2024 -- S 2077

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LC003691

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

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

     

     Introduced By: Senators de la Cruz, Raptakis, Rogers, DeLuca, Paolino, E Morgan,
Ciccone, F. Lombardi, and Lombardo

     Date Introduced: January 12, 2024

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 2. Section 23-17.5-33 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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     23-17.5-33. Minimum staffing level compliance and enforcement program.

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     (a) Compliance determination.

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     (1) The department shall submit proposed rules and regulations for adoption by October

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15, 2021, establishing a system for determining compliance with minimum staffing requirements

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set forth in § 23-17.5-32.

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     (2) Compliance shall be determined quarterly by comparing the number of hours provided

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per resident, per day using the Centers for Medicare and Medicaid Services’ payroll-based journal

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and the facility’s daily census, as self-reported by the facility to the department on a quarterly basis.

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     (3) The department shall use the quarterly payroll-based journal and the self-reported

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census to calculate the number of hours provided per resident, per day and compare this ratio to the

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minimum staffing standards required under § 23-17.5-32. Discrepancies between job titles

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contained in § 23-17.5-32 and the payroll-based journal shall be addressed by rules and regulations.

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     (b) Monetary penalties.

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     (1) The department shall submit proposed rules and regulations for adoption on or before

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October 15, 2021, implementing monetary penalty provisions for facilities not in compliance with

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minimum staffing requirements set forth in § 23-17.5-32.

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     (2) Monetary penalties shall be imposed quarterly and shall be based on the latest quarter

 

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for which the department has data.

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     (3) No monetary penalty may be issued for noncompliance with the increase in the standard

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set forth in § 23-17.5-32(c)(ii) from January 1, 2023, to March 31, 2023. If a facility is found to be

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noncompliant with the increase in the standard during the period that extends from January 1, 2023,

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to March 31, 2023, the department shall provide a written notice identifying the staffing

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deficiencies and require the facility to provide a sufficiently detailed correction plan to meet the

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statutory minimum staffing levels.

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     (4) Monetary penalties shall be established based on a formula that calculates on a daily

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basis the cost of wages and benefits for the missing staffing hours.

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     (5) All notices of noncompliance shall include the computations used to determine

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noncompliance and establishing the variance between minimum staffing ratios and the

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department’s computations.

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     (6) The penalty for the first offense shall be two hundred percent (200%) of the cost of

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wages and benefits for the missing staffing hours. The penalty shall increase to two hundred fifty

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percent (250%) of the cost of wages and benefits for the missing staffing hours for the second

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offense and three hundred percent (300%) of the cost of wages and benefits for the missing staffing

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hours for the third and all subsequent offenses.

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     (7) For facilities that have an offense in three (3) consecutive quarters, EOHHS shall deny

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any further Medicaid Assistance payments with respect to all individuals entitled to benefits who

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are admitted to the facility on or after January 1, 2022, or shall freeze admissions of new residents.

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     (c)(1) The penalty shall be imposed regardless of whether the facility has committed other

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violations of this chapter during the same period that the staffing offense occurred.

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     (2) The penalty may not be waived except as provided in subsection (c)(3) of this section,

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but the department shall have the discretion to determine the gravity of the violation in situations

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where there is no more than a ten percent (10%) deviation from the staffing requirements and make

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appropriate adjustments to the penalty.

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     (3) The department is granted discretion to waive the penalty when unforeseen

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circumstances have occurred that resulted in call-offs of scheduled staff. This provision shall be

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applied no more than two (2) times per calendar year.

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     (4) Nothing in this section diminishes a facility’s right to appeal pursuant to the provisions

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of chapter 35 of title 42 (“administrative procedures”).

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     (d)(1) Pursuant to rules and regulations established by the department, funds that are

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received from financial penalties shall be used for technical assistance or specialized direct care

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staff training.

 

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     (2) The assessment of a penalty does not supplant the state’s investigation process or

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issuance of deficiencies or citations under this title.

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     (3) A notice of noncompliance, whether or not the penalty is waived, and the penalty

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assessment shall be prominently posted in the nursing facility and included on the department’s

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website.

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     (e) Any penalty incurred for any offense committed during calendar years 2022 and 2023

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pursuant to §§ 23-17.5-32, and 23-17.5-33, shall be abated.

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     SECTION 3. 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 amend the law on nursing home minimum staffing requirements in order

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that any penalty incurred during calendar years 2022 and 2023 would be abated.

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     This act would take effect upon passage.

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