Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S780 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 1042 FILED ON: 1/18/2023
3	3	SENATE . . . . . . . . . . . . . . No. 780
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Liz Miranda
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act to address the overuse of temporary nursing service agencies at Massachusetts skilled
13	13	nursing facilities.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :Liz MirandaSecond SuffolkJoanne M. ComerfordHampshire, Franklin and Worcester2/8/2023Jack Patrick Lewis7th Middlesex2/8/2023James K. Hawkins2nd Bristol2/8/2023Vanna Howard17th Middlesex2/8/2023James B. EldridgeMiddlesex and Worcester2/21/2023Michael D. BradySecond Plymouth and Norfolk2/21/2023 1 of 5
17	17	SENATE DOCKET, NO. 1042 FILED ON: 1/18/2023
18	18	SENATE . . . . . . . . . . . . . . No. 780
19	19	By Ms. Miranda, a petition (accompanied by bill, Senate, No. 780) of Liz Miranda, Joanne M.
20	20	Comerford, Jack Patrick Lewis, James K. Hawkins and other members of the General Court for
21	21	legislation to address the overuse of temporary nursing service agencies at Massachusetts skilled
22	22	nursing facilities. Health Care Financing.
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act to address the overuse of temporary nursing service agencies at Massachusetts skilled
29	29	nursing facilities.
30	30	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
31	31	of the same, as follows:
32	32	1 SECTION 1. (a) Notwithstanding any special or general law to the contrary, the
33	33	2department of public health is directed to amend the state regulations governing the reporting by
34	34	3and rates paid by health-care providers to temporary nursing agencies registered with the
35	35	4department (101 CMR 345).
36	36	5 (b) Such amendment shall include reductions in the maximum prices set forth in 101
37	37	6CMR 345.03(2) that an agency may charge for registered nurse, licensed practical nurse, or
38	38	7certified nurse aide services provided to a skilled nursing facility. In setting such reduced
39	39	8maximum rates, the department shall establish hourly rate caps through a process that establishes
40	40	9and considers a weighted average wage for regular skilled nursing facility employees, plus a
41	41	10factor to incorporate payroll taxes, for each applicable employee classification, shift, and region.
42	42	11The department shall establish such weighted average service rates annually utilizing 2 of 5
43	43	12information provided by facilities. In no case shall the established maximum prices of temporary
44	44	13nursing agencies be permitted to exceed one hundred and fifty percent of the established average
45	45	14wages for regular employees at each applicable classification.
46	46	15 (c) Such amendment shall require reporting any individual or business entity with an
47	47	16ownership interest of 5 percent or more of a temporary nursing agency is also the holder of an
48	48	17operating license issued to establish or maintain a Massachusetts skilled nursing facility. Further,
49	49	18a temporary nursing agency so owned by any such individual or entity shall be prohibited from
50	50	19procuring or providing temporary employment at a skilled nursing facility so owned by the same
51	51	20individual or entity.
52	52	21 (d) The process for establishing the amendments as outlined in the subsections above
53	53	22shall also include an examination and analysis of the Temporary Nursing Service Cost Report
54	54	23and Reporting Requirements established in 101 CMR 345.05. As it so determines in such
55	55	24analysis, the department may amend the Reporting Requirements regulatory provision to
56	56	25strengthen the transparency of, increase the mandated disclosures required in or to otherwise
57	57	26strengthen the state accountability standards now included in the mandated Temporary Nursing
58	58	27Service Cost Report. Such analysis shall include and such amendments to the regulatory
59	59	28reporting requirements may include improved standards for temporary nursing agency reporting
60	60	29on compensation, benefits and worker supports for temporary nursing agency workers; licensing,
61	61	30training, and continuing education requirements for assigned workers; reporting on the
62	62	31operations, cost trends and financial performance of temporary nursing agencies; processes
63	63	32utilized to assure prompt arrival of assigned workers; procedures for reporting on, the
64	64	33investigation of and the resolution of complaints about the performance of temporary nursing
65	65	34agency workers; and procedures for the notice of and for resolving actual or suspected abuse, 3 of 5
66	66	35theft, tampering or other diversion of controlled substances by temporary nursing agency staff
67	67	36workers. Such amendments may also include the establishment of or increases to corresponding
68	68	37registration and reporting fees.
