Bill Text: NY A00108 | 2021-2022 | General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Requires certain facilities establish clinical staffing committees.
Spectrum: Moderate Partisan Bill (Democrat 97-14)
Status: (Passed) 2021-06-18 - signed chap.155 [A00108 Detail]
Download: New_York-2021-A00108-Introduced.html
Bill Title: Requires certain facilities establish clinical staffing committees.
Spectrum: Moderate Partisan Bill (Democrat 97-14)
Status: (Passed) 2021-06-18 - signed chap.155 [A00108 Detail]
Download: New_York-2021-A00108-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 108 2021-2022 Regular Sessions IN ASSEMBLY (Prefiled) January 6, 2021 ___________ Introduced by M. of A. GUNTHER, CRUZ, GOTTFRIED, BARRETT, L. ROSENTHAL, SMITH, BRONSON, COLTON, MONTESANO, BRABENEC, BENEDETTO, MAGNARELLI, SALKA, DeSTEFANO, WEPRIN, SCHMITT, J. RIVERA, FALL, AUBRY, MORINELLO, OTIS, STECK, B. MILLER, ASHBY, SANTABARBARA, ZEBROWSKI, ABINANTI, BARRON, SEAWRIGHT, WALKER, BICHOTTE, RICHARDSON, HYNDMAN, PEOPLES-STOKES, PICHARDO, JOYNER, JEAN-PIERRE, ROZIC, KIM, HEVESI, O'DONNELL, DILAN, DAVILA, HUNTER, WILLIAMS, CARROLL, WOERNER, PHEFFER AMATO, JONES, VANEL, NIOU, TAYLOR, DINOWITZ, DICKENS, WALLACE, REYES, STERN, SAYEGH, JACOBSON, McMAHON, ABBATE, CAHILL, FERNANDEZ, FRONTUS, EPSTEIN, BUTTENSCHON, RAMOS, DARLING, BRAUNSTEIN, DE LA ROSA, GRIFFIN, QUART -- Multi-Sponsored by -- M. of A. BARNWELL, COOK, CUSICK, CYMBROWITZ, ENGLEBRIGHT, FAHY, GALEF, GLICK, LUPARDO, McDO- NOUGH, MIKULIN, PAULIN, PERRY, PRETLOW -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to enacting the "safe staffing for quality care act" The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Short title. This act shall be known and may be cited as 2 the "safe staffing for quality care act". 3 § 2. Paragraphs (a) and (b) of subdivision 2 of section 2805 of the 4 public health law, paragraph (a) as amended by chapter 923 of the laws 5 of 1973 and paragraph (b) as added by chapter 795 of the laws of 1965, 6 are amended to read as follows: 7 (a) Application for an operating certificate for a hospital shall be 8 made upon forms prescribed by the department. The application shall 9 [contain] include the name of the hospital, the kind or kinds of hospi- 10 tal service to be provided, the location and physical description of the 11 institution, a documented staffing plan, as defined in section twenty- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD02466-01-1A. 108 2 1 eight hundred twenty-nine of this article, and such other information as 2 the department may require. 3 (b) An operating certificate shall not be issued by the department 4 unless it finds that the premises, equipment, personnel, documented 5 staffing plan, rules and by-laws, standards of medical care, and hospi- 6 tal service are fit and adequate and that the hospital will be operated 7 in the manner required by this article and rules and regulations there- 8 under. 9 § 3. The public health law is amended by adding nine new sections 10 2828, 2829, 2830, 2831, 2832, 2833, 2834, 2835 and 2836 to read as 11 follows: 12 § 2828. Policy and purpose. The legislature finds and declares all of 13 the following: 14 1. Health care services are becoming complex and it is increasingly 15 difficult for patients to access integrated services; 16 2. The quality of patient care is jeopardized because of nurse staff- 17 ing shortages and improper utilization of nursing services; 18 3. To ensure the adequate protection of patients in health care 19 settings, it is essential that qualified registered nurses and other 20 licensed nurses be accessible and available to meet the needs of 21 patients; and 22 4. The basic principles of staffing in the health care setting should 23 be based on the patient's care needs, the severity of condition, 24 services needed and the complexity surrounding those services. 25 § 2829. Safe staffing; definitions. The following words and phrases, 26 as used in this article, shall have the following meanings unless the 27 context otherwise plainly requires: 28 1. "Acute care facility" shall mean a hospital other than a residen- 29 tial health care facility and shall also include any facility that 30 provides health care services pursuant to the mental hygiene law, arti- 31 cle nineteen-G of the executive law or the correction law if such facil- 32 ity is operated by the state or a political subdivision of the state or 33 a public authority or public benefit corporation. 