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SENATE DOCKET, NO. 2389 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 810
The Commonwealth of Massachusetts
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PRESENTED BY:
Bruce E. Tarr
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act ensuring temporary nursing service agency quality.
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PETITION OF:
NAME:DISTRICT/ADDRESS :Bruce E. TarrFirst Essex and Middlesex 1 of 4
SENATE DOCKET, NO. 2389 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 810
By Mr. Tarr, a petition (accompanied by bill, Senate, No. 810) of Bruce E. Tarr for legislation to
ensure temporary nursing service agency quality. Health Care Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act ensuring temporary nursing service agency quality.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 13D of Chapter 118E, as appearing in the Massachusetts General
2Laws 2020 Edition, is hereby amended by striking paragraph 7 and replacing it with the
3following new paragraph
4 In establishing rates for nursing pools under section 72Y of chapter 111, the executive
5office shall establish annually the limit for the rate for service provided by nursing pools to
6licensed facilities. The executive office shall establish industry-wide class rates for such services
7and shall establish separate class rates for services provided to nursing facilities and hospitals.
8The executive office shall establish separate rates for registered nurses, licensed practical nurses
9and certified nursing assistants. The executive office may establish rates by geographic region.
10The rates shall include an allowance for wages, payroll taxes and fringe benefits, which shall be
11based upon, and shall not exceed, median wages, payroll taxes and fringe benefits paid to
12permanent medical personnel of the same type at health care facilities in the same geographic
13region. The rates shall also include an allowance for reasonable administrative expenses and a 2 of 4
14reasonable profit factor, as determined by the executive office. The executive office may exempt
15from the rates certain categories, as defined by the executive office, of fixed-term employees that
16work exclusively at a particular health care facility for a period of at least 90 days and for whose
17services there is a contract between a facility and a nursing pool registered with the department
18of public health. The maximum rates shall be no higher than 130% of the average hourly base
19rate for regular registered nurses, licensed practical nurses and certified nursing assistants. The
20executive office shall establish procedures by which nursing pools shall submit cost reports,
21which may be subject to audit, to the executive office to establish rates. The executive office
22shall determine the nursing pool rate contained in this paragraph by considering wage and benefit
23data collected from cost reports received from nursing pools and from health care facilities and
24other relevant information gathered through other collection tools or reasonable methodologies.
25For purposes of quality, accountability and transparency, the executive office shall annually
26ensure that temporary nursing service agencies are (1) meeting their obligation to provide
27temporary personal work consistent with the requirements of the Department of Public Health
28regulation at 105 CMR 157.00 and (2) assigning staff in conformance with Department of Public
29Health regulations, including CMR 105 CMR 157.00. The executive office shall establish a
30Temporary Nursing Service Agency Performance Report Card and make this information
31publicly available on the Internet as a means to increase the reliability of evaluating a temporary
32nursing services agency before a medical provider contracts for its services. The temporary nurse
33services agency shall be responsible for any employees scheduled to work and fail to work due
34by providing replacement staff to ensure that shifts are covered. The Department of Public
35Health shall subject temporary nursing services agency to periodic audits, surveys, and cost
36reports. Temporary nursing service agencies shall not have more than 5 percent in overhead costs 3 of 4
37and shall not make more than 5% in profit. The Performance Report Card shall include, but not
38be limited to: (a) auditing whether the temporary nursing service agencies are adhering to the
39reporting standards of conduct for nurses set forth at 244 CMR 9.03, Standards of Conduct for
40Nurses, and (b) assessing performance of nursing pool personnel assigned to facilities including
41at a minimum: (i) review and response to facility complaints; (ii) record of staff reliability in
42fulfilling assignments; and (iii) policies to establish on-site assessments of staff placed in
43facilities on each assigned shift. The annual report shall also include, at a minimum, the
44following information by geographic area which the health care personnel performed the work
45by facility type of hospital and nursing: (a) The average amount charged by nursing pools for
46health care personnel by license type; (b) The average amount paid by the nursing pool to health
47care personnel by license type; (c) The average amount of labor-related costs paid by the nursing
48pool by health care personnel license type, such as payroll taxes, workers’ compensation
49insurance, professional liability coverage, credentialling, and other employee-related costs.
50 SECTION 2. Nursing pools certified under section 72Y of chapter 111 of general laws, or
51any of their affiliated parties, shall be prohibited from soliciting and/or hiring nursing facility
52employees from nursing facilities in which the temporary nurse staffing agency has an active
53contract for the period of the contract plus 12 months. Operators shall under 101 CMR 206
54provided annual reports on their use of temporary nursing service agencies.
55 SECTION 3. The Department of Public Health shall amend the “long term care facility
56operating regulations” (105 CMR 150) to require that temp nursing agency workers are
57compliant with all applicable qualifications, and training requirements now required of nursing
58care staff regularly employed in their position. In addition, require temporary nursing service
59agencies pay all fines as assessed by the Department of Public Health or other regulatory body 4 of 4
60generated as a result of assigned agency staff and pertaining to quality of care or documentation
61issues.