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A05685 Summary:

BILL NO	A05685A

SAME AS	No Same As

SPONSOR	Gottfried

COSPNSR	Gunther, Galef, Clark, Taylor, Paulin, Abinanti, Bichotte Hermelyn, McDonald, Hevesi, Bronson, Wallace, Steck, Dinowitz, Thiele, Perry, Jacobson, Englebright, Jackson, Anderson, Simon, Barrett, Sillitti, Cook, Colton, McMahon, Aubry, Richardson, Forrest, Kelles, Buttenschon, Santabarbara, Durso, Weinstein, Burgos, Fernandez, Carroll, Cruz, Epstein, Lunsford, Stirpe, Rivera JD, Barron, Zebrowski, Peoples-Stokes, Gonzalez-Rojas, Rodriguez, Reyes, Meeks, Fall, Rosenthal L, Brabenec

MLTSPNSR

Add §2805-aa, Pub Health L

Requires nursing homes to spend at least the resident care amount necessary to achieve a required resident care percentage and a sufficient direct care service amount so it does not have a direct care service deficit.

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A05685 Actions:

BILL NO

A05685A

02/23/2021

referred to health

03/05/2021

amend and recommit to health

03/05/2021

print number 5685a

03/09/2021

reported referred to codes

03/09/2021

reported referred to ways and means

03/09/2021

reported referred to rules

03/09/2021

reported

03/09/2021

rules report cal.38

03/09/2021

ordered to third reading rules cal.38

03/09/2021

passed assembly

03/09/2021

delivered to senate

03/09/2021

REFERRED TO HEALTH

01/05/2022

DIED IN SENATE

01/05/2022

RETURNED TO ASSEMBLY

01/05/2022

ordered to third reading cal.184

01/25/2022

recommitted to codes

01/25/2022

enacting clause stricken

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A05685 Committee Votes:

Committee:HEALTH   Chair:Gottfried      
DATE:03/09/2021AYE/NAY:17/7  Action: Favorable refer to committee Codes        Gottfried Aye Byrne Nay 
Galef Aye McDonough Excused 
Dinowitz Aye Byrnes Nay 
Cahill Aye Ashby Nay 
Paulin Aye Miller Nay 
Cymbrowitz Aye Salka Nay 
Gunther Aye Jensen Nay 
Rosenthal L Aye 
Hevesi Aye 
Steck Aye 
Abinanti Aye 
Braunstein Aye 
Solages Aye 
Bichotte Hermel Excused 
Barron Aye 
Sayegh Aye 
Rosenthal D Nay 
McDonald Aye 
Reyes Aye 

Committee:CODES   Chair:Dinowitz      
DATE:03/09/2021AYE/NAY:16/6  Action: Favorable refer to committee Ways and Means        Dinowitz Aye Morinello Nay 
Pretlow Aye Giglio Nay 
Cook Aye Montesano Nay 
Cymbrowitz Aye Reilly Nay 
O'Donnell Aye Mikulin Nay 
Lavine Aye Tannousis Nay 
Perry Aye 
Abinanti Aye 
Weprin Aye 
Hevesi Aye 
Fahy Aye 
Seawright Aye 
Rosenthal Aye 
Walker Aye 
Vanel Aye 
Cruz Aye 

Committee:WAYS AND MEANS   Chair:Weinstein      
DATE:03/09/2021AYE/NAY:25/10  Action: Favorable refer to committee Rules        Weinstein Aye Ra Nay 
Glick Aye Fitzpatrick Nay 
Nolan Aye Hawley Nay 
Pretlow Aye Montesano Nay 
Perry Aye Blankenbush Nay 
Colton Aye Norris Nay 
Cook Aye Brabenec Nay 
Cahill Aye Palmesano Nay 
Aubry Aye Byrne Nay 
Cusick Aye Ashby Nay 
Benedetto Aye 
Weprin Aye 
Rodriguez Aye 
Ramos Aye 
Braunstein Aye 
McDonald Aye 
Rozic Aye 
Dinowitz Aye 
Joyner Aye 
Magnarelli Aye 
Zebrowski Aye 
Bronson Aye 
Dilan Aye 
Seawright Aye 
Hyndman Aye 

