AN ACT

 

1Requiring long-term care nursing facilities to maintain certain
2nurse aide staffing levels in order to protect the health and
3safety of residents and employees; providing for powers and
4duties of the Department of Health; and imposing civil
5penalties.

6WHEREAS, This Commonwealth has a large and growing population
7of senior and disabled persons who require nursing facility
8care; and

9WHEREAS, Significant staffing resources are necessary to
10provide quality care to our senior and disabled citizens who
11reside in nursing homes; and

12WHEREAS, Most of the direct care provided to nursing home
13residents is by nurse aides, and long-term care nursing
14facilities that receive public money should be required to
15provide at all times staffing resources to meet the minimum
16levels necessary to provide quality care to each resident; and

17WHEREAS, Nursing facilities that receive public money have a
18responsibility to report to residents, their families and the

1taxpayers of this Commonwealth the staffing levels that they
2provide for the residents in their care.

3The General Assembly of the Commonwealth of Pennsylvania
4hereby enacts as follows:

5Section 1. Short title.

6This act shall be known and may be cited as the Long-term
7Care Facility Nurse Aide Staffing Act.

8Section 2. Definitions.

9The following words and phrases when used in this act shall
10have the meanings given to them in this section unless the
11context clearly indicates otherwise:

12"Department." The Department of Health of the Commonwealth.

13"Facility." A long-term care nursing facility.

14"Licensed nurse." A registered nurse or licensed practical
15nurse.

16"Nurse aide." An individual who provides nursing or nursing-
17related services to residents in a facility. The term does not
18include an individual who is a licensed health professional or
19volunteers who provide those services without monetary
20compensation.

21Section 3. Minimum staffing standards for nurse aides.

22(a) General rule.--Beginning two years after the effective
23date of this section, the department shall not issue or renew a
24license of a facility unless that facility employs nursing
25personnel sufficient in number as set forth in this section to
26provide continuous 24-hour nursing care and service necessary to
27meet the needs of each resident in the facility.

28(b) Minimum hours.--The department shall establish a minimum
29number of hours that nurse aide care shall be provided for a
30patient during each 24-hour period. The total number of hours of

1nurse aide care provided in a 24-hour period shall, when totaled
2for the entire facility, be a minimum of at least 2.15 hours of
3direct care for each resident.

4(c) Review of Statewide median.--At least once every five
5years, the department shall review the Statewide median of hours
6of reported nurse aide care per resident day and may adjust this
7minimum standard upward depending on the Statewide median. If
8the department adjusts the minimum standard upward, facilities
9will have 90 days to comply.

10(d) Regulations.--The minimum certified nurse aide hours
11standard does not replace the standard of 2.7 hours of nursing
12care per resident per day set forth in 28 Pa. Code § 211.12
13(relating to nursing services).

14(e) Restrictions on nurse aide services.--No employee
15designated as a nurse aide shall count any time performing
16nonnursing services toward the nurse aide minimum hours
17requirement, including, but not limited to:

18(1) Food preparation.

19(2) Housekeeping.

20(3) Laundry.

21(4) Maintenance.

22Section 4. Enforcement.

23(a) Civil penalty for staffing violation.--The department
24shall impose a civil penalty upon any facility that fails to
25meet the staffing requirements set forth in section 3. The
26penalty shall be imposed for each day on which the failure
27occurs.

28(b) Amount of penalty.--The amount of penalty under
29subsection (a) shall be determined as follows:

30(1) For deficiencies in staffing that constitute

1immediate jeopardy as determined by the department to
2resident health or safety and for repeat deficiencies when a
3monetary penalty has been previously imposed, the amount of
4the penalty shall be not less than $3,000 nor more than
5$10,000 for each day of the failure.

6(2) For deficiencies in staffing that do not constitute
7immediate jeopardy to resident health or safety, the amount
8of the penalty shall be not less than $50 nor more than
9$3,000 for each day of the failure.

10(c) Legal presumption.--In addition to the penalties under
11subsections (a) and (b), in any action brought by or on behalf
12of a resident of a facility, the resident's heirs, or both, for
13negligent infliction of harm or lack of adequate care, a failure
14to meet the staffing requirements of section 3 shall be presumed
15a contributory cause of an injury sustained by a resident.

16Section 5. Regulations.

17The department shall promulgate rules and regulations
18necessary to administer and enforce this act, which shall
19include, but not be limited to, the following:

20(1) Minimum nurse aide hours per resident day.

21(2) An accessible and confidential system to report the
22failure to comply with requirements of this act and public
23access to information regarding reports of inspections,
24results, deficiencies and corrections under this act.

25Section 6. Effective date.

26This act shall take effect in 60 days.