Current Status Bill Number:238 Type of Legislation:General Bill GB Introducing Body:Senate Introduced Date:19970122 Primary Sponsor:Giese All Sponsors:Giese, Passailaigue, Holland, Reese, Ravenel, Rose and Setzler Drafted Document Number:bbm\10988ac.97 Companion Bill Number:4481 Residing Body:Senate Current Committee:Medical Affairs Committee 13 SMA Subject:Nursing home, minimum patient-staff ratios for nurse care staff; Residential Care Facilities, Medical
Body Date Action Description Com Leg Involved
______ ________ _______________________________________ _______ ____________
Senate 19980527 Recommitted to Committee 13 SMA
Senate 19970520 Committee report: Favorable with 13 SMA
amendment
Senate 19970122 Introduced, read first time, 13 SMA
referred to Committee
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COMMITTEE REPORT
May 20, 1997
S. 238
Introduced by Senators Giese, Passailaigue, Holland, Reese, Ravenel, Rose and Setzler
S. Printed 5/20/97--S.
Read the first time January 22, 1997.
To whom was referred a Bill (S. 238), to amend the Code of Laws of South Carolina, 1976, by adding Section 44-7-262 so as to require a nursing home, etc., respectfully
That they have duly and carefully considered the same, and recommend that the same do pass with amendment:
Amend the bill, as and if amended, by striking all after the enacting words and inserting:
/SECTION 1. The 1976 Code is amended by adding:
"Section 44-7-262. (A) As a condition of licensure, in addition to the number of licensed nursing personnel required by R61-17, a nursing home must provide at a minimum these resident-staff ratios for staff who provide nursing care:
(1) 9 to 1 for shift 1;
(2) 13 to 1 for shift 2;
(3) 22 to 1 for shift 3.
In those facilities utilizing two twelve-hour shifts, the staffing ratios for shift one apply to the twelve-hour shift occurring primarily during the day, and the staffing ratios for shift three apply to the twelve-hour shift occurring primarily during the night.
(B) For purposes of this section:
(1) 'Shift 1' means a work shift that occurs primarily during the daytime hours including, but not limited to, a 7:00 a.m. to 3:00 p.m. shift;
(2) 'Shift 2' means a work shift that generally includes both daytime and evening hours including, but not limited to, a 3:00 p.m. to 11:00 p.m. shift;
(3) 'Shift 3' means a work shift that occurs primarily during the nighttime hours including, but not limited to, an 11:00 p.m. to 7:00 a.m. shift."
SECTION 2. This act takes effect July 1, 1998./
Renumber sections to conform.
Amend title to conform.
THOMAS L. MOORE, for Committee.
First Year General Funds $379,673
Annually Thereafter $379,673
RECURRING NON-RECURRING
Operating Costs:
Other (Private Nursing Homes) $379,673
TOTAL$ 379,673$ 0
Department of Health and Human Services (DHHS)
All payments to Medicaid providers must be based on reasonable cost of services under Title XVIII. Reasonable costs are determined in accordance with regulations and take into account both direct and indirect costs. Reasonable costs include all necessary and proper costs which are appropriate in developing and maintaining the operation of patient care facilities and activities. Expenditures related to patient staffing ratios would be considered reasonable costs, and, therefore, reimbursable to providers of Medicaid services.
According to DHHS, the requirements of this bill would result in the need for additional nursing home aides based upon the proposed staffing ratios. In comparing Department of Health and Environmental Control (DHEC) data on current nursing home staffing patterns to minimum licensing requirements and the staffing requirements as outlined in the bill, DHHS projects the total cost to the nursing home industry in additional staff at $1,750,000. Medicaid represents approximately 73% of the nursing home industry. Therefore, the total Medicaid cost would be $1,277,500 ($1,750,000 X 73%). State general funds needed for implementation based on a 29.72% match rate would be $379,673.
Department of Health and Environmental Control (DHEC)
DHEC has the authority to grant licenses to nursing homes. DHEC indicates that the additional licensing requirement proposed by this bill could be included in the license application form. Therefore, the cost to DHEC of implementing the provisions of this bill through a revision in the application form is negligible and could be absorbed by the agency.
Department of Mental Health (DMH)
The department indicates there would be no fiscal impact to the General Fund of the State. Existing resources at DMH would be used to manage the proposed staffing ratios for licensed nursing home personnel.
Approved By:
Michael L. Shealy
Office of State Budget
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 44-7-262 SO AS TO REQUIRE A NURSING HOME, AS A CONDITION OF LICENSURE, TO ESTABLISH MINIMUM PATIENT-STAFF RATIOS FOR STAFF PROVIDING NURSING CARE, EXCLUDING REGISTERED NURSES AND LICENSED PRACTICAL NURSES.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"Section 44-7-262. As a condition of licensure, a nursing home must provide at a minimum these patient-staff ratios for staff who provide nursing care, excluding registered nurses and licensed practical nurses:
(1) 9 to 1 for the day shift;
(2) 13 to 1 for the evening shift.
For purposes of this section, 'day shift' means a work shift that ocurrs primarily during the day including, but not limited to, a 7:00 a.m. to 3:00 p.m. shift and 'evening shift' means a work shift that generally includes both day and evening hours or all evening hours including, but not limited to, a 3:00 p.m. to 11:00 p.m. shift and a 7:00 p.m. to 7:00 a.m. shift."
SECTION 2. This act takes effect upon approval by the Governor.