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Rhode Island nursing homes could face more than $10 million in penalties in the first quarter of 2023 alone for not meeting the state’s new minimum staffing requirement. Senate lawmakers in late June failed to pass a measure that offered relief against the standard.

“Seventy percent of the nursing homes are out of compliance,” John Gage, president of the Rhode Island Health Care Association, warned.

Rhode Island lawmakers last year passed a new law requiring nursing homes to meet minimum staffing requirements or face fines. It requires facilities to provide 3.58 hours of direct nursing care and 2.44 hours of direct CNA care per resident, per day, or pay a penalty. The penalties are assessed based on a formula that calculates on a daily basis the cost of wages and benefits for the missing staffing hours.

The measure was set to go into effect Jan. 1 until Gov. Dan McKee (D) delayed that for a month. However, the fines were never enforced due to pandemic-related challenges, including workforce shortages and multiple nursing home closures in the state.  

A late amendment to the law that would have suspended staffing fines for providers until June 2023 ultimately failed last week after being pushed “in the final hour and without notice,” House spokesman Larry Berman told local media Wednesday. Providers will now have to wait until the General Assembly’s next session for relief.

“We can’t have these fines that will cripple nursing homes at the same time we are still struggling from COVID,” Sen. Josh Miller (D) said. 

Gage said that this year’s state budget provided a 3% increase in the Medicaid inflation index for the first time, but that gain would be wiped out with the penalties associated with the minimum staffing law. 

An estimate by the state predicted that facilities would owe $68 million in fines over the first year of the mandate taking full effect — and $13 million in the first quarter alone.

“We have reached out to the governor’s office, we have reached out to the Department of Health looking for any other potential relief. We have also reached out to our legal counsel to look at any other legal options that we may have,” Gage said.