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Jimenez Bill to Improve Oversight & Care in NJ Nursing Homes with Minimum Nurse to Patient Ratio Requirement Clears Assembly, Goes to Governor

To ensure proper staffing and improved quality of care for residents in New Jersey nursing homes, legislation sponsored by Assembly Democrat Angelica Jimenez was approved by the full Assembly 51-26-1 on Thursday.

The bill (A-4652) would establish minimum ratios for the number of direct care staff to the number of residents in a nursing home. Direct care staff and direct care staff member is defined as any registered professional nurse, licensed practical nurse, or certified nurse aide who is acting under their authorized scope of practice, and according to documented employee time schedules.

“There isn’t a more important time than now to act to ensure New Jersey’s nursing homes have adequate staffing of direct care professionals for their residents,” said Jimenez (D-Bergen, Hudson). “The onset of Covid-19 quickly illuminated the numerous inefficiencies in staffing, preparedness, and medical equipment in our nursing homes. They were dangerously unprepared for the rapid response needed to address the demands of a public health crisis.

“Nursing home care has, for far too long, been under scrutiny in the state and it’s time to address the concerns. A mandatory minimum for staff-to-patient ratios in these facilities will be critical to fixing the long term healthcare system in the state.”

Under the bill, the direct care staff-to-resident ratios would be as follows:

  • one certified nurse aide to every six residents for the day shift;
  • one direct care staff member to every ten residents for the evening shift provided that no fewer than half of all staff members would be certified nurse aides, and each staff member would be signed in to work as a certified nurse aide and would perform certified nurse aide duties; and
  • one direct care staff member to every fourteen residents for the night shift provided that each direct care staff member would be signed in to work as a certified nurse aide and perform certified nurse aide duties.

The minimum direct care staffing ratios established by the legislation would only apply to direct staff members, including certified nursing aides in nursing homes. It also does not restrict the ability of a nursing home to increase staffing levels at any time, beyond the established minimum in the bill.

The bill would also establish the “Special Task Force on Direct Care Workforce Retention and Recruitment” in the Department of Labor and Workforce Development.

In May 2020, Governor Murphy announced Manatt Health would undertake a rapid review and provide recommendations to protect the residents and staff of Long Term Care (LTC) facilities in light of the continued impact of COVID-19. The final Manatt report noted that New Jersey’s nursing homes were largely underprepared for the threat of a widespread infection and under-resourced due to long-standing staffing shortages. It recommended that the State design and implement minimum staffing ratios for Registered Nurses (RNs), Licensed Practical Nurses (LPN), and Certified Nurse Assistant (CNAs).