Chapter 102
2023 -- S 0927 SUBSTITUTE A AS AMENDED
Enacted 06/19/2023

A N   A C T
RELATING TO HEALTH AND SAFETY -- LICENSING OF NURSING SERVICE AGENCIES

Introduced By: Senators McKenney, and Ruggerio

Date Introduced: April 06, 2023

It is enacted by the General Assembly as follows:
     SECTION 1. Sections 23-17.7.1-3, 23-17.7.1-10 and 23-17.7.1-11 of the General Laws in
Chapter 23-17.7.1 entitled "Licensing of Nursing Service Agencies" are hereby amended to read
as follows:
     23-17.7.1-3. Licensing of nursing service agencies — Rules governing establishment
of fees.
     (a) The director may establish reasonable fees for the licensure application, licensure
renewal, and administrative actions under this chapter. Annual licensure fees shall be five hundred
dollars ($500) per licensee.
     (b) Not later than October 1, 2023, the department of health (DOH) shall develop a system
that allows a temporary nursing services service agency that provides services in the state to register
annually with the department of health.
     (c) The DOH may assess an annual licensure fee of one thousand dollars ($1,000) per
licensee not later than January 1, 2024, no temporary nursing services service agency shall provide
temporary nursing services in the state unless it is registered pursuant to subsection (b) of this
section.
     (b)(d) The department of health shall promulgate licensure standards, and rules and
regulations governing the operation of nursing service agencies to protect the health and welfare of
patients. These regulations shall include, but not be limited to,: employee bonding, maintenance
of service records, and appropriate staff professional registration and certification, licensure
training, supervision, health screening, and liability insurance.
     23-17.7.1-10. Regulations, inspections, and investigations.
     (a) The licensing agency shall, after a public hearing pursuant to chapter 35 of title 42, give
notice, adopt, amend, promulgate, and enforce any rules and regulations and standards with respect
to nursing service agencies to be licensed under this chapter that may be designed to further the
accomplishment of the purposes of this chapter in promoting safe and adequate care of individuals
receiving nursing and nursing assistant services, in the interest of public health, safety, and welfare.
All licensed nursing service agencies shall be required to protect clients by insuring ensuring that
all persons whom it employs receive training and/or competency evaluation pursuant to the
provisions of §§ 23-17.9-3 and 23-17.7-11. The licensing agency shall make or cause to be made
any inspections and investigations that it deems necessary including service records.
     (b) A nursing service agency's maximum rate for services provided to a nursing facility
and or and/or assisted living residence, by a nurse or certified nurse assistant shall not exceed two
hundred percent (200%) of the regional hourly wage of each position. The licensing agency shall
use and publish the most current median hourly wage data reported by the United States Department
of Labor Bureau of Labor Statistics (BLS) Wage Estimates for the state. These positions shall
include registered nurses, licensed practical nurses, certified nurse assistants, and medication aides.
The maximum rate shall include all charges for administrative fees, contract fees, or other special
charges in addition to the hourly rates for the temporary nursing pool personnel supplied to a client.
     (c) Records of required health inspections and investigations shall be kept confidential as
well as all required medical records including COVID-19 testing results, and all other required
vaccinations required by the department.
     (d) The personnel file and folder for each employee shall be kept confidential, including
documented evidence of credentials and other appropriate data, including documentation of
orientation, and quarterly in-service education, records of completion of required training and
educational programs, medical records, and criminal background checks.
     (e) The staffing agency shall maintain insurance coverage for workers' compensation for
all nurses, med technicians, certified nursing assistants, therapists, and therapist aides provided or
procured by the agency.
     (f) Records of violations of public health code by all agency staff shall be tracked and made
a public record.
     (g) The long-term care coordinating council (LTCC) shall develop standards for nurse staff
agencies and a ranking formula to track all agencies for public accountability.
     (h) If an employee of a staffing agency is directly connected to a quality of care or a
substandard quality of care deficiency in a facility, a subsequential investigation by the licensing
agency shall be conducted at the nursing service agency in which that individual is employed.
     23-17.7.1-11. Training and/or competency evaluation program for nursing assistants.
     (a) Every individual who is employed to provide nursing assistant services shall be required
to be registered as required by chapter 17.9 of this title.
     (b) An in-service educational program for direct patient care personnel shall be provided
on an ongoing basis which shall include orientation for new personnel and periodic programs
consisting of three (3) hours per quarter at a minimum for the continued improvement and
development of skills of direct care personnel, including competency training and department
required training based on licensure.
     SECTION 2. Chapter 23-17.7.1 of the General Laws entitled "Licensing of Nursing
Service Agencies" is hereby amended by adding thereto the following sections:
     23-17.7.1-22. Employment prohibitions.
     (a) No nursing service agency shall recruit potential employees from a client to which it
actively provides services in any contract.
     (b) The nursing service agency shall not, in any contract with any employee of a client,
require the payment of liquidated damages, employment fees, or other compensation should the
employee be hired as a permanent employee of a client facility.
     23-17.7.1-23. Annual reporting requirements.
     (a) The agency shall submit an annual statistical report to the department of health
including, but not limited to:
     (1) Mean, median, and average salaries and hourly pay rates of employees, by employment
type;
     (2) Number of employees;
     (3) Number of employees terminated;
     (4) Number of employees reported to the office of the attorney general; and
     (5) Number of employees reported to the department for abuse, neglect, misappropriation,
and job abandonment.
     (b) For every person placed for employment, or temporary performance of services by an
employment agency with a healthcare provider employer, the employment agency shall annually
report:
     (1) The amount charged for each person;
     (2) The amount paid to each person;
     (3) The amount of payment received that is retained by the employment agency;
     (4) Any other information that the department, in conjunction with the department of
human services, determines relevant to determine how much health care healthcare provider
employers who participate in Medicare and Medicaid are charged by employment agency services.
     (c) Reports under this section shall be submitted by the employment agencies no later than
thirty (30) days after the end of the calendar year.
     SECTION 3. This act shall take effect upon passage.
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LC002689/SUB A
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