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General Assembly Substitute Bill No. 1079
January Session, 2019
AN ACT CONCERNING NU RSING HOME FACILITY MINIMUM
STAFFING LEVELS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) (a) For purposes of this 1
section: 2
(1) "Registered nurse's aide" means a nurse's aide registered in 3
accordance with chapter 378a of the general statutes; 4
(2) "Daily minimum staffing ratio" means (A) two and three-tenths 5
hours of direct care per nursing home facility resident provided by 6
registered nurse's aides over a twenty-four-hour period, and (B) seven-7
tenths of one hour of medical care per nursing home facility resident 8
provided by licensed nursing personnel over a twenty-four-hour 9
period; 10
(3) "Department" means the Department of Public Health; 11
(4) "Direct care" means hands-on care provided to a nursing home 12
facility resident by a registered nurse's aide, including, but not limited 13
to, providing assistance with feeding, bathing, toileting, dressing, 14
lifting or moving residents, but not physical or occupational therapy, 15
medication administration, food preparation, housekeeping or laundry 16
services; 17 Substitute Bill No. 1079
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(5) "Licensed nursing personnel" means nurses licensed in 18
accordance with chapter 378 of the general statutes; and 19
(6) "Nursing home facility" means a chronic or convalescent nursing 20
home. 21
(b) On and after October 1, 2019, the Commissioner of Public Health 22
shall require each nursing home facility to maintain a daily minimum 23
staffing ratio as defined in subsection (a) of this section. The daily 24
minimum staffing ratio shall not include break, vacation, sick, 25
personal, training, educational or other time that is not spent on direct 26
care or medical care provided to a nursing home facility resident. 27
(c) The Commissioner of Public Health shall require each nursing 28
home facility to maintain a daily record of (1) the number of residents 29
at such facility, (2) the number of registered nurse's aides scheduled 30
and available to provide direct care, (3) the number of licensed nursing 31
personnel scheduled and available to provide medical care, and (4) 32
whether a sufficient number of registered nurse's aides and licensed 33
nursing personnel are scheduled and available to comply with the 34
requirements of this section. Each nursing home facility shall file 35
quarterly reports not later than fifteen days after the start of the 36
quarters commencing in January, April, July and October of each year 37
with the department on the number and percentage of days in the 38
preceding quarter that such facility has failed to comply with the 39
provisions of this section and the reasons therefore. 40
(d) The Commissioner of Public Health shall require each nursing 41
home facility to post the daily record required pursuant to subsection 42
(c) of this section in a conspicuous place in the nursing home facility 43
along with (1) a copy of this section, and (2) information about how to 44
report a violation of the provisions of this section to the department 45
and the Office of the Long-Term Care Ombudsman. 46
(e) The Commissioner of Public Health may randomly audit a 47
nursing home facility for compliance with the provisions of this section 48 Substitute Bill No. 1079
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and take any disciplinary action against the facility permitted under 49
section 19a-494 of the general statutes for failure to comply with the 50
provisions of this section. 51
(f) Notwithstanding the provisions of section 17b-340 of the general 52
statutes, the Commissioner of Social Services, within available 53
appropriations, shall adjust the Medicaid rate for any nursing home 54
facility that provides evidence satisfactory to the commissioner that such 55
facility has incurred increased costs to comply with the provisions of 56
this section. The rate adjustment shall cover any such costs incurred on 57
or after October 1, 2019. 58
(g) The Commissioner of Public Health, in accordance with the 59
provisions of chapter 54 of the general statutes, shall adopt or amend 60
regulations to implement the provisions of this section, including, but 61
not limited to, apportioning the daily minimum staffing ratio from 62
seven o'clock a.m. to nine o'clock p.m. and nine o'clock p.m. to seven 63
o'clock a.m. The commissioner may adopt policies and procedures to 64
implement the provisions of this section in advance of the regulations 65
provided such policies and procedures are posted on the department's 66
Internet web site and the e-Regulations System at least thirty days 67
prior to adoption. 68
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Statement of Legislative Commissioners:
In Subsec. (b), "pursuant to" was changed to "as defined in" for
accuracy.
HS Joint Favorable Subst.