Relating to nursing facility staffing requirements

This bill relates to nursing facility (facility) staffing requirements. The bill defines “certified nurse aide training program”, “nurse aide”, “physician”, “registered nurse”, “resident assessment”, and “resident care plan”. The bill requires facilities to have sufficient staff with the appropriate competencies and skill sets to provide nursing care and related services to ensure resident safety and attain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual resident care plans and considering the number, acuity, and diagnoses of the nursing facility’s residents. The bill requires facilities to provide nursing care on a 24-hour basis to all residents in accordance with each resident care plan. The bill details the types of employees and types of care a facility must provide.45 hours per resident per day for nurse aides. The minimum hours requirements are not to be construed as setting minimum staffing levels. The bill requires facilities to have a registered nurse on site 24 hours per day that is available to provide direct resident care. If the department of inspections, appeals, and licensing (DIAL) waives the requirement for an on-site registered nurse for a facility, the facility must have a registered nurse, physician assistant, or physician available to respond immediately to telephone calls from the facility. The bill requires facilities to designate a registered nurse to serve as the director of nursing on a full-time basis. The director of nursing may serve as a charge nurse only when the nursing facility has an average daily occupancy of 60 or fewer residents. The bill requires facilities to employ or contract with at least one physician that will evaluate each resident for wounds and infections on a weekly basis. The physician shall treat or recommend a treatment for each of a resident’s identified wounds and infections. The bill requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs as identified through resident assessments and described in each resident care plan. Before employing an individual as a nurse aide, a facility must verify that the individual has met competency evaluation requirements unless the individual is a full-time employee in a training and competency evaluation program, or the individual can prove that they recently completed a certified nurse aide training program and have not yet been included in DIAL’s nurse aide registry. The facility must ensure that the individual actually becomes included in the nurse aide registry. Before employing an individual as a nurse aide, the bill requires a facility to obtain information from every state registry established under section 1819(e)(2)(A) or 1919(e)(2)(A) of the federal Social Security Act that the facility has reason to believe will include information on the individual. The bill requires an individual to complete another training and competency evaluation program if the individual has not provided nursing care or related services for monetary compensation for the most recent 24 consecutive months. The bill requires facilities to conduct a performance review of every nurse aide at least once every 12 months, and provide regular in-service education based on the outcome of these reviews.95(g). The bill authorizes DIAL to waive the certain staffing and hours of care per resident per day requirements for a facility if the facility demonstrates certain conditions exist. The bill details a facility’s duties and DIAL’s duties related to such waivers. The bill details when a facility is not eligible for a waiver due to hardship. A facility may apply to extend a waiver due to hardship each time the facility renews its license. All other waivers are subject to DIAL’s annual review. The bill requires facilities to post data detailed in the bill on a daily basis at the beginning of each shift, in a clear and readable format, and in a prominent place readily accessible to residents, staff, and visitors. Facilities must, upon oral or written request, make the data available to the public for review at a reasonable cost. Facilities must maintain the posted data for a minimum of 18 months. The bill directs DIAL to adopt administrative rules to implement the bill.