Researcher: ND Page 1 3/28/22
OLR Bill Analysis
sHB 5313
AN ACT CONCERNING REGISTRATION OF TEMPORARY
NURSING SERVICES AGENCIES AND MAXIMUM RATES FOR
TEMPORARY NURSING SERVICES AT NURSING HOME
FACILITIES.
SUMMARY
This bill repeals current statutes on nursing pools and replaces them
with provisions for “temporary nursing services agencies” with the
same requirements. Under the bill, these agencies provide temporary
nursing services to nursing homes, residential care homes, and hospitals
on a per diem or temporary basis, excluding fixed-term nursing
services.
Additionally, the bill:
1. requires the Department of Public Health (DPH) commissioner,
by October 1, 2022, to establish an annual registration system for
these agencies and authorizes her to charge an annual
registration fee of up to $750;
2. starting by January 1, 2023, prohibits temporary nursing services
agencies from providing services in the state unless they obtain
DPH registration;
3. requires the DPH commissioner to adopt regulations to establish
requirements for these agencies, including minimum nursing
personnel qualifications and an annual cost report that must be
filed with DPH by each January 15;
4. requires the Department of Social Services (DSS) commissioner,
by January 1, 2023, to set maximum rates these agencies may
charge a nursing home facility in the state by type of nursing
personnel; and 2022HB-05313-R000132-BA.DOCX
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5. requires these agencies, starting January 15, 2024, to submit
annual cost reports to the DSS commissioner, which may be
subject to audit.
The bill also makes technical and conforming changes (§§ 5-8).
EFFECTIVE DATE: July 1, 2022
DEFINITIONS
Under the bill, “temporary nursing services” are services provided to
nursing homes, residential care homes, and hospitals (“health care
facilities”) on a per diem or temporary basis. It does not include fixed
term nursing services (i.e., those provided for at least 90 days by
contracted nursing personnel who live at least 200 miles away from the
facility and require temporary accommodations).
“Nursing personnel” means advanced practice registered nurses,
licensed practical nurses and registered nurses (including those issued
temporary permits), and nurse’s aides.
A “temporary nursing services agency” is any person, firm,
corporation, limited liability company, partnership, or association that
procures or provides temporary nursing services to health care facilities.
It does not include (1) a health care facility or its subsidiary that supplies
nursing personnel only to its own facility without charge or (2)
individuals who offer only their own temporary nursing services.
TEMPORARY NURSING STAFFING AGENCIES
Regulations and Access to Documents
The bill requires the DPH commissioner to adopt regulations to set
requirements for these agencies, including minimum nursing personnel
qualifications and an annual cost report that must be filed with DPH by
each January 15. The report must cover the previous calendar year and
include (1) in-state costs and revenues, (2) average fees the agency
charges health care facilities in Connecticut by type of nursing
personnel, and (3) the permanent states of residency for nursing
personnel supplied by the agency to health care facilities in the state,
aggregated by type of nursing personnel. 2022HB-05313-R000132-BA.DOCX
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The bill also requires agencies to make available to DPH, upon
request, records, books, reports, and other data related to their
operation.
Written Agreements
As under current law for nursing pools, the bill requires temporary
nursing services agencies to enter into a written agreement with a health
care facility that ensures that the assigned nursing personnel have
appropriate credentials. The agreement must be on file at both the
agency and facility within 14 days after the nursing personnel’s
assignment.
The bill subjects health care facilities who fail to do so to DPH
disciplinary action (e.g., probation, letter of reprimand, or license
suspension), as under current law for nursing pools.
Appeals
As under current law for nursing pools, the bill permits a person
aggrieved by a temporary nursing services agency to petition the
Superior Court for the judicial district where the agency’s services were
provided. The aggrieved person may seek relief, including temporary
and permanent injunctions, or bring a civil action for damages.
Civil Penalties
As under current law for nursing pools, the bill authorizes the court
to assess a civil penalty of up to $300 per violation against a temporary
nursing services agency that violates the bill’s provisions. It specifies
that each violation is a separate and distinct offense, and in the case of a
continuing violation, each day it continues is a separate and distinct
offense.
It also allows the DPH commissioner to request the attorney general
to bring a civil action in the Superior Court for the judicial district of
Hartford for injunctive relief to restrain any further violation. The
Superior Court must grant the relief after a notice and hearing.
RATE SETTING
Maximum Rates 2022HB-05313-R000132-BA.DOCX
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The bill requires the DSS commissioner, in consultation with the DPH
commissioner and by January 1, 2023, to set maximum rates that
temporary nursing services agencies may charge a nursing home facility
in the state by type of nursing personnel.
Under the bill, the rates must include an allowance for wages, payroll
taxes, workers’ compensation insurance, training, and fringe benefits,
which must be based on the median rates for these allowances paid to
permanent nursing personnel staff of the same type at nursing homes in
the same geographic area.
The bill requires the DSS commissioner to include in the rates an
allowance for reasonable administrative expenses and a reasonable
profit factor of up to 15%, as she determines. It allows the commissioner
to set higher rates for certain fixed-term nursing services personnel who
are contracted to work exclusively at a nursing home for at least 90 days.
The bill also allows the DSS commissioner to adopt regulations to
implement the rate setting.
Annual Cost Reports
Starting January 15, 2024, the bill requires temporary nursing services
agencies to submit to the DSS commissioner annual cost reports, which
may be subject to audit. The cost reports must include data on the (1)
average fees the agency charges to nursing homes in Connecticut by the
type of nursing personnel supplied to the homes and (2) wages and
benefits provided to these nursing personnel.
Under the bill, the commissioner must consider these cost reports,
along with annual nursing home cost reports required under existing
law, when setting maximum rates for temporary nursing services
agencies.
COMMITTEE ACTION
Aging Committee
Joint Favorable Substitute
Yea 9 Nay 6 (03/10/2022)