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OLR Bill Analysis
sSB 989 (File 554, as amended by Senate “A”)*
AN ACT CONCERNING NURSING HOME AIR CONDITIONING,
COST REPORTING TRANSPARENCY, WAITING LIST
REQUIREMENTS, INVOLUNTARY PATIENT TRANSFER NOTICES
AND TRANSPORTATION FOR RESIDENT SOCIAL VISITS.
TABLE OF CONTENTS:
SUMMARY
§§ 1-3 — AIR CONDITIONING IN NURSING HOMES
Requires nursing homes to provide air conditioning in every resident room by January 1,
2026; requires DPH to review and report to the legislature on this topic before the
requirement takes effect; and creates a working group to make recommendations on
financing air conditioning projects and a revolving loan account within CHEFA to help
nursing home owners pay to install resident air conditioning systems
§ 4 — NURSING HOME TRANSPORTATION FOR NO NAMBULATORY
RESIDENTS
Allows nursing homes to transport residents to their family members’ homes under
certain conditions and requires DSS to report on transportation as a health-related social
need and potential federal funding for it
§ 5 — NURSING HOME WAITLIST WORKING GROUP
Requires the Long-Term Care Ombudsman and the DPH commissioner to convene a
working group to recommend revisions to nursing home waitlist requirements and report
to the Human Services and Public Health committees
§ 6 — ADMISSIONS FROM CORRECTIONAL FACILITIES
Requires certain nursing home administrators to conduct background checks and ensure
compliance with state sexual offender registry requirements when admitting out-of-state
inmates or parolees
SUMMARY
The bill makes several changes in laws affecting nursing homes to
address air conditioning requirements, transportation, waitlists, and
background checks, as described in the section-by-section analysis
below.
*Senate Amendment “A” principally (1) adds provisions creating a
working group on financing nursing home air conditioning and 2023SB-00989-R01-BA.DOCX
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requiring background checks when admitting out-of-state inmates and
parolees to certain nursing home facilities; (2) moves up the deadline for
the air conditioning report from the Department of Public Health (DPH)
by one year from January 1, 2025, to January 1, 2024; (3) requires CHEFA
to additionally submit its report on its air conditioning assistance
account to the Appropriations and Finance, Revenue and Bonding
committees; (3) changes the membership and leadership for the nursing
home waitlist working group; and (4) removes provisions in the
underlying bill that would have (a) authorized the Department of Social
Services (DSS) to establish a grant program to fund nonemergency
transportation, (b) required additional notice for involuntary transfers
by nursing homes, (c) required nursing homes to submit expenditure
summaries to DSS, and (d) broadened nursing home related party cost
reporting requirements.
EFFECTIVE DATE: Various, see below.
§§ 1-3 — AIR CONDITIONING IN NURSING HOM ES
Requires nursing homes to provide air conditioning in every resident room by January 1,
2026; requires DPH to review and report to the legislature on this topic before the
requirement takes effect; and creates a working group to make recommendations on
financing air conditioning projects and a revolving loan account within CHEFA to help
nursing home owners pay to install resident air conditioning systems
The bill requires nursing homes, by January 1, 2026, to provide air
conditioning in every resident room. (It expressly exempts residential
care homes from this requirement.) Before the requirement takes effect,
the bill requires DPH to review each nursing home to determine which
homes do not currently do this and report specified information on
these homes to the Aging, Appropriations, Human Services, and Public
Health committees by January 1, 2024.
Additionally, the bill creates a (1) working group to make
recommendations on financing nursing home capital improvement
projects to ensure air conditioning in every resident room and (2)
revolving loan account within the Connecticut Health and Educational
Facilities Authority (CHEFA) to help nursing home owners pay to
install the resident air conditioning systems. 2023SB-00989-R01-BA.DOCX
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EFFECTIVE DATE: Upon passage, except the working group
provisions are effective January 1, 2024, and provisions on CHEFA’s
revolving loan account are effective October 1, 2024.
DPH Review and Report
The bill requires DPH to review each nursing home to determine
which homes already have air conditioning in all resident rooms. Those
homes that do not must report the following information to DPH as the
commissioner prescribes:
1. whether and how the nursing home can adequately control the
climate in resident rooms,
2. feasible air conditioning system options to install at the nursing
home, and
3. the cost and physical plant needs for providing air conditioning
in each resident room and any other impediments to doing so.
The bill requires DPH to report on this information to the Aging,
Appropriations, Human Services, and Public Health committees by
January 1, 2024.
Working Group on Financing
The bill creates a six-member working group to make
recommendations on financing nursing home facility capital
improvement projects to ensure that air conditioning is available in
every resident room. The working group includes the following
members (or, for ex-officio members, their designees):
1. the CHEFA executive director;
2. the public health and social services commissioners;
3. the State Ombudsman (i.e., presumably, the State Long Term
Care Ombudsman);
4. a nonprofit nursing home organization representative, appointed
by the social services commissioner; and 2023SB-00989-R01-BA.DOCX
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5. a for-profit nursing home organization representative, appointed
by the public health commissioner.
Under the bill, the working group’s cochairs are the public health
commissioner and the CHEFA executive director, or their designees.
The bill requires the working group to (1) hold its first meeting by
February 1, 2024, and (2) consider DPH’s report (see above) when
developing its recommendations.
