Bill Text: NJ A3934 | 2014-2015 | Regular Session | Introduced
Bill Title: Requires DOH to adopt rules and regulations to facilitate nursing home compliance with statutory mattress replacement requirements, and to regularly report on its implementation and enforcement efforts.
Sponsorship: Partisan Bill (Democrat 2)
Status: (Introduced - Dead) 2014-12-04 - Introduced, Referred to Assembly Health and Senior Services Committee [A3934 Detail]
Download: New_Jersey-2014-A3934-Introduced.html
Sponsored by:
Assemblyman TIMOTHY J. EUSTACE
District 38 (Bergen and Passaic)
Assemblyman GARY S. SCHAER
District 36 (Bergen and Passaic)
SYNOPSIS
Requires DOH to adopt rules and regulations to facilitate nursing home compliance with statutory mattress replacement requirements, and to regularly report on its implementation and enforcement efforts.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning pressure ulcers and nursing home mattress replacement requirements, and amending P.L.2009, c.44.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2009, c.44 (C.26:2H-12.54) is amended to read as follows:
1. The Legislature finds and declares that:
a. Pressure ulcers, or bedsores, are a serious public health concern, and elderly persons, who comprise the majority of residents in nursing homes in this State, are most at risk of experiencing pressure ulcers;
b. There are four stages of pressure ulcers, ranging from Stage 1 (skin still intact), to Stage 4 (loss of tissue and exposed muscle, tendon, and bone);
c. Persons with pressure ulcers can experience severe pain, as well as complications from infection;
d. According to 2007 survey data reported by the Centers for Medicare and Medicaid Services, nursing home residents in New Jersey had pressure ulcer rates , at that time, that were higher than the national overall average. New Jersey ranked fourth highest among all states and the District of Columbia in the percentage of nursing home residents with pressure ulcers and fifth highest in the percentage of nursing home residents with pressure ulcers at the time of admission to the facility; [and]
e. By September of 2014, according to a report that was issued by the AARP Public Policy Institute under the title, "Raising Expectations, 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers," New Jersey was still ranked in the bottom quartile of states in relation to the prevention of pressure ulcers in long term care, and was ranked 49th in the nation in relation to the percentage of high-risk (movement- or nutritionally-impaired) patients suffering from pressure ulcers;
f. As recognized by the 2014 AARP report, pressure ulcers are preventable with good care, and nursing homes with lower rates of pressure ulcers among their residents tend to provide higher quality long-term care than those with high pressure ulcer rates;
g. The use of pressure redistribution mattresses is widely recognized as one of the more effective ways to prevent and treat pressure ulcers; and
h. It is, therefore, in the public interest for the State to facilitate a reduction in the percentage of nursing home residents with pressure ulcers by requiring the Department of Health to manage and oversee the replacement, by nursing homes, of existing mattresses with new pressure redistribution mattresses, and to undertake appropriate enforcement actions against those nursing homes that fail to comply with mattress replacement requirements.
(cf: P.L.2009, c.44, s.1)
2. Section 2 of P.L.2009, c.44 (C.26:2H-12.55) is amended to read as follows:
2. a. Beginning one year after the effective date of [this act] P.L.2009, c.44 (C.26:2H-12.55 et seq.), when a nursing home replaces a mattress for use by a nursing home resident, the nursing home shall replace the mattress with a pressure redistribution mattress that is designed to address, at a minimum, Stage 1 pressure ulcers.
b. (1) No later than three years after the effective date of [this act] P.L.2009, c.44 (C.26:2H-12.54 et seq.), a nursing home shall replace all mattresses used by its nursing home residents with pressure redistribution mattresses that are designed to address, at a minimum, Stage 1 pressure ulcers.
