S T A T E O F N E W Y O R K
________________________________________________________________________
1718
2009-2010 Regular Sessions
I N A S S E M B L Y
January 9, 2009
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Introduced by M. of A. GOTTFRIED, GUNTHER, P. RIVERA, BRADLEY, MILLMAN,
TITONE, COOK, JACOBS, PEOPLES, JOHN, TITUS, EDDINGTON, COLTON, PAULIN,
SCARBOROUGH -- Multi-Sponsored by -- M. of A. ALESSI, BENEDETTO, BING,
BOYLAND, BRENNAN, CLARK, DESTITO, FIELDS, GLICK, HEASTIE, HOOPER,
HYER-SPENCER, JAFFEE, JEFFRIES, LIFTON, MAISEL, McENENY, PERRY, PHEF-
FER, J. RIVERA, ROBINSON, ROSENTHAL, SCHIMEL, STIRPE, SWEENEY, TOWNS,
WEISENBERG -- read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to nursing home
staffing levels
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. The public health law is amended by adding a new section
2895-b to read as follows:
S 2895-B. NURSING HOME STAFFING LEVELS. 1. DEFINITIONS. AS USED IN
THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
(A) "ADVISORY COUNCIL" MEANS THE ADVISORY COUNCIL ON NURSING HOME
STAFFING CREATED IN SUBDIVISION TWO OF THIS SECTION.
(B) "CERTIFIED NURSE AIDE" MEANS ANY PERSON INCLUDED IN THE NURSING
HOME NURSE AIDE REGISTRY PURSUANT TO SECTION TWENTY-EIGHT HUNDRED
THREE-J OF THIS CHAPTER.
(C) "STAFFING RATIO" MEANS THE QUOTIENT OF THE NUMBER OF PERSONNEL IN
A PARTICULAR CATEGORY REGULARLY ON DUTY FOR A PARTICULAR TIME PERIOD IN
A NURSING HOME DIVIDED BY THE NUMBER OF RESIDENTS OF THE NURSING HOME AT
THAT TIME.
2. ADVISORY COUNCIL ON NURSING HOME STAFFING. THERE IS HEREBY CREATED
IN THE DEPARTMENT AN ADVISORY COUNCIL ON NURSING HOME STAFFING TO STUDY
AND MAKE RECOMMENDATIONS RELATING TO THE STAFFING STANDARDS UNDER THIS
SECTION. THE ADVISORY COUNCIL SHALL BE APPOINTED BY THE COMMISSIONER AND
SHALL BE COMPOSED OF REPRESENTATIVES OF NURSING HOME OPERATORS, CONSUM-
ERS, AND NON-ADMINISTRATIVE NURSING HOME EMPLOYEES AND THE PUBLIC. THE
ADVISORY COUNCIL SHALL, FROM TIME TO TIME, REPORT TO THE GOVERNOR, THE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01113-01-9
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LEGISLATURE, THE PUBLIC AND THE COMMISSIONER ANY RECOMMENDATIONS REGARD-
ING STAFFING LEVELS IN NURSING HOMES.
3. STAFFING STANDARDS. (A) THE COMMISSIONER, IN CONSULTATION WITH THE
ADVISORY COUNCIL, SHALL, BY REGULATION, ESTABLISH STAFFING STANDARDS FOR
NURSING HOME MINIMUM STAFFING LEVELS TO MEET APPLICABLE STANDARDS OF
SERVICE AND CARE AND TO PROVIDE SERVICES TO ATTAIN OR MAINTAIN THE HIGH-
EST PRACTICABLE PHYSICAL, MENTAL, AND PSYCHOSOCIAL WELL-BEING OF EACH
RESIDENT OF THE NURSING HOME. THE COMMISSIONER SHALL ALSO REQUIRE BY
REGULATION THAT EVERY NURSING HOME MAINTAIN RECORDS ON ITS STAFFING
LEVELS, REPORT ON SUCH RECORDS TO THE DEPARTMENT, AND MAKE SUCH RECORDS
AVAILABLE FOR INSPECTION BY THE DEPARTMENT.
(B) EVERY NURSING HOME SHALL:
(I) COMPLY WITH THE STAFFING STANDARDS UNDER THIS SECTION; AND
(II) EMPLOY SUFFICIENT STAFFING LEVELS TO MEET APPLICABLE STANDARDS OF
SERVICE AND CARE AND TO PROVIDE SERVICE AND CARE AND TO PROVIDE SERVICES
TO ATTAIN OR MAINTAIN THE HIGHEST PRACTICABLE PHYSICAL, MENTAL, AND
PSYCHOSOCIAL WELL-BEING OF EACH RESIDENT OF THE NURSING HOME.
