North Carolina § 131E-100 - Title; purpose.

§ 131E-100. Title; purpose.

This Part shall be known as the "Nursing Home Licensure Act." The purpose of the Nursing Home Licensure Act is to establish authority and duty for the Department to inspect and license private nursing homes. History (1983, c. 775, s. 1.) Editor's Note. - Session Laws 2001-385, ss. 2(a) through (e), provide: "Section 2.(a) The Department of Health and Human Services shall establish a Skilled Nursing Facility Quality Improvement Consultation Project to assist providers in the development of quality improvement plans for each long-term care facility and program that offers skilled nursing services to the public. In order to avoid conflict with federal regulations, the Department shall locate the project in a section of the Division of Facility Services [now the Division of Health Service Regulation] other than the Licensure and Certification Section. Project staff shall include nurses who have previous experience in long-term care. Staff shall be available to all licensed nursing facilities and, upon request of the facility, shall provide on-site consultation in at least the following areas: "(1) Analysis of recent survey results in order to assist the facility with its efforts to correct problems or deficiencies identified by the survey. "(2) Training for in-house quality improvement programs. "(3) Specific area or issues of concern raised by the facility. "(4) Best practices information. The Department may contract with a private entity to assist in the implementation of the project. "Section 2.(b) The Department of Health and Human Services shall offer joint training of survey team members and nursing home providers. The training shall be offered no fewer than two times per year, and subject matter of the training should be based on one or more of the 10 deficiencies cited most frequently in the State during the immediately preceding calendar year. The joint training shall be designed to reduce inconsistencies experienced by providers in the survey process, to increase objectivity by survey team members in conducting surveys, and to promote a higher degree of understanding between facility staff and survey team members in what is expected during the survey process. "Section 2.(c) The Department of Health and Human Services shall require survey team members who have no previous nursing home experience to spend part of their basic training in a nursing home observing operations of the nursing home. On-site training should be designed to provide the survey team member with experience in the actual operation of a nursing facility outside of the survey process and to achieve a general understanding of the following facility functions: administration, nursing, personal care services, and dietary services. On-site training requirement shall be for a minimum of three days and must be completed before the survey team member assumes survey work or oversight responsibilities. In addition to on-site training, at least fifty percent (50%) of the annual continuing education requirement of survey team members shall be in the subject area of geriatric care. "Section 2.(d) The Department of Health and Human Services shall convene a Skilled Nursing Facility Quality of Standards Work Group to explore alternatives to existing oversight and survey practices that will ensure quality in skilled nursing facilities. The Work Group shall do the following: "(1) Clarify and provide guidance on terms applicable in the survey and oversight process to ensure uniformity. Terms that should be clarified include 'immediate jeopardy', 'harm', 'potential harm', 'avoidable', and 'unavoidable'. The Department shall ensure that clarification of terms is included in basic and continuing survey training. "(2) Identify rules that impede the direct care of patients and develop a proposal for repeal of those rules, including any necessary repeal of, or amendment to, current law that is the basis for the rule. "(3) Examine possible incentives for providers such as extended survey period, increased reimbursement rates, accreditation, and deemed status. The Work Group shall consider all available quality measurements in developing recommendations for incentives. The Work Group shall also identify changes in current law necessary to implement incentives. "(4) Explore aspects of quality assessment/monitoring that should be changed to facilitate improvements and determine if a waiver from the Health Care Financing Administration is necessary to implement innovative approaches to the delivery and monitoring of long-term care in this State. "The Work Group shall consist of representatives of the Division of Facility Services [now the Division of Health Service Regulation] of the Department of Health and Human Services and the North Carolina Health Care Facilities Association. "Section 2.(e) The Department of Health and Human Services of the Department of Health and Human Services shall report to the Joint Legislative Health Care Oversight Committee and the North Carolina Study Commission on Aging on the status of implementation of this section. The report shall be submitted on October 1, 2001, and March 1, 2002." Session Laws 2020-3, s. 3A.1(a), provides: "Unless the context clearly indicates otherwise, the following definitions apply in this Part: "(1) CDC. - The federal Centers for Disease Control and Prevention. "(2) COVID-19. - Coronavirus disease 2019. "(3) COVID-19 diagnostic test. - A test the federal Food and Drug Administration has authorized for emergency use or approved to detect the presence of the severe acute respiratory syndrome coronavirus 2. "(4) COVID-19 emergency. - The period beginning March 10, 2020, and ending on the date the Governor signs an executive order rescinding Executive Order No. 116, Declaration of a State of Emergency to Coordinate Response and Protective Actions to Prevent the Spread of COVID-19. "(5) COVID-19 antibody test. - A serological blood test the federal Food and Drug Administration has authorized for emergency use or approved to measure the amount of antibodies or proteins present in the blood when the body is responding to an infection caused by the severe acute respiratory syndrome coronavirus 2." Session Laws 2020-3, s. 3E.3(a)-(c), provides: "(a) Notwithstanding any provision of Article 2 of Chapter 122C , Articles 1 and 3 of Chapter 131D , and Chapter 131E of the General Statutes, or any other provision of law to the contrary, the Department of Health and Human Services, Division of Health Service Regulation, and as applicable, local departments of social services, shall suspend all annual and biennial inspections and regular monitoring requirements for licensed facilities under Article 2 of Chapter 122C of the General Statutes, Articles 1 and 3 of Chapter 131D of the General Statutes, and Articles 5, 6, and 10 of Chapter 131E of the General Statutes, and provisions within any rules adopted under these chapters that pertain to the Department or DHSR monitoring, inspection, or investigative requirements, except (i) as DHSR deems necessary to avoid serious injury, harm, impairment, or death to employees, residents, or patients of these facilities or (ii) as directed by the Centers for Medicare and Medicaid Services. "(b) DHSR shall review the compliance history of all facilities licensed under Article 2 of Chapter 122C of the General Statutes and Article 1 of Chapter 131D of the General Statutes that were determined to be in violation, assessed penalties, or placed on probation within the six-month period preceding the beginning of the COVID-19 emergency, for noncompliance with rules or statutes or Centers for Disease Control and Prevention guidelines regarding infection control or the proper use of personal protective equipment. DHSR shall require employees of these facilities to undergo immediate training designated by DHSR about infection control and the proper use of personal protective equipment. The training required by this section may be conducted online, by video conference, or in such manner as DHSR determines appropriate under the circumstances. "(c) This section is effective when it becomes law [May 4, 2020] and expires 60 days after Executive Order No. 116 is rescinded, or December 31, 2020, whichever is earlier." Session Laws 2020-3, s. 5, is a severability clause. Legal Periodicals. - For article, "The Obligation of North Carolina Municipalities and Hospital Authorities to Provide Uncompensated Hospital Care to the Medically Indigent," see 20 Wake Forest L. Rev. 317 (1984). For article, "A Senior Moment: The Executive Branch Solution to the Problem of Binding Arbitration Agreements in Nursing Home Admission Contracts," see 31 Campbell L. Rev. 157 (2009).