34 2. "Acuity system" shall mean an established measurement instrument 35 which (a) predicts nursing care requirements for individual patients 36 based on severity of patient illness, need for specialized equipment and 37 technology, intensity of nursing interventions required, and the 38 complexity of clinical nursing judgment needed to design, implement and 39 evaluate the patient's nursing care plan; (b) details the amount of 40 nursing care needed, both in number of direct-care nurses and in skill 41 mix of nursing personnel required, on a daily basis, for each patient in 42 a nursing department or unit; and (c) is stated in terms that readily 43 can be used and understood by direct-care nurses. The acuity system 44 shall take into consideration the patient care services provided not 45 only by registered professional nurses but also by licensed practical 46 nurses, social workers and other health care personnel. 47 3. "Assessment tool" shall mean a measurement system that compares the 48 staffing level in each nursing department or unit against actual patient 49 nursing care requirements in order to review the accuracy of an acuity 50 system. 51 4. "Direct-care nurse" and "direct-care nursing staff" shall mean any 52 nurse who has principal responsibility to oversee or carry out medical 53 regimens, nursing or other bedside care for one or more patients. 54 5. "Documented staffing plan" shall mean a detailed written plan 55 setting forth the minimum number and classification of direct-care nurs- 56 es required in each nursing department or unit in an acute care facilityA. 108 3 1 for a given year, based on reasonable projections derived from the 2 patient census and average acuity level within each department or unit 3 during the prior year, the department or unit size and geography, the 4 nature of services provided and any foreseeable changes in department or 5 unit size or function during the current year. 6 6. "Nurse" shall mean a registered professional nurse or licensed 7 practical nurse licensed pursuant to article one hundred thirty-nine of 8 the education law. 9 7. "Nursing care" shall mean that care which is within the definition 10 of the practice of nursing pursuant to section sixty-nine hundred two of 11 the education law, or otherwise encompassed with the recognized stand- 12 ards of nursing practice, including assessment, nursing diagnosis, plan- 13 ning, intervention, evaluation and patient advocacy. 14 8. "Safe staffing requirements" shall mean the provisions of this 15 section and sections twenty-eight hundred twenty-nine, twenty-eight 16 hundred thirty, twenty-eight hundred thirty-one, twenty-eight hundred 17 thirty-two, twenty-eight hundred thirty-three, twenty-eight hundred 18 thirty-four, twenty-eight hundred thirty-five and twenty-eight hundred 19 thirty-six of this article and all rules and regulations adopted pursu- 20 ant thereto. 21 9. "Skill mix" shall mean the differences in licensing, specialty and 22 experience among direct-care nurses. 23 10. "Staffing level" shall mean the actual numerical nurse to patient 24 ratio within a nursing department or unit. 25 11. "Unit" shall mean a patient care component, as defined by the 26 department, within an acute care facility. 27 12. "Non-nursing direct-care staff" shall mean any employee who is not 28 a nurse or other person licensed, certified or registered under title 29 eight of the education law whose principal responsibility is to carry 30 out patient care for one or more patients or provides direct assistance 31 in the delivery of patient care. 32 § 2830. Commissioner and council; powers and duties. The commissioner 33 shall: 34 1. appoint an acute care facility council consisting of thirteen 35 members. No less than seven members shall be registered professional 36 nurses, three of whom shall be direct care registered nurses, three of 37 whom shall be nurse managers and one of whom shall be a nurse adminis- 38 trator. No less than two members of the acute care facility council 39 shall be representatives of recognized or certified collective bargain- 40 ing agents of non-nursing direct care staff. There shall be at least two 41 representatives of acute care facilities, one representative of a nurs- 42 ing professional association, and one representative of a recognized or 43 certified bargaining agent of nurses. The acute care facility council 44 shall advise the commissioner in the development of regulations, includ- 45 ing registered professional nurse to patient staffing requirements and 46 non-nursing direct-care staff to patient ratios that are not specified 47 in this article; the efficacy of acuity systems submitted for approval 48 by the commissioner; the development of an assessment tool used to eval- 49 uate the efficacy of acuity systems; and review and make recommendations 50 on approval of staffing plans prior to the granting of an operating 51 certificate by the department. 