69	69	38 (e) The process for determining maximum rates as outlined in subsection (b) above shall
70	70	39also include an examination and analysis of Travel Nurse Factor established in 101 CMR 345(e).
71	71	40The department may amend the Travel Nurse Factor provision to reduce the established
72	72	41percentage amount above which an agency’s price for travel nurses’ services provided to a
73	73	42nursing facility may exceed the base rate limits established in 101 CMR 345.03.
74	74	43 (f) Prior to and during the process of making the regulatory amendments outlined in the
75	75	44subsections above, the department shall consult with the Massachusetts Senior Care Association,
76	76	45Inc. and 1199 SEIU United Healthcare Workers East.
77	77	46 (g) The department of public health shall complete the processes above and file for
78	78	47Emergency Adoption of such amended regulations no later than 180 days after passage of this
79	79	48Act.
80	80	49 SECTION 2. (a) Notwithstanding any special or general law to the contrary, the
81	81	50executive office of health and human services is directed to amend the state standard payment
82	82	51regulations establishing Quality Adjustment Payments (101 CMR 206.06).
83	83	52 (b) Such amendment shall require each nursing facility to report to EOHHS on the
84	84	53amount and percentage of the facility’s federally reported nursing care hours per patient day that
85	85	54was provided by temporary nursing agency staff. 4 of 5
86	86	55 (c) Such amendment shall include establish a new Quality Adjustment Payment
87	87	56subsection and a Nursing Care Staffing Levels Achievement rate adjustment that implements
88	88	57such new rate adjustment and that is based upon a facility’s compliance with the Massachusetts
89	89	58hours per resident day standard. For purposes of determining such a rate adjustment, a facility’s
90	90	59reported nursing care hours per resident day standard shall be adjusted downward to reduce the
91	91	60facility’s credit for reported hours of care provided by temporary nursing agency staff by a
92	92	61percentage to be determined by EOHHS but that shall adjust credited hours downward by least
93	93	62twenty-five percent.
94	94	63 (d) Prior to and in making the regulatory amendments as outlined in the subsections
95	95	64above, the executive office of health and human services shall consult with the Massachusetts
96	96	65Senior Care Association, Inc. and 1199 SEIU United Healthcare Workers East.
97	97	66 (e) The executive office of health and human services shall complete the process above
98	98	67and file for Emergency Adoption of such amended regulations no later than 180 days after
99	99	68passage of this Act.
100	100	69 SECTION 3. (a) Notwithstanding any special or general law to the contrary, the
101	101	70department of public health is directed to amend the Massachusetts long term care facility
102	102	71operating regulations provisions relative to Staff Qualifications and Training (105 CMR
103	103	72150.024) and Educational Programs (105 CMR 150.7(I)).
104	104	73 (b) Such amendments shall require that any temporary nursing agency staff that works in
105	105	74a skilled nursing facility is compliant with all applicable requirements and qualifications, as
106	106	75determined by the department, that are required of nursing care staff regularly employed in their
107	107	76position. Such amendments shall require temporary nursing agency staff working for more than 5 of 5
108	108	77one hundred hours in a facility participate in any job orientation and other continuing in-service
109	109	78educational programs appropriate to the care provided in the facility by regularly employed
110	110	79nursing personnel.
111	111	80 (c) Prior to and in making the regulatory amendments as outlined in the subsections
112	112	81above, the executive office of health and human services shall consult with the Massachusetts
113	113	82Senior Care Association, Inc. and 1199 SEIU United Healthcare Workers East.
114	114	83 (d) The department of public health shall complete the process above and file for
115	115	84Emergency Adoption of such amended regulations no later than 180 days after