2023 -- H 6074

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LC002451

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HEALTH AND SAFETY -- RIGHTS OF NURSING HOME PATIENTS

     

     Introduced By: Representatives Fenton-Fung, and Lima

     Date Introduced: March 03, 2023

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-17.5-32 of the General Laws in Chapter 23-17.5 entitled "Rights

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of Nursing Home Patients" is hereby amended to read as follows:

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     23-17.5-32. Minimum staffing levels.

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     (a) Each facility shall have the necessary nursing service personnel (licensed and non-

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licensed) in sufficient numbers on a twenty-four (24) hour basis, to assess the needs of residents,

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to develop and implement resident care plans, to provide direct resident care services, and to

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perform other related activities to maintain the health, safety, and welfare of residents. The facility

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shall have a registered nurse on the premises twenty-four (24) hours a day.

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     (b) For purposes of this section, the following definitions shall apply:

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     (1) “Direct caregiver” means a person who receives monetary compensation as an

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employee of the nursing facility or a subcontractor as a registered nurse, a licensed practical nurse,

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a medication technician, a certified nurse assistant, a licensed physical therapist, a licensed

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occupational therapist, a licensed speech-language pathologist, a mental health worker who is also

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a certified nurse assistant, or a physical therapist assistant.

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     (2) “Hours of direct nursing care” means the actual hours of work performed per patient

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day by a direct caregiver.

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     (c)(i) Commencing on January 1, 2022, nursing facilities shall provide a quarterly

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minimum average of three and fifty-eight hundredths (3.58) hours of direct nursing care per

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resident, per day, of which at least two and forty-four hundredths (2.44) hours shall be provided by

 

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certified nurse assistants.

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     (ii) Commencing on January 1, 2023, nursing facilities shall provide a quarterly minimum

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of three and eighty-one hundredths (3.81) hours of direct nursing care per resident, per day, of

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which at least two and six-tenths (2.6) hours shall be provided by certified nurse assistants.

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     (iii) Any facility required to comply with this section, that has, since June 1, 2021, achieved

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at least ninety percent (90%) compliance with this subsection towards the requirement of a

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quarterly minimum of three and eighty-one hundredths (3.81) hours of direct nursing care per

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resident, per day, shall be exempt from the payment of any administrative penalty for a period of

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twelve (12) months from the point of achieving ninety percent (90%) compliance with this

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subsection as long as the facility continues its goal to reach a one hundred percent (100%)

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compliance status.

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     (d) Director of nursing hours and nursing staff hours spent on administrative duties or non-

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direct caregiving tasks are excluded and may not be counted toward compliance with the minimum

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staffing hours requirement in this section.

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     (e) The minimum hours of direct nursing care requirements shall be minimum standards

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only. Nursing facilities shall employ and schedule additional staff as needed to ensure quality

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resident care based on the needs of individual residents and to ensure compliance with all relevant

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state and federal staffing requirements.

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     (f) The department shall promulgate rules and regulations to amend the Rhode Island code

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of regulations in consultation with stakeholders to implement these minimum staffing requirements

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on or before October 15, 2021.

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     (g) On or before January 1, 2024, and every five (5) years thereafter, the department shall

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consult with consumers, consumer advocates, recognized collective bargaining agents, and

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providers to determine the sufficiency of the staffing standards provided in this section and may

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promulgate rules and regulations to increase the minimum staffing ratios to adequate levels.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- RIGHTS OF NURSING HOME PATIENTS

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     This act would provide that nursing home facilities that have achieved ninety percent (90%)

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compliance with the staffing requirements that commenced in January 2023, would be granted a

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twelve (12) month grace period to achieve one hundred percent (100%) compliance without being

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penalized.

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     This act would take effect upon passage.

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