Committee:RULES   Chair:Gottfried      
DATE:03/09/2021AYE/NAY:21/8  Action: Favorable         Heastie Excused Barclay Nay 
Gottfried Aye Hawley Nay 
Nolan Aye Giglio Nay 
Weinstein Aye Blankenbush Nay 
Pretlow Aye Norris Nay 
Cook Aye Montesano Nay 
Glick Aye Ra Nay 
Aubry Aye Brabenec Nay 
Englebright Aye 
Dinowitz Aye 
Colton Aye 
Magnarelli Aye 
Perry Aye 
Paulin Aye 
Peoples-Stokes Aye 
Benedetto Aye 
Lavine Aye 
Lupardo Aye 
Zebrowski Aye 
Thiele Aye 
Braunstein Aye 
Dickens Aye 
Davila Excused

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A05685 Floor Votes:

Yes

Abbate

Yes

Clark

Yes

Frontus

Lalor

Yes

Paulin

Yes

Sillitti

Yes

Abinanti

Yes

Colton

Yes

Galef

Yes

Lavine

Yes

Peoples-Stokes

Yes

Simon

Yes

Anderson

Yes

Conrad

Yes

Gallagher

Lawler

Yes

Perry

Simpson

Angelino

Yes

Cook

Gallahan

Lemondes

Yes

Pheffer Amato

Smith

Ashby

Yes

Cruz

Gandolfo

Yes

Lunsford

Yes

Pichardo

Smullen

Yes

Aubry

Cusick

Giglio JA

Yes

Lupardo

Yes

Pretlow

Yes

Solages

Barclay

Yes

Cymbrowitz

Giglio JM

Yes

Magnarelli

Yes

Quart

Yes

Steck

Yes

Barnwell

Yes

Darling

Yes

Glick

Yes

Mamdani

Stern

Yes

Barrett

Davila

Yes

Gonzalez-Rojas

Manktelow

Yes

Rajkumar

Yes

Stirpe

Yes

Barron

Yes

De La Rosa

Goodell

Yes

McDonald

Yes

Ramos

Tague

Yes

Benedetto

DeStefano

Yes

Gottfried

McDonough

Reilly

Tannousis

Bichotte Hermel

Yes

Dickens

Griffin

Yes

McMahon

Yes

Reyes

Yes

Taylor

Blankenbush

Yes

Dilan

Yes

Gunther

Yes

Meeks

Yes

Richardson

Yes

Thiele

Brabenec

Yes

Dinowitz

Hawley

Mikulin

Yes

Rivera J

Yes

Vanel

Yes

Braunstein

DiPietro

Yes

Hevesi

Miller B

Yes

Rivera JD

Walczyk

Yes

Bronson

Yes

Durso

Yes

Hunter

Miller M

Yes

Rodriguez

Yes

Walker

Brown

Eichenstein

Yes

Hyndman

Yes

Mitaynes

Rosenthal D

Yes

Wallace

Yes

Burdick

Yes

Englebright

Yes

Jackson

Montesano

Yes

Rosenthal L

Walsh

Yes

Burgos

Yes

Epstein

Yes

Jacobson

Morinello

Yes

Rozic

Yes

Weinstein

Yes

Burke

Yes

Fahy

Yes

Jean-Pierre

Yes

Niou

Salka

Yes

Weprin

Yes

Buttenschon

Yes

Fall

Jensen

Yes

Nolan

Yes

Santabarbara

Yes

Williams

Byrne

Yes

Fernandez

Yes

Jones

Norris

Yes

Sayegh

Yes

Woerner

Byrnes

Fitzpatrick

Yes

Joyner

Yes

O'Donnell

Schmitt

Yes

Zebrowski

Yes

Cahill

Yes

Forrest

Yes

Kelles

Yes

Otis

Yes

Seawright

Yes

Zinerman

Yes

Carroll

Friend

Yes

Kim

Palmesano

Yes

Septimo

Yes

Mr. Speaker

‡ Indicates voting via videoconference

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A05685 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A5685A                  Revised 3/8/2021
 
