Michigan nursing home responsiveness requirements

Staff may not physically, mentally or emotionally abuse, mistreat or harmfully neglect a patient. An employee with reasonable suspicion must report to the nursing home administrator or nursing director AND to the department as required by federal regulations; an administrator or nursing director must report the suspicion by telephone to the department and 1 or more law enforcement entities; a physician or other licensed health care personnel must report to the department and 1 or more law enforcement entities. Any individual may report a violation, and eviction, harassment, dismissal or retaliation against a patient, a patient's representative or a reporting employee is prohibited.

A nursing home employee who has reasonable suspicion of an act prohibited by this section shall report the suspicion to the nursing home administrator or nursing director and to the department as required by federal regulations. A nursing home administrator or nursing director who has reasonable suspicion of an act prohibited by this section shall report the suspicion by telephone to the department and 1 or more law enforcement entities as required by federal regulations.

A nursing home cannot be licensed unless it has formulated and is ready to implement a plan giving residents immediate access to acute care facilities for emergency care.

A nursing home shall not be licensed under this part unless the nursing home has formulated, and is prepared to implement, insofar as possible, a plan to provide immediate access to acute care facilities for the emergency care of patients.

Every nursing home must run a program of planned and continuing medical treatment under the charge of physicians, and may employ or contract with an individual licensed or otherwise authorized to engage in a health profession under part 170 (medicine) or part 175 (osteopathic medicine and surgery) to provide that care, including direct clinical services to residents.

A program of planned and continuing medical treatment under the charge of physicians.

Nursing care facility admissions require a physician order, an initial physician medical examination within 30 days of admission, and routine examinations at least every 60 days thereafter.

An initial medical examination of a patient by a physician must be completed within 30 days of the admission date.

A nursing home must have on staff at least one registered nurse with specialized training or relevant experience in gerontology to serve as director of nursing responsible for planning and directing nursing care, keep at least one licensed nurse on duty at all times, provide continuous 24-hour nursing care, and maintain no less than 2.25 nursing hours per patient per day with shift ratios capped at 8:1 (morning), 12:1 (afternoon) and 15:1 (night).

The nursing home shall have at least 1 licensed nurse on duty at all times and shall employ additional registered and licensed practical nurses in accordance with subsection (2).

The facility must designate a registered professional nurse as director of nursing to direct all nursing services, delegable in writing only to another qualified RN so that nursing services remain continuous.

A health facility or agency shall designate a registered professional nurse to serve as the director of nursing.

Nursing home patients may associate and communicate privately with persons of their choice, must get at least 8 hours of daily visiting time and reasonable privacy for visits, and each patient is entitled to reasonable telephone access.

Each patient shall have reasonable access to a telephone.

A patient is entitled to private communications and consultations with their physician, advanced practice registered nurse, attorney or any other individual of their choice, and to send and receive personal mail unopened on the day it arrives.

A patient or resident is entitled to associate and have private communications and consultations with his or her physician or a physician's assistant with whom the physician has a practice agreement, with his or her advanced practice registered nurse, with his or her attorney, or with any other individual of his or her choice and to send and receive personal mail unopened on the same day it is received at the health facility or agency

The facility must make telephone service available on patient care units.

A health facility shall provide a telephone service that is available on patient care units.

The facility must adopt, post and distribute written policies protecting the statutory patient rights in MCL 333.20201-20203, give them to the patient and guardian/representative before admission, and convey information in a form the patient can reasonably understand.

A health facility or agency shall develop, adopt, implement, post, and distribute written policies and procedures to protect the rights and responsibilities of patients as provided in sections 20201, 20202, and 20203 of the code, MCL 333.20201, 333.20202, and 333.20203.

As part of its emergency preparedness program the facility must keep a written communication plan covering notification of local emergency response agencies, personnel, patients, patient guardians/families, the patient's physician, utility and information-management vendors, other essential suppliers and the department, plus provisions for transferring patients and their records, available to the department on request.

As part of its emergency preparedness program, an applicant or licensee shall have a written communication plan. The communication plan must include, but is not limited to, notification of the following as appropriate to the emergent event:

A nurse call system must be provided in each facility, with call devices of specified types at the locations mandated by Table 2 (including patient bed locations and patient water closets, showers and baths).

A nurse call system must be provided in each facility. This system must provide call devices of the designated types shown at the locations identified in Table 2.

The governing body must ensure a defined, implemented and maintained quality assessment and performance improvement (QAPI) program that addresses identified priorities, evaluates improvements for effectiveness, specifies data collection methods, sets patient safety expectations, allocates staff and training, and is periodically evaluated and revised.

The governing body shall ensure the health facility or agency has a quality assessment and performance improvement program that is defined, implemented, maintained, and includes all of the following:

The QAPI program must be data-driven and ongoing, monitor quality in all operational areas that could adversely affect patient care, identify problems, reduce medical errors, improve patient safety, and demonstrate measurable improvements, prioritizing high-risk, high-volume and problem-prone areas.

The quality assessment and performance improvement program must monitor quality in all areas of operations that may adversely affect patient care or core services, demonstrate measurable improvements in patient health or palliative outcomes, and improve patient safety.