(2) No later than one year after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Health shall conduct an inspection of the mattresses at each nursing home in the State to determine each nursing home's compliance with the provisions of paragraph (1) of this subsection. Any nursing home that, as of the time of inspection, has not complied with the provisions of this subsection, shall be subject to a penalty for noncompliance, in an amount to be determined by the department pursuant to rules and regulations adopted in accordance with subsection c. of this section. Such nursing home, moreover, shall be subject to both regular and random mattress inspections, to be conducted by the department pursuant to rules and regulations adopted in accordance with subsection c. of this section, until such time that the department determines the nursing home to be in compliance with this subsection's mattress replacement requirements.
c. Within 60 days after the effective date of P.L. , c. (C. ) (pending before the Legislature as this bill), the Department of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to implement and enforce the provisions of this section. Such rules and regulations shall include specific reference to the replacement of old mattresses with pressure redistribution mattresses and the reduction of pressure ulcers, and shall establish distinct penalties for nursing homes that fail to comply with mattress replacement requirements. The regulations shall also require the department to conduct both regular and random mattress inspections, separate and apart from its normal facility inspections or surveys, in order both to determine whether a noncompliant facility is making progress toward the replacement of all mattresses with pressure redistribution mattresses, and to assist a noncompliant facility in proactively addressing any deficiencies that may be evident in the facility's mattress replacement plan.
d. Until such time as all nursing home mattresses in the State are replaced with pressure redistribution mattresses, as required by this section, the Department of Health shall annually prepare and submit a report to the Governor, and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, describing the department's efforts to facilitate the replacement of mattresses in nursing homes in accordance with the provisions of this section. At a minimum, each annual report shall identify: (1) by name and location, each nursing home that has not yet fully complied with the provisions of this section; (2) any new rules and regulations that have been adopted in the preceding year to facilitate compliance with this section; (3) any enforcement efforts that have been undertaken in the preceding year against noncompliant facilities; and (4) the amount of any monetary penalties imposed in the preceding year against noncompliant facilities.
(cf: P.L.2009, c.44, s.2)
3. This act shall take effect immediately.
STATEMENT
This bill would clarify that the Department of Health is required to adopt distinct rules and regulations to manage, oversee, and enforce a 2009 State law (P.L.2009, c.44) that required all nursing homes in the State to replace existing mattresses with pressure redistribution mattresses, as a means to reduce the incidence of pressure ulcers (also known as "bedsores") in the State.
Although P.L.2009, c.44 required all nursing homes in the State to replace existing mattresses with pressure redistribution mattresses within three years of its enactment date (i.e., by 2012), it is clear that there has been an absence of compliance with this law. This lack of compliance, moreover, has prevented the State from making headway in the area of pressure sore reduction. According to a 2014 report that was issued by the AARP Public Policy Institute under the title, "Raising Expectations, 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers," New Jersey is ranked in the bottom quartile of states in relation to the prevention of pressure ulcers in long term care, and is ranked 49th in the nation in relation to the percentage of high-risk patients - i.e., patients with a movement or nutritional impairment - who are suffering from pressure ulcers.
The laxity of compliance with mattress replacement requirements has likely been facilitated by the absence of rules and regulations, and penalties and enforcement mechanisms, that are specific to the issue of nursing home mattress replacement. Accordingly, this bill would make it clear that the Department of Health is required to adopt separate and distinct rules and regulations in relation to nursing home mattress replacement, including rules and regulations that require the department to conduct both regular and random mattress inspections of noncompliant facilities, and rules and regulations that establish distinct penalties for noncompliance.
Pursuant to the bill's provisions, the department would be required, not later than one year after the bill's effective date, to conduct an inspection of the mattresses at each nursing home in the State, in order to determine each nursing home's compliance with the mattress replacement requirement established by P.L.2009, c.44. Any nursing home that, as of the time of inspection, has not complied with the mattress replacement requirement, would be subject to a penalty for noncompliance, in an amount to be determined by the department pursuant to the rules and regulations adopted thereby in accordance with the bill's provisions. A noncompliant nursing home would also be subject to both regular and random mattress inspections, to be conducted by the department pursuant to rules and regulations adopted in accordance with the bill's provisions, until such time that the department determines the nursing home to be in compliance with the law's mattress replacement requirement.
Finally, the bill would require the department to annually report to the Governor and the Legislature on the status of mattress replacement in the State, until such time as all nursing home mattresses in the State have been replaced in accordance with the law's provisions. Each annual report would be required to indicate, at a minimum: (1) the name and location of each nursing home that has not yet fully complied with mattress replacement requirements; (2) any new rules and regulations that have been adopted in the preceding year to facilitate compliance with nursing home mattress replacement requirements; (3) any enforcement efforts that have been undertaken in the preceding year against noncompliant facilities; and (4) the amount of any monetary penalties imposed in the preceding year against noncompliant facilities.
