A3842

An Act concerning nursing homes, supplementing Title 26 of the Revised Statutes, amending P.L.2020, c.112 and P.L.1977, c.239, and making an appropriation.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. (New section) As used in this act:

"Nursing home" means a long-term care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), as well as the distinct part of another health care facility or continuing care retirement community that is licensed to provide skilled nursing care services pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

2. a. (New section) The Department of Health shall conduct unannounced, biennial, on-site inspections of each nursing home in this State.

b. The Department of Health shall post on its Internet website each inspection report prepared following an inspection of a nursing home, which is performed pursuant to this section, within 90 days of the inspection.

3. (New section) A nursing home shall afford each resident the opportunity to visit with a physician or an advanced practice nurse every 15 days, if such periodic visits are medically necessary.

4. Section 1 of P.L.2020, c.112 (C.30:13-18) is amended as follows:

1. a. Notwithstanding any other staffing requirements as may be established by law, every nursing home as defined in section 2 of P.L.1976, c.120 (C.30:13-2) or licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall maintain the following minimum direct care staff -to-resident ratios:

(1) one certified nurse aide to every [eight] seven residents for the day shift;

(2) one direct care staff member to every [10] nine residents for the evening shift, provided that no fewer than half of all staff members shall be certified nurse aides, and each staff member shall be signed in to work as a certified nurse aide and shall perform certified nurse aide duties; and

(3) one direct care staff member to every 14 residents for the night shift, provided that each direct care staff member shall sign in to work as a certified nurse aide and perform certified nurse aide duties.

b. Upon any expansion of resident census by the nursing home, the nursing home shall be exempt from any increase in direct care staffing ratios for a period of nine consecutive shifts from the date of the expansion of the resident census.

c. (1) The computation of minimum direct care staffing ratios shall be carried to the hundredth place.

(2) If the application of the ratios listed in subsection a. of this section results in other than a whole number of direct care staff, including certified nurse aides, for a shift, the number of required direct care staff members shall be rounded to the next higher whole number when the resulting ratio, carried to the hundredth place, is fifty-one hundredths or higher.

(3) All computations shall be based on the midnight census for the day in which the shift begins.

d. Nothing in this section shall be construed to affect any minimum staffing requirements for nursing homes as may be required by the Commissioner of Health for staff other than direct care staff, including certified nurse aides, or to restrict the ability of a nursing home to increase staffing levels, at any time, beyond the established minimum.

e. The minimum direct care staffing ratios required by this section shall not apply to any pediatric long-term care facility licensed by the Department of Health.

f. As used in this section, "direct care staff member" means any registered professional nurse, licensed practical nurse, or certified nurse aide who is acting in accordance with that individual's authorized scope of practice, and pursuant to documented employee time schedules.

(cf: P.L.2020, c.112, s.1)

5. Section 5 of P.L.1977, c.239 (C.52:27G-5) is amended as follows:

5. The ombudsman, as administrator and chief executive officer of the office, shall:

a. Administer and organize the work of the office and establish therein such administrative subdivisions as necessary, proper, and expedient. He or she may formulate and adopt rules and regulations and prescribe duties for the efficient conduct of the business, work, and general administration of the office. He or she may delegate to subordinate officers or employees in the office such power as may be desirable to be exercised under his or her supervision and control;

b. Appoint and remove such stenographic, clerical, and other secretarial assistants as may be required for the proper conduct of the office, subject to the provisions of Title 11 (Civil Service) of the Revised Statutes, and other applicable statutes, and within the limits of funds appropriated or otherwise made available therefor. In addition, and within such funding limits, the ombudsman may appoint, retain, or employ, without regard to the provisions of the said Title 11 (Civil Service), or any other statutes, such officers, investigators, experts, consultants, or other professionally qualified personnel on a contract basis or otherwise as necessary.

c. Appoint and employ, notwithstanding the provisions of P.L.1944, c.20 (C.52:17A-1 et seq.), a general counsel and such other attorneys or counsel as he or she may require, for the purpose, among other things, of providing legal advice on such matters as the ombudsman may from time to time require, of attending to and dealing with all litigation, controversies, and legal matters in which the office may be a party or in which its rights and interests may be involved, of representing the office in all proceedings or actions of any kind which may be brought for or against it in any court of this State. With respect to all of the foregoing, such counsel and attorneys shall be independent of any supervision or control by the Attorney General or by the Department of Law and Public Safety, or by any division or officer thereof;

d. Have authority to adopt and promulgate pursuant to law such rules and regulations as necessary to carry out the purposes of this act;

e. Maintain suitable headquarters for the office and such other quarters as necessary to the proper functioning of the office;

f. Solicit and accept grants of funds from the federal government and from other public and any private sources for any of the purposes of this act; provided, however, that any such funds shall be expended only pursuant to an appropriation made by law;

g. Perform such other functions as may be prescribed in this act or by any other law; [and]

h. Establish, in consultation with the Department of Health, an annual long-term care training program in a manner to be determined by the ombudsman. At a minimum, the program shall address the following subjects: the rights of residents of long-term care facilities; fostering choice and independence among residents of long-term care facilities; identifying and reporting abuse, neglect, or exploitation of residents of long-term care facilities; long-term care facility ownership; updates on State and federal guidelines, laws, and regulations that pertain to long-term care facilities; and issues, trends, and policies that impact the rights of long-term care residents. The annual training program shall be completed by the ombudsman's investigative and advocacy staff, the ombudsman's volunteer advocates, and Department of Health long-term care facility surveyors, inspectors, and complaint investigators. Subject to the availability of staff and funding, the training program shall be offered to residents of long-term care facilities, those residents' family members, advocacy organizations, government agencies, and long-term care facility employees. To develop and implement the training program, the ombudsman may contract or consult with a non-profit organization that possesses expertise on the rights of residents in long-term care settings; and

i. Employ geriatric social workers to meet with nursing home residents on a regular basis for the purpose of addressing concerns regarding the legal, financial, and service needs of nursing home residents, in a manner to be determined by the ombudsman.

(cf: P.L.2021, c.294, s.1)

6. There is appropriated from the General Fund to the Office of the State Long Term Care Ombudsman such sums of money as are necessary to comply with the provisions of subsection i. of section 5 of P.L.1977, c.239 (C.52:27G-5).

7. The Commissioner of Health shall adopt rules and regulations, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as are necessary to effectuate the provisions of this act.

8. This act shall take effect 180 days after the date of enactment.

STATEMENT

This bill makes various revisions to nursing home regulations.

Under the bill, the Department of Health (department) is to conduct unannounced, biennial, on-site inspections of each nursing home in this State. The department is to post on its Internet website each inspection report prepared following an inspection of a nursing home within 90 days of the inspection. The bill provides that a nursing home is to afford each resident the opportunity to visit with a physician or an advanced practice nurse every 15 days, if such periodic visits are medically necessary.

The bill amends P.L.2020, c.112 to increase the nursing home staff-to-resident ratio in the following manner: (1) one certified nurse aide to every seven residents, instead of eight residents as provided under current law, for the day shift; and (2) one direct care staff member to every nine residents, instead of 10 residents as provided under current law, for the evening shift.

The bill amends P.L.1977, c.239 to require the State Long-Term Care Ombudsman to employ geriatric social workers to meet with nursing home residents on a regular basis for the purpose of addressing concerns regarding the legal, financial, and service needs of nursing home residents, in a manner to be determined by the ombudsman. The bill appropriates funds to the Office of the State Long Term Care Ombudsman that are necessary to pay for the office’s compliance with the bill’s provisions.