SPONSOR: Gottfried

 
TITLE OF BILL:
 
An act to amend the public health law, in relation to establishing a
required resident care spending ratio for nursing homes
 
 
PURPOSE OR GENERAL IDEA OF BILL:
 
To require that nursing homes spend at least a set minimum amount of
total operating revenue on resident care, and of that, of that at least
a set amount on direct care nursing staff
 
 
SUMMARY OF SPECIFIC PROVISIONS:
 
Adds a new Public Health Law § 2805-aa to define "resident care" to
include direct nursing care (RN, LPN, CNA); support and program services
such as housing, laundry, food service, other therapeutics; and recre-
ational programs; but excluding administrative costs (other than nurse
administration), and capital costs, rent, or debt service. Where direct
care is provided through a contract agency, only 80% of that cost will
apply towards the required percentage.
 
Nursing homes must spend at least a 70% of total operating revenue on
resident care. Within that required spend, 60% of that amount must be
spent on direct nursing care. If a nursing home fails to meet the
required percentages in a calendar year, it would owe the difference to
DOH (to be collected, if necessary, by deducting from Medicaid payments
or by lawsuit). The money would go to the Nursing Home Quality Improve-
ment Demonstration Program under PHL § 2808-d(6).
 
 
JUSTIFICATION:
 
The 2021 report of the State Attorney General found that "The current
state reimbursement model for nursing homes gives a financial incentive
to owners of for-profit nursing homes to transfer funds to related
parties (ultimately increasing their own profit) instead of investing in
higher levels of staffing and PPE." The AG's report is the most recent
of much analysis that has reached similar conclusions. Some not-for-pro-
fit nursing homes also siphon off revenue through contracts and real
estate arrangements into various pockets.
 
This bill will require operators and owners to prioritize the care of
their residents first and foremost. The stunning growth of the for-pro-
fit nursing home industry over the past decade indicates that where
there was money being made, that money should be redirected towards
improve the wellbeing of residents and the staff that care for them.
 
 
PRIOR LEGISLATIVE HISTORY:
 
New bill
 
 
FISCAL IMPLICATIONS:
 
None.
 
 
EFFECTIVE DATE:
Immediately

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A05685 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5685--A
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 23, 2021
                                       ___________
 
        Introduced by M. of A. GOTTFRIED, GUNTHER, GALEF, CLARK, TAYLOR, PAULIN,
          ABINANTI,   BICHOTTE HERMELYN,  McDONALD,  HEVESI,  BRONSON,  WALLACE,
          STECK,  DINOWITZ,  THIELE,  PERRY,  JACOBSON,  ENGLEBRIGHT,   JACKSON,
          CUSICK,  ANDERSON,  SIMON,  BARRETT,  SILLITTI, COOK, COLTON, McMAHON,
          AUBRY, RICHARDSON, FORREST, KELLES, BUTTENSCHON,  SANTABARBARA,  DURSO
          --  read  once  and  referred  to the Committee on Health -- committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee
 
        AN ACT to amend the public health law, in  relation  to  establishing  a
          required resident care spending ratio for nursing homes
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. The public health law is amended by adding  a  new  section
     2  2805-aa to read as follows:
     3    §  2805-aa.  Nursing  home  resident  care  ratio.  1. As used in this
     4  section, the following terms have the following meanings:
     5    (a) "Resident care" means: (i) direct care provided by certified nurse
     6  aides, licensed practical nurses, and registered  nurses;  (ii)  support
     7  services  including  housing, laundry, housekeeping, food service, nurse
     8  administration, activity program, social services and transportation  as
     9  identified  in  reports  required  by  the  department;  (iii) ancillary
    10  program services including medical,  dental,  podiatric  and  laboratory
    11  services,  inhalation and other physical, mental, occupational therapeu-
    12  tics as identified in reports  required  by  the  department;  and  (iv)
    13  program  services  for residents including personal grooming, as identi-
    14  fied in reports required by  the  department.  Resident  care  does  not
    15  include  administrative costs (other than nurse administration), capital
    16  costs, rent, or debt service.
    17    (b) "Resident care amount" means the amount spent by the nursing  home
    18  for  care of residents of the nursing home; provided that for any amount
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09825-03-1

