Michigan Office of Administrative Hearings and Rules

MOAHR-Rules@michigan.gov

AGENCY REPORT TO THE

JOINT COMMITEE ON ADMNINISTRATIVE RULES (JCAR)

1. Agency Information

Agency name:

Licensing and Regulatory Affairs

Division/Bureau/Office:

Bureau of Community and Health Systems

Name of person completing this form:

Tammy Bagby

Phone number of person completing this form:

517-243-9351

E-mail of person completing this form:

BagbyT@michigan.gov

Name of Department Regulatory Affairs Officer reviewing this form:

Elizabeth Arasim

2. Rule Set Information

MOAHR assigned rule set number:

2022-21 LR

Title of proposed rule set:

Homes for the Aged

3. Purpose for the proposed rules and background:

The Homes for the Aged administrative rules provide for the licensing regulation of homes for the

aged, including establishing the standard of quality care requirements.

The proposed changes are due to obsolete rules and to comply with the requirements set forth in MCL

333.20171.

The specific rules proposed for revision are:

R 324.1901 (10),(14) and (17)- Definitions

R 325.1924 - Reporting of incidents

R 325.1932 - Medications

4. Summary of proposed rules:

The proposed rules establish requirements for state licensed homes for the aged providers to record,

track, and respond to incidents where a resident is harmed. These documents must be available to the

department upon request during routine inspections or complaint investigations.

5. List names of newspapers in which the notice of public hearing was published and

publication dates:

MCL 24.242 and 24.245

Agency Report to JCAR-Page 2

7/26/2022 Flint Journal

7/27/2022 Grand Rapids Press

7/28/2022 Marquette Mining Journal

6. Date of publication of rules and notice of public hearing in Michigan Register:

8/15/2022

7. Date, time, and location of public hearing:

8/18/2022 09:00 AM at Williams Building, 1st Floor Auditorium , 525 West Ottawa Street, Lansing,

MI 48933

8. Provide the link the agency used to post the regulatory impact statement and cost-benefit

analysis on its website:

https://ARS.apps.lara.state.mi.us/Transaction/RFRTransaction?TransactionID=1380

9. List of the name and title of agency representative(s) attending public hearing:

Larry Horvath, Director of the Bureau of Community and Health Systems

Heather Hosey, Director of the Health Facility Licensing, Permits and Support Division in the Bureau

of Community and Health Systems, and Andrea Moore, Manager of the Long-Term Care State

Licensing Section

10. Persons submitting comments of support:

Dalton Herbel, LeadingAge MI

11. Persons submitting comments of opposition:

None

12. Persons submitting other comments:

Robert Stein, Michigan Assisted Living Association,

Linda Lawther, Michigan Center for Assisted Living (MCAL)

Michelle Roberts, Disability Rights Michigan

13. Identify any changes made to the proposed rules based on comments received during the

public comment period:

Name &

Organization public hearing

Comments made at Written

Agency Rationale Rule number

for Rule Change & citation

and Description changed

of Change(s)

Comments

Made

1

Robert Stein,

Michigan

Assisted Living

Association

Rule 1(n) - Our The bureau agreed R 325.1901

organization that the suggested (n)

recommends that change provides

the proposed clarity and to

definition under remove the

R 325.1932

(2), (3)(b)(ii),

(3)(b)(vi) and

3(c)

Rule 1(n) be

revised to the

following

"service plan"

phrase.

MCL 24.242 and 24.245

Agency Report to JCAR-Page 3

language:

325.1901 (n)

“Medication

management”

definition revised

and removed

means assistance reference to

with the

service plan.

acquisition and

administration of changed from

a

resident’s

prescribed

medication.

“Medication

management"

means assistance

with the

acquisition and

administration of a

resident's

medication as

prescribed

medication as

listed in a

resident’s service

plan by a licensed

health care

professional.

To

"Medication

management"

means assistance

with the

acquisition and

administration of a

resident’s

prescribed

medication

resident's

medication as

prescribed by a

licensed health

care professional.

The changes listed

below were

necessary based

on the changes

made due to Mr.

Stein’s comments

on 325.1901 (n).

MCL 24.242 and 24.245

Agency Report to JCAR-Page 4

325.1932 (2)

“service plan”

was agreed upon

to be removed

from 325.1901 (n),

based on Mr.

Stein’s comments.

For consistency, it

also needed to be

removed from

325.1932 (2).

1932 (3)(b)(ii)

325.1901 (n) was

modified and

added

“prescribed” based

on Mr. Stein’s

comments. For

consistency, it also

needed to be

added to 1932 (3)

(b)(ii).

In response to Mr.

Stein’s comments

to remove the

documentation of

medication from

the service plan,

the bureau needed

to provide

clarification on

where the

documentation of

medication

changes needed to

be in place of the

service plan,

which is the

addition of the

reference to

medication log.

325.1932 (3)(b)

MCL 24.242 and 24.245

Agency Report to JCAR-Page 5

(vi) added

language

referencing

subdivision (c).

325.1932 (3)(c)

added ”medication

log” to ensure

medication was

recorded at a

minimum in a log

with the removal

of service plan

term.

2

Dalton Herbel,

LeadingAge MI

We ask that the The bureau agreed R 325.1924

language used to with the suggested (1) (6) and (9)

describe these

change to avoid

internal incident confusion and

and accident

reporting

changed " Quality

Assessment and

entities/programs Performance

be changed from Improvement

“Quality

Program" to

Assessment and “Quality Review

Performance

Improvement

Program” (QAPI)

to

Program” .

simply “Quality

Review

Program”.

MCL 24.242 and 24.245

Agency Report to JCAR-Page 6

3

Linda Lawther,

Michigan

Center for

Assisted Living

(MCAL)

Rule 24(3), the

following

language is

preferred:

The program

must be staffed

by a multi-

The bureau agreed R 325.1924

the suggested

change provides

clarity to the

(3)

minimum number

of staff needed for

a multi-

disciplinary team. disciplinary team.

The multi-

disciplinary team Changed from

shall consist

of not less than 2 must be staffed by

personnel from a multi-

(3) The program

the home and if disciplinary team.

needed additional The multi-

staff who have

training or

disciplinary team

shall consist of not

experience with less than 2

the type of the

incident being

evaluated.

personnel from the

home and

additional staff

who have training

or experience with

the type of the

incident being

evaluated.

Changed to

(3) The program

must be staffed by

a multi-

disciplinary team.

The multi-

disciplinary team

shall consist of not

less than 2

personnel that

have training or

experience with

the type of

incident being

evaluated.

14.Date report completed:

11/14/2022

MCL 24.242 and 24.245