SB 273 — AN ACT CONCERNING NURSING HOME STAFFING.

Senate General Assembly SubstituteFile Bill No.

273318 February Session, 2024 ANSubstitute ACTSenate CONCERNINGBill NURSINGNo. HOME STAFFING.

273 Senate, April 8, 2024 The Committee on Public Health reported through SEN.

ANWAR of the 3rd Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.

AN ACT CONCERNING NURSING HOME STAFFING.

[(a)] (b) On or before [January 1, 2022] October 1, 2024, the Department of Public Health shall (1) establish minimum staffing level requirementssSB273 for/ nursingFile homesNo. of three hours of direct care per resident per day, including fifty-five-hundredths of an hour of care by a registered nurse, licensed pursuant to chapter 378, twenty-nine hundredths of an hour of care by a licensed practical nurse, licensed pursuant to chapter 378, and two and sixteen-hundredths hours of care by a nurse's aide, registered pursuant to chapter 378a;

and318 (2) modify LCO 1 ofsSB273 3File Substitute Bill No.

273318 staffing level requirements for socialnursing workhomes andof recreationalthree staffhours of nursingdirect homescare suchper thatresident theper requirementsday, (A)including forfifty-five-hundredths socialof work,an anumberhour of hourscare thatby isa basedregistered onnurse, onelicensed full-timepursuant socialto workerchapter per378, sixtytwenty-nine residentshundredths andof thatan shallhour varyof proportionallycare basedby ona thelicensed numberpractical ofnurse, residentslicensed inpursuant theto nursingchapter home,378, and (B)two forand recreationalsixteen-hundredths staffhours areof [lower]care higherby thana thenurse's currentaide, requirements,registered aspursuant deemedto appropriatechapter by378a; the Commissioner of Public Health.

and (2) modify staffing level requirements for social work and recreational staff of nursing homes such that the requirements (A) for social work, anumber of hours that is based on one full-time social worker per sixty residents and that shall vary proportionally based on the number of residents in the nursing home, and (B) for recreational staff are [lower] higher than the current requirements, as deemed appropriate by the Commissioner of Public Health.

SectionsSB273 1/ fromFile passageNo. 19a-563h Statement of Legislative Commissioners:

318 2 sSB273 File No.

318 Section 1 from passage 19a-563h Statement of Legislative Commissioners:

LCOPH 2Joint ofFavorable 3Subst. Substitute Bill No.

273-LCO PHsSB273 Joint/ FavorableFile Subst.No.

-LCO318 LCO 3 ofsSB273 3File No.

318 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 25 $ FY 26 $ Social Services, Dept.

GF - Cost See Below Up to $28 million Note:

GF=General Fund Municipal Impact:

None Explanation The bill results in a cost to the Department of Social Services related to nursing home staffing ratios.

The bill requires specific staffing requirements for the three hours of direct care provided to nursing home residents, by 10/1/24.

This is estimated to result in a gross cost to nursing homes of between $43 million and $56 million.

As these costs are incurred by nursing homes and included in cost reports, they will likely roll out into Medicaid rates with a state share of about 50% of gross costs.

The actual cost to staff at the proposed levels will depend on the number and level of staff required and how such costs are incorporated into Medicaid payments to nursing homes.

The bill may also increase costs to DSS to the extent nursing homes hire additional recreational staff to meet the new minimum requirements to be established by DPH.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to staffing costs and the associated Medicaid share.

sSB273 / File No.

318 4 sSB273 File No.

318 OLR Bill Analysis SB 273 AN ACT CONCERNING NURSING HOME STAFFING.

SUMMARY Existing law requires the Department of Public Health (DPH) to set minimum staffing levels in nursing homes of at least three hours of direct care per resident per day.

This bill requires, by October 1, 2024, that the three hours include the following:

1.

0.55 hours of care by a licensed registered nurse (RN), 2.

0.29 hours of care by a licensed practical nurse (LPN), and 3.

2.16 hours of care by a registered nurse’s aide.

The bill prohibits direct care provided by the following professionals from counting towards the minimum staffing level requirement:

1.