| 19 | | - | Section 1. (NEW) (Effective from passage) (a) For purposes of this 1 |
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| 20 | | - | section: 2 |
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| 21 | | - | (1) "Registered nurse's aide" means a nurse's aide registered in 3 |
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| 22 | | - | accordance with chapter 378a of the general statutes; 4 |
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| 23 | | - | (2) "Daily minimum staffing ratio" means (A) two and three-tenths 5 |
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| 24 | | - | hours of direct care per nursing home facility resident provided by 6 |
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| 25 | | - | registered nurse's aides over a twenty-four-hour period, and (B) seven-7 |
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| 26 | | - | tenths of one hour of medical care per nursing home facility resident 8 |
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| 27 | | - | provided by licensed nursing personnel over a twenty-four-hour 9 |
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| 28 | | - | period; 10 |
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| 29 | | - | (3) "Department" means the Department of Public Health; 11 |
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| 30 | | - | (4) "Direct care" means hands-on care provided to a nursing home 12 |
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| 31 | | - | facility resident by a registered nurse's aide, including, but not limited 13 |
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| 32 | | - | to, providing assistance with feeding, bathing, toileting, dressing, 14 |
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| 33 | | - | lifting or moving residents, but not physical or occupational therapy, 15 |
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| 34 | | - | medication administration, food preparation, housekeeping or laundry 16 |
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| 35 | | - | services; 17 Substitute Bill No. 1079 |
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| 24 | + | Section 1. (NEW) (Effective from passage) (a) As used in this section, 1 |
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| 25 | + | (1) "nursing home facility" means a chronic and convalescent nursing 2 |
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| 26 | + | home, and (2) "nursing staff" means licensed practical nurses, licensed 3 |
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| 27 | + | pursuant to chapter 378 of the general statutes, and registered nurse's 4 |
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| 28 | + | aides, registered pursuant to chapter 378a of the general statutes. 5 |
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| 29 | + | (b) On and after October 1, 2019, each nursing home facility shall 6 |
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| 30 | + | have sufficient nursing staff available on site to maintain a daily 7 |
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| 31 | + | minimum staffing ratio of not less than two and three-tenths nursing 8 |
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| 32 | + | staff hours per resident. 9 |
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| 33 | + | (c) If any nursing home facility experiences increased costs or 10 |
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| 34 | + | expenditures due to compliance with the provisions of this section, the 11 |
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| 35 | + | Department of Social Services shall adjust such facility's Medicaid rates 12 |
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| 36 | + | and provide payment for any such costs or expenditures within a 13 |
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| 37 | + | reasonable period of time and retroactive to the date of such increased 14 Raised Bill No. 1079 |
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| 42 | | - | (5) "Licensed nursing personnel" means nurses licensed in 18 |
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| 43 | | - | accordance with chapter 378 of the general statutes; and 19 |
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| 44 | | - | (6) "Nursing home facility" means a chronic or convalescent nursing 20 |
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| 45 | | - | home. 21 |
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| 46 | | - | (b) On and after October 1, 2019, the Commissioner of Public Health 22 |
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| 47 | | - | shall require each nursing home facility to maintain a daily minimum 23 |
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| 48 | | - | staffing ratio as defined in subsection (a) of this section. The daily 24 |
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| 49 | | - | minimum staffing ratio shall not include break, vacation, sick, 25 |
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| 50 | | - | personal, training, educational or other time that is not spent on direct 26 |
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| 51 | | - | care or medical care provided to a nursing home facility resident. 27 |
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| 52 | | - | (c) The Commissioner of Public Health shall require each nursing 28 |
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| 53 | | - | home facility to maintain a daily record of (1) the number of residents 29 |
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| 54 | | - | at such facility, (2) the number of registered nurse's aides scheduled 30 |
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| 55 | | - | and available to provide direct care, (3) the number of licensed nursing 31 |
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| 56 | | - | personnel scheduled and available to provide medical care, and (4) 32 |
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| 57 | | - | whether a sufficient number of registered nurse's aides and licensed 33 |
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| 58 | | - | nursing personnel are scheduled and available to comply with the 34 |