52 2. promulgate, after consultation with the acute care facility coun- 53 cil, the rules and regulations necessary to carry out the purposes and 54 provisions of the safe staffing requirements, including regulations 55 defining terms, setting forth direct-care nurse to patient ratios, 56 setting forth non-nursing direct-care staff to patient ratios andA. 108 4 1 prescribing the process for approving facility specific acuity systems; 2 and 3 3. assure that the provisions of safe staffing requirements are 4 enforced, including the issuance of regulations which at a minimum 5 provide for an accessible and confidential system to report the failure 6 to comply with such requirements and public access to information 7 regarding reports of inspections, results, deficiencies and corrections 8 pursuant to such requirements. 9 § 2831. Staffing requirements. 1. Staffing requirements. Each acute 10 care facility shall ensure that it is staffed in a manner that provides 11 sufficient, appropriately qualified direct-care nurses in each depart- 12 ment or unit within such facility in order to meet the individualized 13 care needs of the patients therein. At a minimum, each such facility 14 shall meet the requirements of subdivisions two and three of this 15 section. 16 2. Staffing plan. The department shall not issue an operating certif- 17 icate to any acute care facility unless such facility annually submits 18 to the department a documented staffing plan and a written certification 19 that the submitted staffing plan is sufficient to provide adequate and 20 appropriate delivery of health care services to patients for the ensuing 21 year. The documented staffing plan shall: 22 (a) meet the minimum requirements set forth in subdivision three of 23 this section; 24 (b) be adequate to meet any additional requirements provided by other 25 laws, rules or regulations; 26 (c) employ and identify an acuity system for addressing fluctuations 27 in actual patient acuity levels and nursing care requirements requiring 28 increased staffing levels above the minimums set forth in the plan; 29 (d) factor in other unit or department activity such as discharges, 30 transfers and admissions, staff breaks, meals, routine and expected 31 absences from the unit and administrative and support tasks that are 32 expected to be done by direct-care nurses in addition to direct nursing 33 care; 34 (e) include a plan to meet necessary staffing levels and services 35 provided by non-nursing direct-care staff in meeting patient care needs 36 pursuant to subdivision one of this section; provided, however, that the 37 staffing plan shall not incorporate or assume that nursing care func- 38 tions required by laws, rules or regulations, or accepted standards of 39 practice to be performed by a registered professional nurse are to be 40 performed by other personnel; 41 (f) identify the system that will be used to document actual staffing 42 on a daily basis within each department or unit; 43 (g) include a written assessment of the accuracy of the prior year's 44 staffing plan in light of actual staffing needs; 45 (h) identify each nurse staff classification referenced in such plan 46 together with a statement setting forth minimum qualifications for each 47 such classification; and 48 (i) be developed in consultation with a majority of the direct-care 49 nurses within each department or unit or, where such nurses are repres- 50 ented, with the applicable recognized or certified collective bargaining 51 representative or representatives of the direct-care nurses and of other 52 supportive and assistive staff. 53 3. Minimum staffing requirements. (a) The documented staffing plan 54 shall incorporate, at a minimum, the following direct-care nurse-to-pa- 55 tient ratios:A. 108 5 1 (i) one nurse to one patient: operating room and trauma emergency 2 units and maternal/child care units for the second or third stage of 3 labor; 4 (ii) one nurse to two patients: maternal/child care units for the 5 first stage of labor, and all critical care areas including emergency 6 critical care and all intensive care units and postanesthesia units; 7 (iii) one nurse to three patients: antepartum, emergency room, pedia- 8 trics, step-down and telemetry units and units for newborns and interme- 9 diate care nursery units; 10 (iv) one nurse to three patients: postpartum mother/baby couplets 11 (maximum six patients per nurse); 12 (v) one nurse to four patients: non-critical antepartum patients, 13 postpartum mother only units and medical/surgical and acute care psychi- 14 atric units; 15 (vi) one nurse to five patients: rehabilitation units and subacute 16 patients; and 17 (vii) one nurse to six patients: well-baby nursery units. 