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County nursing homes urge caution on prescriptive staffing mandate in HB 11‑79
Summary
Representative Linda Haskins proposed raising minimum direct care hours per resident day to 4.1 in HB 11‑79 after constituent complaints of neglect. County nursing home administrators and associations opposed the bill as an unfunded, prescriptive mandate that doesn’t account for resident acuity, paperwork burdens on RNs, or Medicaid funding shortfalls; they recommended funding, workforce housing, and targeted supports instead.
Representative Linda Haskins introduced HB 11‑79 following constituent complaints about neglect at a private nursing home. Haskins said New Hampshire’s minimum staffing is lower than other New England states and proposed raising hours per resident day to 4.1 (she noted a pending federal rule of roughly 3.48 hours as a comparison point).
County nursing home administrators and the New Hampshire Association of Counties testified against the bill as written. Catherine Kindock, administrator at Maplewood of Cheshire County, said some county homes already exceed the proposed levels but warned the bill is overly prescriptive: resident acuity varies and facilities need flexibility to staff appropriately (for example, behavioral units require social work and therapeutic staff in addition to RNs). Administrators emphasized that hiring RN capacity is constrained, survey and documentation requirements (MDS work) pull RNs off bedside care, and counties would absorb unfunded Medicaid cost increases if a statutory mandate passed without dedicated funding.
Committee members asked about implementation pathways, phased approaches and study options. Sponsors and administrators signaled willingness to consider amendments, phased timetables or a study to identify funding and workforce solutions before imposing numeric minimums.