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| 59 | | - | requirements of this section. Each nursing home facility shall file 35 |
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| 60 | | - | quarterly reports not later than fifteen days after the start of the 36 |
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| 61 | | - | quarters commencing in January, April, July and October of each year 37 |
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| 62 | | - | with the department on the number and percentage of days in the 38 |
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| 63 | | - | preceding quarter that such facility has failed to comply with the 39 |
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| 64 | | - | provisions of this section and the reasons therefore. 40 |
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| 65 | | - | (d) The Commissioner of Public Health shall require each nursing 41 |
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| 66 | | - | home facility to post the daily record required pursuant to subsection 42 |
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| 67 | | - | (c) of this section in a conspicuous place in the nursing home facility 43 |
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| 68 | | - | along with (1) a copy of this section, and (2) information about how to 44 |
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| 69 | | - | report a violation of the provisions of this section to the department 45 |
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| 70 | | - | and the Office of the Long-Term Care Ombudsman. 46 |
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| 71 | | - | (e) The Commissioner of Public Health may randomly audit a 47 |
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| 72 | | - | nursing home facility for compliance with the provisions of this section 48 Substitute Bill No. 1079 |
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| 41 | + | LCO No. 5963 2 of 2 |
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| 74 | | - | |
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| 75 | | - | LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-01079- |
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| 76 | | - | R01-SB.docx } |
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| 77 | | - | 3 of 3 |
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| 78 | | - | |
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| 79 | | - | and take any disciplinary action against the facility permitted under 49 |
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| 80 | | - | section 19a-494 of the general statutes for failure to comply with the 50 |
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| 81 | | - | provisions of this section. 51 |
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| 82 | | - | (f) Notwithstanding the provisions of section 17b-340 of the general 52 |
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| 83 | | - | statutes, the Commissioner of Social Services, within available 53 |
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| 84 | | - | appropriations, shall adjust the Medicaid rate for any nursing home 54 |
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| 85 | | - | facility that provides evidence satisfactory to the commissioner that such 55 |
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| 86 | | - | facility has incurred increased costs to comply with the provisions of 56 |
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| 87 | | - | this section. The rate adjustment shall cover any such costs incurred on 57 |
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| 88 | | - | or after October 1, 2019. 58 |
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| 89 | | - | (g) The Commissioner of Public Health, in accordance with the 59 |
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| 90 | | - | provisions of chapter 54 of the general statutes, shall adopt or amend 60 |
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| 91 | | - | regulations to implement the provisions of this section, including, but 61 |
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| 92 | | - | not limited to, apportioning the daily minimum staffing ratio from 62 |
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| 93 | | - | seven o'clock a.m. to nine o'clock p.m. and nine o'clock p.m. to seven 63 |
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| 94 | | - | o'clock a.m. The commissioner may adopt policies and procedures to 64 |
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| 95 | | - | implement the provisions of this section in advance of the regulations 65 |
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| 96 | | - | provided such policies and procedures are posted on the department's 66 |
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| 97 | | - | Internet web site and the e-Regulations System at least thirty days 67 |
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| 98 | | - | prior to adoption. 68 |
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| 43 | + | costs or expenditures. 15 |
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| 44 | + | (d) The Commissioner of Public Health shall adopt or amend 16 |
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| 45 | + | regulations, in accordance with the provisions of chapter 54 of the 17 |
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| 46 | + | general statutes, to implement the provisions of this section. Such 18 |
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| 47 | + | regulations shall include, but need not be limited to, (1) use of data 19 |
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| 48 | + | collected by each facility pursuant to federal staff data collection 20 |
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| 49 | + | requirements as documentation of the number of nursing staff hours 21 |
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| 50 | + | available on site to provide direct care to residents, and (2) a definition 22 |
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| 51 | + | of the term "direct care". 23 |
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