OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
sSB-1057
AN ACT CONCERNING MINIMUM STAFFING LEVELS IN
NURSING HOMES.
Primary Analyst: ES 4/19/21
Contributing Analyst(s): RDP, LD, CP
Reviewer: LD
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $
Social Services, Dept. GF - Cost See Below See Below
Note: GF=General Fund
Municipal Impact: None
Explanation
The bill results in a cost to the Department of Social Services (DSS)
associated with revising nursing home staffing levels and establishing
a minimum level of reimbursement for nursing homes.
Staffing ratio requirements will result in a significant cost to DSS to
the extent nursing home staffing costs are reflected in future Medicaid
payments. The bill specifies that a total of 4.1 hours of direct care be
provided per resident per day, including 0.75 hours by a registered
nurse (RN), 0.54 hours by a licensed practical nurse (LPN), and 2.81
hours by a certified nurse's assistant (CNA).
Based on 2019 nursing home staffing data, approximately 50% of
homes do not meet the bill's requirements for RNs (with an average of
0.70 hours of direct care provided per resident per day).
Approximately 10% of homes do not meet the LPN staffing
requirements, while approximately 80% do not meet the requirements
for CNAs. The cost for nursing homes to staff at the proposed levels
will depend on the actual number and level of staff required and their
associated wages but is anticipated to be at least $80 million. 2021SB-01057-R000522-FN.DOCX Page 2 of 2
In addition, the bill requires DSS to establish a minimum percentage
of Medicaid reimbursement to nursing homes for the provision of
direct care to nursing home residents. The impact depends on the
minimum rate that will be established.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to inflation.