South Carolina General Assembly
112th Session, 1997-1998

Bill 238


Indicates Matter Stricken
Indicates New Matter


                    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

History

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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(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

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.

THE COMMITTEE ON MEDICAL AFFAIRS

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

REPORT:

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.

STATEMENT OF ESTIMATED FISCAL IMPACT

First Year General Funds $379,673

Annually Thereafter $379,673

Itemization of Additional Cost to General Fund for First Year

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

A BILL

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.

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