The “Nursing Home Staffing and Quality Care Act” was recently signed into law and establishes minimum staffing levels and standards for care in nursing facilities, with new reporting requirements and monetary penalties for violations. The Act appropriates $600,000 in funds for training and provides for a pay increase to direct care staff. According to a press release issued by the Rhode Island State House, the Act was introduced due to concerns regarding low wages and staffing shortages, which were exacerbated by the COVID-19 Pandemic.
Included in the Act are specific requirements pertaining to staffing ratios. For example, effective January 1, 2022, nursing facilities must provide a minimum average of 3.58 hours of direct nursing care per resident, per day, with 2.44 of those hours to be provided by CNAs. The next year, effective January 1, 2023, the quarterly minimum will increase to 3.81 hours of direct nursing care per resident, per day, with 2.6 hours to be provided by CNAs. In addition, a Registered Nurse will be required to be present on the premises 24 hours per day, and no nursing staff can be regularly scheduled to work double shifts.
The Act provides for pay increases for direct care staff that are non-exempt employees by allocating inflation index rate increases in Medicaid reimbursements to compensation for direct care staff. The Rhode Island Department of Labor and Training will provide grants to eligible facilities to be used for enhanced training for direct care and support services. To be eligible, a facility must pay employees a minimum of $15.00 per hour, have a staff retention above the statewide median, and comply with minimum staffing requirements.
Although many facilities may not have difficulty meeting the staffing mandates, the imposition of additional reporting requirements and monetary penalties may be a burden on an industry that is already heavily regulated and subject to stringent state and federal reporting guidelines. The Act establishes concrete criteria as it relates to the standard of care in Rhode Island nursing homes, which may have an impact on future nursing home litigation.