18 For any units not listed in this paragraph, including, but not limited 19 to, psychiatric units, and acute care facilities operated pursuant to 20 the mental hygiene law or the correction law, the department shall 21 establish by regulation the appropriate direct-care nurse-to-patient 22 ratio. 23 (b) The nurse-to-patient ratios set forth in paragraph (a) of this 24 subdivision shall reflect the maximum number of patients that may be 25 assigned to each direct-care nurse in a unit at any one time. 26 (c) There shall be no averaging of the number of patients and the 27 total number of nurses on the unit during any one shift nor over any 28 period of time. 29 (d) The commissioner, in consultation with the acute care facility 30 council, shall establish regulations providing for the maintenance of 31 minimum nurse-to-patient ratios, as set forth in this section, including 32 during routine or expected absences from the unit, such as meals or 33 breaks. 34 4. Licensed practical nurses. In any situation in which licensed prac- 35 tical nurses are included in the documented staffing plan, any patients 36 assigned to the licensed practical nurse shall also be included in 37 calculating the number of patients assigned to any registered profes- 38 sional nurse who is required by law, rule, regulation, contract or prac- 39 tice to supervise or oversee the direct-nursing care provided by the 40 licensed practical nurse. 41 5. Skill mix. The skill mix shall not incorporate or assume that nurs- 42 ing care functions required by section sixty-nine hundred two of the 43 education law or accepted standards of practice to be performed by a 44 registered professional nurse are to be performed by a licensed practi- 45 cal nurse or unlicensed assistive personnel, or that nursing care func- 46 tions required by section sixty-nine hundred two of the education law or 47 accepted standards of practice to be performed by a licensed practical 48 nurse are to be performed by unlicensed assistive personnel. 49 6. Adjustments by facility. The minimum staffing requirement and 50 nurse-to-patient ratio set forth in this section shall be adjusted by 51 the acute care facility as necessary to reflect the need for additional 52 direct-care nurses. Additional staff shall be assigned in accordance 53 with the approved, facility-specific patient acuity system for determin- 54 ing nursing care requirements, including the severity of the illness, 55 the need for specialized equipment and technology, the complexity of 56 clinical judgment needed to design, implement and evaluate the patientA. 108 6 1 care plan and the ability for self-care, and the licensure of the 2 personnel required for care. 3 7. Commissioner regulations. The commissioner may by regulation 4 require a documented staffing plan to have higher nurse-to-patient 5 ratios than those set forth in this section. 6 8. Nothing contained in this section shall supersede or diminish the 7 terms of a collective bargaining agreement that provides for staffing 8 ratios that exceed the ratios established under this section. 9 § 2832. Compliance with staffing plan and recordkeeping. 1. Each 10 acute care facility shall at all times staff in accordance with its 11 documented staffing plan and the staffing standards set forth in section 12 twenty-eight hundred thirty-one of this article; provided, however, that 13 nothing in this section shall be deemed to preclude any such facility 14 from implementing higher direct-care nurse-to-patient staffing levels, 15 nor shall the requirements set forth in such section twenty-eight 16 hundred thirty-one of this article be deemed to supersede or replace any 17 higher requirements otherwise mandated by law, regulation or contract. 18 2. For purposes of compliance with the minimum staffing requirements 19 standards set forth in section twenty-eight hundred thirty-one of this 20 article, no nurse shall be assigned, or included in the nurse-to-patient 21 ratio count in a nursing unit or a clinical area within an acute care 22 facility unless that nurse has an appropriate license pursuant to arti- 23 cle one hundred thirty-nine of the education law, has received prior 24 orientation in that clinical area sufficient to provide competent nurs- 25 ing care to the patients in that unit or clinical area, and has demon- 26 strated current competence in providing care in that unit or clinical 27 area. Acute care facilities that utilize temporary nursing agencies 28 shall have and adhere to a written procedure to orient and evaluate 29 personnel from such sources to ensure adequate orientation and competen- 30 cy prior to inclusion in the nurse-to-patient ratio. In the event of an 31 emergency staffing situation in which insufficient staffing may lead to 32 unsafe patient care, nurses may be temporarily assigned to a different 33 unit or clinical area, provided that such nurses shall be assigned 34 patients appropriate to their skill and competency level. The facility 35 shall establish a consistent plan for addressing emergency staffing 36 situations and monitor outcomes. Emergencies are defined as natural 37 disasters, declared emergencies, mass casualty incidents or other events 38 not reasonably anticipated and planned for and not regularly occurring 39 within the facility. 