Governor Signs Budget Trailer Bill Authorizing Higher Staff-To-Patient Ratios In Skilled Nursing Facilities

On Wednesday, July 12, Governor Edmund G. “Jerry” Brown, Jr., signed SB 97, a budget trailer bill that will increase the minimum nursing hours per patient day (NHPPD) in nursing homes from 3.2 to 3.5 hours. Furthermore, this bill will also require than within the 3.5 NHPPD, certified nursing assistants (CNAs) cover 2.4 of those hours.

The Governor signed the main $125 billion budget bill, AB 97, at the end of June.

LeadingAge California is very disappointed that the Governor signed this proposal, as skilled nursing facilities are already struggling to recruit and retain qualified CNAs, and this mandate will only exacerbate this problem. Furthermore, this proposal will add a huge burden on providers to staff potentially less qualified direct care staff. If a facility is already staffing at or above 3.5 NHPPD, yet does not meet the 2.4 CNA mandate, facilities either will have to lay off licensed nursing staff in favor of hiring CNAs, or will have to staff their facilities with more CNAs, regardless of how many licensed nurses are on staff, just to meet the mandate.

Also, we estimate that this proposal will have somewhere near a $30 million General Fund cost, yet the Legislature only allocated $10 million in General Fund money, making it significantly underfunded. The provisions of this bill are set to take effect July 1, 2018.

LeadingAge California will be intimately involved in the rulemaking process to ensure that communities that cannot recruit the necessary workforce to fulfill this mandate have some mechanism for relief.