CHAPTER 258

FORMERLY

SENATE BILL NO. 368

AS AMENDED BY SENATE AMENDMENT NO. 1

AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO MINIMUM STAFFING FOR NURSING HOME FACILITIES AND TRAINING FOR CERTIFIED NURSING ASSISTANTS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE :

WHEREAS, the acuity levels in Delaware’s nursing homes are on the rise and issues of minimum staffing are critical to the health and safety of Delaware’s nursing home residents; and

WHEREAS, in an effort to enhance the quality of care for all nursing home residents in Delaware, minimum staffing requirements were mandated in Delaware with the enactment of Eagle’s Law in the year 2000; and

WHEREAS, studies in Delaware and elsewhere have demonstrated a significant relationship between increased minimum staffing and improved quality of care for nursing home residents; and

WHEREAS, the staffing ratios under Eagle’s Law ensure staffing on all shifts, including licensed staff, in an effort to ensure proper levels of care for residents; and

WHEREAS, studies in Delaware and elsewhere have identified a significant relationship between the increased use of temporary agency staff and problems with quality care in nursing homes; and

WHEREAS, some of Delaware’s nursing homes have particular physical characteristics that result in difficulty in meeting some of the staffing ratios, on some shifts, without undue reliance on temporary staff; and

WHEREAS, Delaware's nursing homes commit to meeting the staffing requirements, without undue reliance on temporary staff, while patient advocates and state regulators look forward to a cooperative relationship toward that end.

NOW THEREFORE:

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend § 1162(c), Title 16, Delaware Code by inserting after the minimum shift ratios provided therein the following:

“To the extent a nursing facility meets the minimum nurse staff levels of 3.28 hours of direct care and compliance with the above referenced shift ratios provided in this subsection requires more than 3.28 hours of direct care, the Division may permit a nursing facility to alter the shift ratios above, provided, however, the alternative shift ratios as determined by the Division shall not, on any shift or at any time, fall below the following alternative minimum shift ratios:

RN/LPN C.N.A. (Or other direct care-givers)

Day 1:20 1:9

Evening 1:25 1:10

Night 1:40 1:22

If a nursing facility cannot meet the above referenced shift ratios due to building configuration or any other special circumstances, they may apply for a special waiver through the Division, subject to final approval by the Delaware Nursing Home Residents Quality Assurance Commission. All nursing facilities shall conspicuously display the minimum shift ratios governing the nursing facility, along with posting requirements pursuant to §1162(a). Notwithstanding § 1162(g), the time period for review and compliance with any alternative minimum shift ratios or ratios pursuant to a special waiver under this subsection, shall be 1 day.”

Section 2. No current nursing facility altered to provide increased capacity shall be eligible for alternative shift ratios provided in § 1162(c) of Title 16.

Section 3. Amend § 1162(d), Title 16, Delaware Code by deleting the words “On or before January 1, 2003,” and inserting in lieu thereof the words “Within 6 months of an appropriation by the General Assembly funding the staffing requirements of § 1162(e),”.

Section 4. Amend § 3003A(2), Title 16, Delaware Code by inserting after the words “registered nurse instructor” and before the words “for all” the words “or a licensed practical nurse having at least 3 years experience and under the supervision of a registered nurse”.

Section 5. Section 4 of this Act shall sunset on July 1, 2003, absent a recommendation by the Delaware Nursing Home Residents Quality Assurance Commission to the Governor and members of the General Assembly to maintain the provisions therein..

Approved May 15, 2002