Safe Staffing For Skilled Nursing Facilities
What is SB 97?
SB 97 is new legislation passed in 2017 that requires all Skilled Nursing Facilities (SNFs) in California to staff at a level of 3.5 direct care hours per patient day (hppd), of which 2.4 hppd must be performed by Certified Nursing Assistant (CNAs).
When does SB 97 go into effect?
SB 97 will go into effect on July 1st, 2018.
Why is SB 97 needed?
The Local 2015 Safe Staffing Member Steering Committee raised the issue of inadequate staffing in SNFs that leads to worker injuries, stress, and decreased quality care due to an unreasonable resident caseload per worker. SB 97 was developed by Local 2015 members and staff to address these chronic staffing problems in California SNFs.
How was SB 97 passed?
Members led the way on passing this legislation through lobby visits at the Capitol, rallies, and engaging other nursing home workers on this issue.
What happens if a SNF is unable to, or does not make efforts to, increase their direct care staff in order to meet the new requirements under SB 97?
If a SNF believes they cannot reasonably fill all the direct care staff roles to meet either the 3.5 hppd or 2.4 CNA hppd requirement, they will have the opportunity to submit one of two waiver applications to allow more time to hire the necessary staff to come into compliance.
Why does SB 97 include a waiver for SNFs?
Some counties in California experience ongoing CNA workforce shortages. One reason for this is because access to CNA training can be very limited. Local 2015 will be working with SNFs and the California Department of Public Health on training opportunities to train and recruit more CNAs and address the anticipated workforce shortage. In the meantime, a SNF can apply for a waiver on a limited time basis while they work on a plan to train and recruit the necessary CNAs to meet the new staffing standards.
What are the two waivers available for SNFs?
There are two different waivers available for SNFs to apply for under SB 97. One is the Workforce Shortage Waiver, and the second is the Patient Acuity Waiver.
What is the Workforce Shortage Waiver?
The Workforce Shortage Waiver allows a SNF that can show it is experiencing a workforce shortage a designated period of time to come into compliance for staffing to the full level of either 3.5 hppd or the 2.4 hppd requirement for CNAs.
What is the Patient Acuity Waiver?
The Patient Acuity Waiver allows SNFs to use direct care staff other than CNAs to meet the 2.4 hppd requirement in SB 97 when a SNF is able to show with evidence that their staffing plan meets the needs of their residents in a safe and adequate way. This may include Registered Nurses (RNs) or Licensed Vocational Nurses (LVNs).
What is SEIU Local 2015 doing to ensure the successful implementation of SB 97, and how can nursing home workers make sure their SNF is abiding by the new staffing regulations?
Local 2015 has been working from the beginning to help develop improved staffing regulations in California that will benefit both nursing home workers and residents. Our union has been communicating with the State and other stakeholders at public meetings and through written comments regarding the implementation and enforcement of SB 97, including advocating for a robust waiver application process that only allows for a limited number of SNFs to temporarily staff below 3.5 or 2.4 hppd. We will continue to work with the State to make sure the new law is meeting its goals of improving the quality of care for nursing home residents and the working conditions of the direct care workers who care for them.
As a nursing home worker, you can monitor the number of staff assigned per resident per day, and take note of any potential violations by your employer. It will also be important to note if/when your employer applies for a waiver, and the status. Make sure that any approved waivers are posted publicly and that potential new residents are made aware of the waiver that has been granted to the SNF.