Connecticut laws/regulations;

OLR Research Report

September 21, 2012




By: Nicole Dube, Associate Analyst

This report briefly describes current nursing home direct care staffing requirements under Department of Public Health (DPH) regulations.

DPH licenses nursing homes at two levels of care: (1) chronic convalescent nursing homes (CCNH), which provide skilled nursing care, and (2) rest homes with nursing supervision (RHNS), which provide intermediate care. A nursing home can be licensed at one or both levels of care.

DPH regulations require nursing homes to employ nurses and nurse's aides to provide appropriate patient care 24 hours per day, seven days per week. The number, qualifications, and experience of nursing staff must ensure each patient (1) is kept clean, comfortable, and well-groomed; (2) is protected from infections, accidents, incidents, or other unusual circumstances; and (3) receives the treatment, medications, therapies, and nourishment prescribed in his or her care plan. In addition, there must be at least one registered nurse on duty 24 hours per day, seven days per week.

Minimum direct care staffing requirements for CCNHs and RHNSs vary somewhat depending on whether the nursing home is providing CCNH or RHNS levels of care. (Most of the state's nursing home beds are CCNHs.) The nurse-to-resident hours per day are set separately for the periods from 7 a.m. to 9 p.m. and 9 p.m. to 7 a.m. and are less for RHNSs than for CCNHs, as shown in Table 1 (Conn. Agencies Reg. 19-13 D8t(m)).

Table 1: DPH Nursing Home Minimum Direct Care Staffing Requirements

Direct Care Personnel



7 a.m. to 9 p.m.

9 p.m. to 7 a.m.

7 a.m. to 9 p.m.

9 p.m. to 7 a.m.

Licensed Nursing Personnel (licensed practical nurses and registered nurses)

0.47 hours per patient (hpp)

(28 min.)

0.17 hpp

(10 min.)

0.23 hpp

(14 min.)

0.08 hpp

(5 min.)

Total Nurses and Nurse Aide Personnel

1.40 hpp

(1 hr. 24 min.)

0.50 hpp

(30 min.)

0.70 hpp

(42 min.)

0.17 hpp

(10 min.)