant is prepared to provide, as described by the following categories:

   a.  Direct Comprehensive Management Services: Applicants must describe their ability to provide direct services, including the ability to utilize existing resources to provide the following:

   --Comprehensive assessment of residents and interventions to address the immediate needs of all residents.

   --Services which may include, but are not limited to: physician evaluations, rehabilitative services, nutritional evaluations, psychiatric assessments, behavior management, physical and chemical restraint reduction, infection control and other resident-centered services.

   --Financial management.

   --Monitoring of staff performance.

   --Replacement staff (including a detailed analysis of the use and effectiveness of agency personnel).

   --Staff training.

   --Clinical records' audits.

   --Administrative and management services including evaluation of efficacy of contracted services, and replacement of contractors.

   b.  Indirect Comprehensive Management Services: Applicants must describe their ability to obtain and retain resources to provide the services detailed in item (a) through the use of contracts or other arrangements with service providers.

   c.  Limited Management or Educational Services: Applicants must describe specialized services that they can provide on an as-needed basis, such as:

   --Nursing home administrators on a consultant or full-time basis.

   --Resident assessment and care planning.

   --Staff education and training.

   --Development, implementation and monitoring of plans of correction

   --Infection control.

   --Other services.

   5.  Specific geographic area in which the applicant is able to provide direct, indirect or limited services.

   6.  Applicants shall demonstrate an understanding of cultural diversity by:

   a.  Providing evidence of the ability to perform in a manner which does not discriminate on the basis of age, race, sex, religion, handicap or national origin.

   b.  Submitting copies of the applicant's nondiscriminatory policy and any other documentation that may support compliance with nondiscriminatory requirements.

   7.  Written and oral presentation.

   Applicants must be prepared to demonstrate the ability to provide temporary management services in a written and oral presentation to senior level department officials. This presentation will describe the immediate, and long-term plans for bringing a designated facility into substantial compliance with State and Federal regulations. The Department reserves the right to consider this presentation as the basis for approving or denying the applicant the opportunity to act as a temporary manager.

   Interested persons are encouraged to apply by submitting the required information to: Director; Division of Nursing Care Facilities; Room 526, Health and Welfare Building; Harrisburg, PA 17120.

   For additional information, or for persons with a disability who desire or require an auxiliary aid, service or other accommodation to do so, contact William Bordner at (717) 787-1816. V/TT: (717) 783-6514 for speech and/or hearing impaired persons, or the Pennsylvania AT&T Relay Services at (800) 654-5984 [TT].

Acting Secretary

[Pa.B. Doc. No. 99-597. Filed for public inspection April 9, 1999, 9:00 a.m.]

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