NJ providers resisting nurse-aide minimum staffing bill

New Jersey provider organizations are raising concerns over a state bill that would create minimum staffing requirements for certified nursing assistants.

The bill, which was approved by a state Assembly panel on Monday, would require nursing homes to have one CNA on duty for every eight residents on the day shift, one for every 10 on the late day shift and one for every 16 residents on the overnight shift. New Jersey legislators said 40% of the state's skilled nursing facilities already meet the proposed staffing requirements, and another 25% would have to hire one or two more CNAs to meet the standards, according to NJ.com.

While state legislators say the bill would improve resident outcomes and safety, leaders of New Jersey's healthcare associations say the requirements would do more harm than good.

“If you concentrate on staffing, it doesn't guarantee quality, ” Michele Kent, president and CEO of LeadingAge New Jersey, told McKnight's. “Quantity is not a measure of quality.”

Kent testified against the bill on Monday, offering the example of a facility that received a 5-star rating for staffing, but only a 2-star rating overall. The facility's “rich” staffing didn't translate to quality, showing that “more is not necessarily better in terms of care,” she said.

The bill's focus on staffing over quality stems from heavy union support, providers said.

“It was not a discussion about clinical outcomes and what really goes into safety and positive quality improvements in our state,” said Health Care Association of New Jersey President and CEO Jon Dolan. “It's very much a labor-related piece of legislation.”

Dolan said the bill's implications need to be watched on a national level, as more states consider safe staffing legislation. Dolan and HCANJ looked to other states when proposing amendments to the legislation, including South Carolina and Pennsylvania, which have ratio-based staffing requirements for CNAs.

Both Dolan and Kent expressed concern that the bill's ratio-based standards fail to take into account the ever-changing level of acuity and care needed in each facility. Some facilities, they said, may hire additional workers so that CNAs — who require 75 hours of training — may focus on direct patient care.

“It was impossible for my members to agree with a ratio-driven, one-size-fits-all approach,” Dolan told McKnight's. “It's just wrong, it's not appropriate for the industry.”

While the bill is expected to pass the Senate and General Assembly, both organizations believe Gov. Chris Christie (R) would veto it.