40 3. Each acute care facility shall maintain accurate daily records 41 showing: 42 (a) the number of patients admitted, released and present in each 43 nursing department or unit within such facility; 44 (b) the individual acuity level of each patient present in each nurs- 45 ing department or unit within such facility; and 46 (c) the identity and duty hours of each direct-care nurse in each 47 nursing department or unit within such facility. 48 4. Each acute care facility shall maintain daily statistics, by nurs- 49 ing department and unit, of mortality, morbidity, infection, accident, 50 injury and medical errors. 51 5. All records required to be kept pursuant to this section shall be 52 maintained for a period of seven years. 53 6. All records required to be kept pursuant to this section shall be 54 made available upon request to the department and to the public; 55 provided, however, that information released to the public shall comply 56 with the applicable patient privacy laws, rules and regulations, andA. 108 7 1 that in facilities operated pursuant to the correction law the identity 2 and hours of staff shall not be released to the public. 3 § 2833. Work assignment policy. 1. General. Each acute care facility 4 shall adopt, disseminate to direct-care nurses and comply with a written 5 work assignment policy, that meets the requirements of subdivisions two 6 and three of this section, detailing the circumstances under which a 7 direct-care nurse may refuse a work assignment. 8 2. Minimum conditions. At a minimum, the work assignment policy shall 9 permit a direct-care nurse to refuse an assignment: 10 (a) for which the nurse is not prepared by education, training or 11 experience to safely fulfill the assignment without compromising or 12 jeopardizing patient safety, the nurse's ability to meet foreseeable 13 patient needs or the nurse's license; or 14 (b) would otherwise violate the safe staffing requirements. 15 3. Minimum procedures. At a minimum, the work assignment policy shall 16 contain procedures for the following: 17 (a) reasonable requirements for prior notice to the nurse's supervisor 18 regarding the nurse's request and supporting reasons for being relieved 19 of an assignment or continued duty; 20 (b) where feasible, an opportunity for the supervisor to review the 21 specific conditions supporting the nurse's request, and to decide wheth- 22 er to remedy the conditions, to relieve the nurse of the assignment, or 23 to deny the nurse's request to be relieved of the assignment or contin- 24 ued duty; 25 (c) a process that permits the nurse to exercise the right to refuse 26 the assignment or continued on-duty status when the supervisor denies 27 the request to be relieved if: 28 (i) the supervisor rejects the request without proposing a remedy or 29 the proposed remedy would be inadequate or untimely, 30 (ii) the complaint and investigation process with a regulatory agency 31 would be untimely to address the concern, and 32 (iii) the employee in good faith believes that the assignment meets 33 conditions justifying refusal; and 34 (d) recognition that a nurse who refuses an assignment pursuant to a 35 work assignment policy as set forth in this section shall not be deemed, 36 by reason thereof, to have engaged in negligent or incompetent action, 37 patient abandonment, or otherwise to have violated any law relating to 38 nursing. 39 § 2834. Public disclosure of staffing requirements. Every acute care 40 facility shall: 41 1. post in a conspicuous place readily accessible to the general 42 public a notice prepared by the department setting forth a summary of 43 the safe staffing requirements applicable to that facility together with 44 information about where detailed information about the facility's staff- 45 ing plan and actual staffing may be obtained; 46 2. upon request, make copies of the documented staffing plan filed 47 with the department available to the public; and 48 3. upon request make readily available to the nursing staff within a 49 department or unit, during each work shift, the following information: 50 (a) a copy of the current staffing plan for that department or unit, 51 (b) documentation of the number of direct-care nurses required to be 52 present during the shift, based on the approved adopted acuity system, 53 and 54 (c) documentation of the actual number of direct-care nurses present 55 during the shift.A. 108 8 1 § 2835. Enforcement responsibilities. The department shall not dele- 2 gate its responsibilities to enforce the safe staffing requirements 3 promulgated pursuant to this article. 