(C) SUBJECT TO SUBDIVISION FIVE OF THIS SECTION, STAFFING STANDARDS
UNDER THIS SECTION SHALL, AT A MINIMUM, BE THE STAFFING STANDARDS UNDER
SUBDIVISION FOUR OF THIS SECTION.
(D) IN DETERMINING COMPLIANCE WITH THE STAFFING STANDARDS UNDER THIS
SECTION, AN INDIVIDUAL SHALL NOT BE COUNTED WHILE PERFORMING SERVICES
THAT ARE NOT DIRECT NURSING CARE, SUCH AS ADMINISTRATIVE SERVICES, FOOD
PREPARATION, HOUSEKEEPING, LAUNDRY, MAINTENANCE SERVICES, OR OTHER
ACTIVITIES THAT ARE NOT DIRECT NURSING CARE.
4. STATUTORY STANDARD. BEGINNING TWO YEARS AFTER THE EFFECTIVE DATE
OF THIS SECTION, EVERY NURSING HOME SHALL MAINTAIN A STAFFING RATIO
EQUAL TO AT LEAST THE FOLLOWING:
(A) FROM 2.4 TO 2.8 HOURS OF CARE PER RESIDENT PER DAY BY A CERTIFIED
NURSE AIDE;
(B) FROM 1.15 TO 1.3 HOURS OF CARE PER RESIDENT PER DAY BY A LICENSED
PRACTICAL NURSE OR A REGISTERED NURSE; AND
(C) FROM 0.55 TO 0.75 HOURS OF CARE PER RESIDENT PER DAY BY A REGIS-
TERED NURSE.
5. PHASE-IN. (A) THE COMMISSIONER SHALL MAKE THE FIRST REGULATIONS
UNDER SUBDIVISION THREE OF THIS SECTION WITHIN ONE YEAR AFTER THIS
SECTION BECOMES A LAW.
(B) IF THE COMMISSIONER DETERMINES THAT COMPLIANCE WITH THE STATUTORY
STANDARD UNDER SUBDIVISION FOUR OF THIS SECTION IS NOT REASONABLY FEASI-
BLE FOR NURSING HOMES BY THE TIME SPECIFIED IN THAT SUBDIVISION, THE
COMMISSIONER MAY DELAY THE IMPLEMENTATION OF THAT STAFFING STANDARD FOR
A PHASE-IN PERIOD NOT TO EXCEED FIVE YEARS AFTER THIS SECTION BECOMES A
LAW. IF THE COMMISSIONER DELAYS IMPLEMENTATION OF THAT STAFFING STAND-
ARD, THE COMMISSIONER SHALL PHASE IN, OVER THE PHASE-IN PERIOD, STAFF-
ING STANDARDS THAT GRADUALLY INCREASE IN EACH OF THE YEARS OF THE
PHASE-IN PERIOD UNTIL THE STAFFING STANDARD MEETS AT LEAST THE STATUTORY
STANDARD UNDER SUBDIVISION FOUR OF THIS SECTION.
6. PUBLIC DISCLOSURE OF STAFFING LEVELS. (A) A NURSING HOME SHALL POST
ITS ACTUAL STAFFING LEVELS, ACCORDING TO THE MOST RECENTLY CONCLUDED
COST REPORTING PERIOD, BROKEN DOWN BY THE CATEGORIES IN SUBDIVISION
THREE OF THIS SECTION. SUCH INFORMATION SHALL BE EXPRESSED IN ACTUAL
NUMBERS AND AS STAFFING RATIOS, AND SHALL INCLUDE ADDITIONAL INFORMATION
RELATED TO STAFFING STANDARDS UNDER THIS SECTION. INFORMATION UNDER
THIS PARAGRAPH SHALL BE DISPLAYED IN A FORM APPROVED BY THE DEPARTMENT
AND BE POSTED IN A MANNER WHICH IS VISIBLE AND ACCESSIBLE TO RESIDENTS,
THEIR FAMILIES AND THE STAFF, AS REQUIRED BY THE COMMISSIONER.
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(B) A NURSING HOME SHALL POST A SUMMARY OF THIS SECTION, PROVIDED BY
THE DEPARTMENT, IN CLOSE PROXIMITY TO EACH POSTING REQUIRED BY PARAGRAPH
(A) OF THIS SUBDIVISION.
S 2. This act shall take effect immediately.