The bill also requires the working group to report by October 1, 2024,
to the Aging; Appropriations; Finance, Revenue and Bonding; Human
Services; and Public Health committees on the following:
1. the estimated amount and type of state financial assistance
needed for nursing homes to provide air conditioning in every
patient room; and
2. if state funding is deemed necessary, recommendations on
criteria to provide the funding to nursing homes and reporting
requirements for nursing homes on their use of it.
CHEFA Revolving Loan Account
Under the bill, the revolving loan account must contain (1) moneys
provided or required by law to be deposited into it and (2) public or
private contributions CHEFA accepts.
The bill subjects the loans’ terms and conditions to eligibility, loan
approval, credit, and other underwriting requirements and criteria that
CHEFA determines are reasonable given the program’s purpose. When
making these determinations, CHEFA must take the working group’s
recommendations into account. To implement the program, CHEFA
may use its existing powers and must adopt written procedures
following notice requirements for quasi-public agencies.
The bill prohibits CHEFA from issuing new loans to nursing homes
after January 1, 2026, once the air conditioning requirement takes effect.
At that time, it may withdraw any remaining account funds and use
them for other purposes, subject to any restrictions on account 2023SB-00989-R01-BA.DOCX
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contributions.
By law, CHEFA generally assists higher education institutions,
healthcare institutions, nursing homes, child care or child development
facilities, and qualified nonprofit organizations with construction,
financing, or refinancing projects, or in other ways authorized by law
(CGS § 10a-180).
CHEFA Report
The bill requires CHEFA to report the following information to the
Aging; Appropriations; Finance, Revenue and Bonding; Human
Services; and Public Health committees by January 1, 2026:
1. a list of program loans issued and a general description of their
terms, conditions, and repayment history;
2. an assessment of their impact on nursing homes’ compliance
with the bill’s air conditioning requirement;
3. the need for additional program funding; and
4. other information CHEFA deems relevant to evaluate the
program’s success in meeting its objectives.
Background — Nursing Home Minimum Temperature Standards
DPH regulations set minimum temperature requirements of 75
degrees in areas that residents use and at least 70 degrees in all other
occupied areas (Conn. Agencies Regs., § 19-13-D8t(d)(4)).
§ 4 — NURSING HOME T RANSPORTATION FOR
NONAMBULATORY RESIDE NTS
Allows nursing homes to transport residents to their family members’ homes under
certain conditions and requires DSS to report on transportation as a health-related social
need and potential federal funding for it
The bill allows nursing homes to transport nonambulatory residents
(i.e., those unable to walk) to their family members’ homes if:
1. a licensed physician, physician’s assistant, or advanced practice
registered nurse approves it at least five business days in 2023SB-00989-R01-BA.DOCX
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advance;
2. the nursing home has available vehicles equipped to transport
the residents; and
3. the family members live within 15 miles of the nursing home.
The bill also requires the social services commissioner to evaluate if
(1) the need for this transportation would qualify as a health-related
social need (i.e., a health need derived from an adverse social condition
that contributes to poor health and health disparities) and (2) there is
any available federal funding for the transportation. She must report on
the evaluation to the Council on Medical Assistance Program Oversight
(MAPOC) by October 1, 2023.
EFFECTIVE DATE: July 1, 2023
§ 5 — NURSING HOME W AITLIST WORKING GROU P
Requires the Long-Term Care Ombudsman and the DPH commissioner to convene a
working group to recommend revisions to nursing home waitlist requirements and report
to the Human Services and Public Health committees
The bill requires the Long-Term Care Ombudsman and the public
health and social services commissioners to convene a working group
to recommend revisions to existing law’s nursing home waitlist
requirements (CGS § 19a-533). The Long-Term Care Ombudsman and
the DSS commissioner, or their designees, serve as the working group’s
chairpersons. Working group members also include the DPH
commissioner, or her designee, and at least two nursing home industry
representatives appointed by the DSS commissioner.
The bill requires the working group to meet at least monthly. Under
the bill, the working group must report its recommended changes to the
waiting list requirements (e.g., authorizing nursing homes to maintain
waiting lists electronically) by January 1, 2024, to the Human Services
and Public Health committees.
EFFECTIVE DATE: Upon passage
§ 6 — ADMISSIONS FROM CORRECTIONAL FACIL ITIES 2023SB-00989-R01-BA.DOCX
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Requires certain nursing home administrators to conduct background checks and ensure
compliance with state sexual offender registry requirements when admitting out-of-state
inmates or parolees
Existing law allows the DSS, Department of Correction, and
Department of Mental Health and Addiction Services (DMHAS)
commissioners to contract for nursing home care for people who require
a nursing home level of care and (1) are transitioning from a correctional
facility in the state or (2) receive DMHAS services (CGS § 17b-372a).
The bill requires administrators for nursing homes that contract with
the state under this law to take certain actions when admitting an inmate
being released from a correctional facility in another state or a parolee
from another state. Specifically, the bill requires them to (1) conduct a
comprehensive criminal history records check, including checking the
federal National Sex Offender Public Website for crimes the inmate or
parolee committed in any state and (2) ensure that the inmate or parolee
comply with state sexual offender registration requirements if the
offense requires registration.
EFFECTIVE DATE: July 1, 2023
COMMITTEE ACTION
Human Services Committee
Joint Favorable Substitute
Yea 20 Nay 1 (03/28/2023)
Judiciary Committee
Joint Favorable
Yea 34 Nay 3 (05/09/2023)