4 § 2836. Private right of action for violations of section twenty-eight 5 hundred thirty-three of this article. Any acute care facility that 6 violates the rights of an employee pursuant to an adopted work assign- 7 ment policy under section twenty-eight hundred thirty-three of this 8 article may be held liable to such employee in an action brought in a 9 court of competent jurisdiction for such legal or equitable relief as 10 may be appropriate to effectuate the purposes of the safe staffing 11 requirements, including but not limited to reinstatement, promotion, 12 lost wages and benefits, and compensatory and consequential damages 13 resulting from the violation together with an equal amount in liquidated 14 damages. The court in such action shall, in addition to any judgment 15 awarded to a prevailing plaintiff, award reasonable attorneys' fees and 16 costs of action to be paid by the defendant. An employee's right to 17 institute a private action pursuant to this subdivision shall not be 18 limited by any other right granted by the safe staffing requirements. 19 § 4. Section 2801-a of the public health law is amended by adding a 20 new subdivision 3-b to read as follows: 21 3-b. In considering character, competence and standing in the communi- 22 ty under subdivision three of this section, the public health and health 23 planning council shall consider any past violations of state or federal 24 rules, regulations or statutes relating to employer-employee relations, 25 workplace safety, collective bargaining or any other labor related prac- 26 tices, obligations or imperatives. The public health and health planning 27 council shall give substantial weight to violations of the provisions of 28 this chapter concerning nurse staff and supportive staff ratios. 29 § 5. Section 2805 of the public health law is amended by adding a new 30 subdivision 3 to read as follows: 31 3. In determining whether to issue or renew an operating certificate 32 to an applicant seeking to operate, or operating, a hospital in accord- 33 ance with this article, the commissioner shall consider any past 34 violations of state or federal rules, regulations or statutes relating 35 to employer-employee relations, workplace safety, collective bargaining 36 or any other labor related practices, obligations or imperatives. The 37 public health and health planning council shall give substantial weight 38 to violations of the provisions of this chapter concerning nurse staff 39 and supportive staff ratios. 40 § 6. The public health law is amended by adding a new section 2895-b 41 to read as follows: 42 § 2895-b. Residential health care facility staffing levels. 1. Defi- 43 nitions. As used in this section, the following terms shall have the 44 following meanings: 45 (a) "Certified nurse aide" means any person included in the residen- 46 tial health care facility nurse aide registry pursuant to section twen- 47 ty-eight hundred three-j of this chapter. 48 (b) "Staffing ratio" means the quotient of the number of personnel in 49 a particular category regularly on duty for a particular time period in 50 a nursing home divided by the number of residents of the nursing home at 51 that time. 52 2. Commissioner and residential health care facility council; powers 53 and duties. The commissioner shall: Appoint a residential health care 54 facility council consisting of thirteen members. No less than two 55 members shall be direct care licensed practical nurses, no less than 56 two members shall be direct care certified nurse assistants and no lessA. 108 9 1 than one member shall be a direct care registered professional nurse. 2 The council shall also include no less than one representative each of 3 recognized or certified collective bargaining agents of registered nurs- 4 es, of non-registered nurse direct care staff and a representative of 5 nursing professional associations. The council shall also include no 6 less than two representatives of residential health care facility opera- 7 tors, two representatives of residential health care facility nurse 8 administrators and one representative of consumers. The residential 9 health care facility council shall advise the commissioner in the devel- 10 opment of regulations relating to the staffing standards under this 11 section; and may from time to time, report to the governor, the legisla- 12 ture, the public and the commissioner any recommendations regarding 13 staffing levels in residential health care facilities. 