        A. 5685--A                          2
 
     1  spent for contracted or purchased personal services, only eighty percent
     2  of that amount shall count as spending on resident care.
     3    (c)  "Total operating revenue" means the revenue received by the nurs-
     4  ing home from or on behalf of residents of the nursing home,  government
     5  payers,  or third-party payers, to pay for a resident's occupancy of the
     6  nursing home, resident care, and the operation of the nursing home.
     7    (d) "Required resident care percentage" means the ratio of  a  nursing
     8  home's  resident care amount to its total operating revenue, required by
     9  subdivision two of this section.
    10    (e) "Resident care deficit" means the amount, in dollars, by which the
    11  nursing home's resident care amount is less than the  required  resident
    12  care percentage.
    13    (f)  "Direct  care  service"  means  the  amount, in dollars, spent on
    14  direct care by certified nurse aides,  licensed  practical  nurses,  and
    15  registered  nurses which shall be at least sixty percent of the required
    16  resident care percentage.
    17    2. Every nursing home shall, in every calendar year,  spend  at  least
    18  (a)  the resident care amount necessary to achieve the required resident
    19  care percentage and (b) the sufficient direct care service  amount.  For
    20  the  calendar  year  two thousand twenty-two, and every year thereafter,
    21  the required resident care percentage shall be seventy percent.
    22    3. For any calendar year in which a nursing home has a  resident  care
    23  deficit  or  direct care service deficit, it shall pay to the department
    24  an amount equal to the deficit, payable in a manner and time  determined
    25  by the commissioner in regulations. Where a nursing home does not pay as
    26  required by this subdivision, the commissioner shall sue (represented by
    27  the  state  attorney  general)  the  nursing  home  to obtain the unpaid
    28  amount, or deduct the unpaid amount  from  medical  assistance  payments
    29  otherwise  due  to  the nursing home, or a combination of those methods.
    30  Moneys so collected shall be transferred to  the  nursing  home  quality
    31  improvement  demonstration  program, to be used under subdivision six of
    32  section twenty-eight hundred eight-d  of  this  article  in  support  of
    33  projects  or  programs  designed to improve specific areas of quality of
    34  care.
    35    4. For purposes of this section, a nursing  home's  spending,  revenue
    36  and  percentages  of  various  amounts shall be calculated on an accrual
    37  basis, under regulations of the commissioner.
    38    5. The commissioner shall make regulations,  make  medical  assistance
    39  state  plan  amendments, seek waivers from the federal centers for Medi-
    40  care and Medicaid services, and take other actions reasonably  necessary
    41  to implement this section.
    42    6.  The  commissioner  shall,  by regulations and otherwise, make sure
    43  that reports by nursing homes under section twenty-eight hundred  five-e
    44  of  this article include information as to all items referred to in this
    45  section and organize that information consistent with the terms of  this
    46  section.
    47    § 2. This act shall take effect immediately.

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New York State Assembly

Speaker Carl E. Heastie

A05685 Summary:

A05685 Actions:

A05685 Committee Votes:

A05685 Floor Votes:

A05685 Memo:

A05685 Text:

Heastie	Excused	Barclay	Nay
Gottfried	Aye	Hawley	Nay
Nolan	Aye	Giglio	Nay
Weinstein	Aye	Blankenbush	Nay
Pretlow	Aye	Norris	Nay
Cook	Aye	Montesano	Nay
Glick	Aye	Ra	Nay
Aubry	Aye	Brabenec	Nay
Englebright	Aye
Dinowitz	Aye
Colton	Aye
Magnarelli	Aye
Perry	Aye
Paulin	Aye
Peoples-Stokes	Aye
Benedetto	Aye
Lavine	Aye
Lupardo	Aye
Zebrowski	Aye
Thiele	Aye
Braunstein	Aye
Dickens	Aye
Davila	Excused