HB 2176
Initials AG Page 1 House Engrossed
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-seventh Legislature
First Regular Session
House: HHS DPA/SE 11-1-0-0
HB 2176: health facilities; complaints; investigations; training
NOW: training; investigations; complaints; health facilities
Sponsor: Representative Willoughby, LD 13
House Engrossed
Overview
Establishes requirements for the Arizona Department of Health Services (DHS) relating to
complaint investigations. Describes the process for licensee's who receive a statement of
deficiencies following a state survey or complaint investigation and wishes to refute those
deficiencies. Requires DHS to implement an annual training program for all licensing
surveyors, supervisors and managers of licensing surveyors to ensure compliance with health
care institution licensing, survey and complaint investigation requirements and outlines
objectives for the training program.
History
A health care institution is every place, institution, building or agency, whether organized for
profit or not, that provides facilities with medical services, nursing services, behavioral
health services, health screening services, other health-related services, supervisory care
services, personal care services or directed care services and includes home health agencies,
outdoor behavioral health care programs and hospice service agencies.
Current law establishes processes and procedures that applicants must follow to obtain a
health care institution license. Applicants must submit to DHS: 1) an application on a written
or electronic form that contains certain information about the health care institution; 2) a
notarized attestation form that verifies the architectural plans and specifications of the
health care institution; and 3) the applicable application fee. An application for a health care
institution license must be submitted at least 60 days, but not more than 120 days before the
anticipated date of operation. An application for a substantial compliance survey must be
submitted at least 30 days before the date on which the survey was requested.
If a current licensee intends to terminate the operation of a licensed health care institution
or if a change in ownership is planned, the current licensee must notify the DHS Director in
writing at least 30 days before the termination of operation or change in ownership has taken
place. The current licensee is responsible for preventing any interruption of services required
to sustain the life, health and safety of the patients or residents. A new owner is prohibited
from beginning to operate the health care institution until the DHS Director issues a license
to the new owner (A.R.S. § 36-401 and 36-422).
The DHS Director may continue to pursue any court, administrative or enforcement action
against a licensee even if the health care institution is in the process of being sold, transferred
or has closed. DHS may deny an application for a health care institution license if either: 1)
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note HB 2176
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the applicant, the licensee or controlling person has a health care institution license that is
in an enforcement action or court action related to the health and safety of the residents or
patients; or 2) DHS has determined for other reasons that the issuance of a new license is
likely to jeopardize resident or patient safety. DHS may deny the approval of a change in
ownership of a currently licensed health care institution if it determines that the transfer of
ownership, whether involving a direct or indirect owner, may jeopardize patient safety
(A.R.S. § 36-420.05).
Provisions
Complaint Priority Matrix
1. Requires DHS to notify the licensee of the nature of the complaint when entering a health
care institution for an investigation related to a complaint. (Sec. 2)
2. Requires DHS to ensure that the notice does not include protected health information or
information that may identify the complainant. (Sec. 2)
3. Requires DHS to provide a priority matrix for complaints filed against health care
institutions on its public website with a link to the rules that govern the complaint
process. (Sec. 2)
4. Requires the priority matrix to provide:
a) details of the various levels of complaints;
b) the process for determining the complaint level assignment; and
c) the time frames for initiating a complaint investigation. (Sec. 2)
5. Requires DHS, before conducting a complaint investigation to disclose:
a) the level of the complaint; and
b) all documents that affect the internal procedures of the department or impose
additional requirements or penalties on the licensees. (Sec. 2)
6. Prohibits DHS from considering or investigating any alleged violation that occurred more
than one year before the date that the state survey or initial complaint investigation is
being conducted. (Sec. 2)
7. Requires DHS to include in a statement of deficiencies that is issued following a state
survey or complaint investigation the citation for the statute or rule that applies to each
identified deficiency. (Sec. 2)
8. Requires a licensee that receives a statement of deficiencies following a state survey or
complain investigation and wishes to refute them to do the following during the informal
dispute process:
a) indicate to DHS each deficiency the licensee is refuting;
b) provide a detailed explanation of why the licensee believes the information contained
in the statement of deficiencies is inaccurate;
c) provide a request for the information to be corrected or rescinded; and
d) provide any supporting documentation that explains the reason the deficiency should
be rescinded. (Sec. 2)
9. Requires DHS to review the information and documentation provided by the licensee
within 10 days after receiving the information and render a written decision stating:
a) whether the licensee's request is approved or denied; and
b) contain a detailed explanation of the approval or reason for approving or denying each
deficiency contained in the dispute. (Sec. 2) HB 2176
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10. Directs DHS to close the complaint if it approves the removal of all deficiencies from the
statement of deficiencies during the informal dispute resolution process. (Sec. 2)
DHS Annual Training Program
11. Requires DHS to implement an annual training program for all licensing surveyors,
supervisors and managers of licensing surveyors to ensure compliance with the health
care institution licensing, investigations and complaints. (Sec. 2)
12. Requires the annual training program to include modules and a process that train
surveyors, supervisors and managers of licensing surveyors to demonstrate practical
knowledge and understanding on the following:
a) governing policies and procedures, statues and rules for which the employee is
responsible;
b) how to ascertain whether a complaint or grievance that is filed with DHS should result
in opening a complaint investigation;
c) how to act in a professional manner with an emphasis on dignity and respect; and
d) the importance of clear and transparent communication with licensees. (Sec. 2)
Miscellaneous
13. Allows DHS to deny an application for a health care institution license if the issuance of
a new license is likely to jeopardize resident or patient safety because there are grounds
for licensure denial pursuant to statute. (Sec. 1)
14. Permits DHS to deny the approval of a change in ownership of a currently licensed health
care institution if DHS determines that the transfer of ownership, whether involving a
new direct or indirect owner, may jeopardize patient safety because there are grounds for
licensure pursuant to statute. (Sec. 1)
15. Requires DHS to adopt rules outlining the evaluation process for the transfer, sale or
change in ownership of a health care institution license from which the DHS Director will
make a determination. (Sec. 1)