14 3. Staffing standards. (a) The commissioner, in consultation with the 15 council, shall, by regulation, establish staffing standards for residen- 16 tial health care facility minimum staffing levels to meet applicable 17 standards of service and care and to provide services to attain or main- 18 tain the highest practicable physical, mental, and psychosocial well-be- 19 ing of each resident of the facility. The commissioner shall also 20 require by regulation that every residential health care facility main- 21 tain records on its staffing levels, report on such records to the 22 department, and make such records available for inspection by the 23 department. 24 (b) Every residential health care facility shall: 25 (i) comply with the staffing standards under this section; and 26 (ii) employ sufficient staffing levels to meet applicable standards of 27 service and care and to provide service and care and to provide services 28 to attain or maintain the highest practicable physical, mental, and 29 psychosocial well-being of each resident of the facility. 30 (c) Subject to subdivision five of this section, staffing standards 31 under this section shall, at a minimum, be the staffing standards under 32 subdivision four of this section. 33 (d) In determining compliance with the staffing standards under this 34 section, an individual shall not be counted while performing services 35 that are not direct nursing care, such as administrative services, food 36 preparation, housekeeping, laundry, maintenance services, or other 37 activities that are not direct nursing care. 38 4. Statutory standard. Beginning two years after the effective date 39 of this section, every residential health care facility shall maintain a 40 staffing ratio equal to at least the following: 41 (a) 2.8 hours of care per resident per day by a certified nurse aide; 42 (b) 1.3 hours of care per resident per day by a licensed practical 43 nurse or a registered nurse; 44 (c) 0.75 hours of care per resident per day by a registered nurse; the 45 minimum of 0.75 hours of care per resident provided by a registered 46 nurse shall be divided among all shifts to ensure an appropriate level 47 of registered nurse care twenty-four hours per day, seven days a week, 48 to meet resident needs; and 49 (d) Residential health care facilities that care for subacute patients 50 shall maintain at a minimum, the following direct-care nurse-to-patient 51 ratio: one nurse to five patients. 52 5. Any residential health care facility that violates the rights of 53 an employee pursuant to an adopted work assignment policy under this 54 section may be held liable to such employee in an action brought in a 55 court of competent jurisdiction for such legal or equitable relief as 56 may be appropriate to effectuate the purposes of the safe staffingA. 108 10 1 requirements, including but not limited to reinstatement, promotion, 2 lost wages and benefits, and compensatory and consequential damages 3 resulting from the violation together with an equal amount in liquidated 4 damages. The court in such action shall, in addition to any judgment 5 awarded to a prevailing plaintiff, award reasonable attorneys' fees and 6 costs of action to be paid by the defendant. An employee's right to 7 institute a private action pursuant to this subdivision shall not be 8 limited by any other right granted by the safe staffing requirements. 9 6. Public disclosure of staffing levels. (a) A residential health care 10 facility shall post information regarding nurse staffing that the facil- 11 ity is required to make available to the public under section twenty- 12 eight hundred five-t of this chapter. Information under this paragraph 13 shall be displayed in a form approved by the department and be posted in 14 a manner which is visible and accessible to residents, their families 15 and the staff, as required by the commissioner. 16 (b) A residential health care facility shall post a summary of this 17 section, provided by the department, in proximity to each posting 18 required by paragraph (a) of this subdivision. 19 § 7. If any provision of this act, or any application of any provision 20 of this act, is held to be invalid, or ruled by any federal agency to 21 violate or be inconsistent with any applicable federal law or regu- 22 lation, that shall not affect the validity or effectiveness of any other 23 provision of this act, or of any other application of any provision of 24 this act. 25 § 8. This act shall take effect on the one hundred eightieth day after 26 it shall have become a law. Effective immediately, the addition, amend- 27 ment and/or repeal of any rule or regulation necessary for the implemen- 28 tation of this act on its effective date are authorized to be made and 29 completed on or before such effective date.
