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Minimum Nursing Home Staffing Levels Proposed by Rhode Island Legislation

Rhode Island legislators are considering a bill that would set stringent nursing home staffing levels, establishing a minimum amount of direct care for each patient, as well as increased wages for workers providing care for residents at the facilities.

The bill, H7624 (PDF) was first introduced in February, and the Rhode Island House Finance Committee held a hearing on Wednesday to receive testimony for and against the bill.

The legislation would require every nursing home in Rhode Island to provide a minimum of 4.1 hours of direct care to every resident on a daily basis. In addition, it also requires that nursing home staff be paid a minimum of $15 per hour.

In addition, there must be the necessary nursing service personnel on-site 24 hours per day to meet and assess any resident’s needs, and a registered nurse must be on the premises 24 hours per day.

Failure to provide adequate staffing has long been considered a major problem in U.S. nursing homes, and is often considered a risk factor for nursing home neglect injuries.

Rhode Island Attorney General Peter F, Neronha submitted testimony in a July 8 letter (PDF) supporting the legislation. He noted that Rhode Island is one of the few states without minimum staffing regulations already in place.

“Many falls, infections, and other injuries can be prevented by ensuring that health care workers are spending the time we know nursing home residents need to be safe and well cared for,” he wrote. “By establishing a much-needed standard, the legislation also provides for better accountability. The reporting, monitoring, and fines for non-compliance should ensure that nursing homes maintain safe staffing levels, provide training to staff, and ultimately provide better care to their residents.”

However, the nursing home industry has criticized the bill, saying Rhode Island nursing homes are already highly rated, and say the legislation, if passed, would force some facilities to shut down.

“There is no way homes can comply with the provisions of this bill and stay in business,” Scott Fraser, president of the Rhode Island Health Care Association, said in his testimony (PDF). “It really is that simple.”

The bill is under consideration in the midst of the global COVID-19 pandemic, which has brought heightened attention on nursing home staffing and safety procedures. It is estimated that more than 40,000 nursing home residents and staff have died due to the outbreak since late February.

Federal investigators are exploring the possibility of nursing home neglect playing a role in the COVID-19 outbreak, which was first detected in a nursing home in Washington State that became the epicenter for the U.S. pandemic. Investigators say the nursing home failed to respond to the outbreak adequately, placing residents in jeopardy of illness and death.

Facing growing criticism and lawsuits, many nursing homes are seeking immunity from coronavirus death lawsuits.

Federal officials now recommend all nursing home residents and staff be tested for COVID-19.

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