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Solomon & Relihan are actively engaged with the Arizona State Legislature to push important legislation forward that protects nursing home residents from neglect and abuse. Recently, State Representative Jennifer Longdon introduced two important bills to the Arizona State Legislature concerning nursing home practices and procedures. These bills are an important step forward in addressing two recurrent reasons abuse or neglect happens in nursing homes.
HB 2249: Certification Requirements for Nursing Home Medical Directors
Currently, Arizona law does not require specific training or certifications for Medical Directors of nursing homes. HB 2249 (short for “House Bill”) would establish specific certification requirements for anyone hired as Medical Director for any long-term care institution in the state. The main provisions of the bill include:
- Medical Directors must be certified by the American Board of Post-Acute and Long-Term Care Medicine or an equivalent organization.
- Nursing care institutions that hire or contract with un-certified Medical Directors must ensure that the Medical Director becomes certified within 5 years of the date of the contract or initial hire.
- Any Medical Director hired on or before January 1, 2023, must become a certified Medical Director by January 1, 2028.
- On the initial hire or contract date, nursing care facilities are required to report the Medical Director’s resume and certification status or expected date of certification.
- All nursing care institutions must provide proof of Medical Director certification or plans for certification on or before November 1, 2023.
Why is HB 2249 important?
Medical Directors are responsible for overseeing the medical care provided in their nursing home, including coordinating physician care for residents, establishing clinical practices, ensuring quality medical care, educating staff, and assuring the rights of individual residents and staff are protected. Mistakes that Medical Directors make could result in medication errors, mistreatment of bedsores, poor infection control, or other neglect of medical issues.
Requiring certification for Medical Directors helps prevent abusive or neglectful practices in nursing homes that directly affect the health and safety of residents. Properly trained Medical Directors are better equipped to manage important medical care and ensure that proper practices and procedures are being followed.
HB 2250: Nursing Home Minimum Staffing Requirements
Being understaffed is one of the biggest reasons for abuse and neglect in nursing homes. HB 2250 outlines requirements for nursing home staff-to-resident ratios to help ensure that there is enough staff on each shift to give proper attention to each resident. The general staffing requirements include:
- The day shift must have at least one certified nurse aide for every eight residents.
- The evening shift must have one direct care staff member for every ten residents and at least one-half of all direct care staff members must be certified nurse aides.
- The night shift must have one direct care staff member for every fourteen residents who is a certified nurse aide.
- Nursing homes will be exempt from direct care staffing ratios for nine consecutive shifts after an increase in nursing home residents.
- Staffing ratio requirements are only for direct care staff members, including certified nurse aides. Administrative positions are not included in this ratio.
- Nursing homes are free to increase staffing levels beyond the minimum requirement at any time.
- Direct care staff members can be any registered nurse, licensed practical nurse, or certified nurse aide.
Why is HB 2250 important?
When nursing homes are understaffed, the quality of care provided to each resident is negatively affected. Understaffed facilities may accidentally or purposely skip some steps in care, including forgetting meals (resulting in malnutrition or dehydration), neglecting to move or rotate patients with mobility issues (resulting in bedsores), or being unavailable to assist patients to the bathroom or out of bed (resulting in falls). Overloaded staff may also rush through their duties and make mistakes when administering medication.
Requiring better staff-to-resident ratios on a state level will help nursing homes have the resources to provide more one-on-one, high-quality care to each resident. This minimizes the chance of making mistakes with medication, providing inadequate nutrition, or missing signs of other medical conditions.
Contact Your Representative
As these two important bills move through the Arizona State Legislature, our team at Solomon & Relihan encourages you to contact your representative to request their affirming vote. Your voice is important in speaking up for the vulnerable elderly population in nursing homes.
Visit https://www.azleg.gov/findmylegislator/ to find the contact information for your representative. Please help us continue to protect nursing home residents from abuse and neglect.
Martin J. Solomon is a principal at Solomon & Relihan PC and has been licensed to practice law in Arizona since 1970. He practices exclusively in the area of personal injury litigation, with an emphasis on nursing home abuse and neglect. Martin is a graduate of the University of Arizona College of Law, a past president of the Arizona Trial Lawyers Association, and has served as a member of the Board of Directors for the Arizona Center for Disability Law and the Arizona Center for Law in the Public Interest. He is a member of the Nursing Home Litigation Group in the American Association for Justice (formerly the American Trial Lawyers Association), the National Citizens’ Coalition for Nursing Home Reform and the Maricopa Elder Abuse Prevent Prevention Alliance.