Deborah Franklin: Protect Florida elders by keeping nursing home certificate-of-need process

nursing care
Deborah Franklin

Throughout my professional career, I have been dedicated to the continued growth and enhancement of quality long-term care in Florida. A key element of quality care is maintaining a sense of independence among the elders we serve, a priority that is fostered by Florida’s long-standing commitment to helping them remain in the least restrictive setting possible.

However, I believe a proposal now before the Constitution Revision Commission would undermine that goal and threaten the continued independence of countless older Floridians.

The proposed amendment to our State Constitution would eliminate the Certificate of Need (CON) process for nursing homes, among others, and change that would disrupt the mission of continuing quality care in skilled nursing care centers. The CON process requires Florida’s Health Planning Councils to identify areas which have a need for additional beds.

Facilities must document how they will meet those needs, either through new development or adding on to an existing center. Beds are awarded based on several factors, including a center’s quality outcomes and financial stability.

The intent is to prevent an oversaturation of care facilities, so the taxpayers don’t end up subsidizing unused beds.

Florida has the nation’s highest share of seniors, and elimination of the nursing home CON requirement would fly in the face of the state’s ongoing support of home and community-based care — a policy that allows elders to remain in their own homes as long as possible.

If additional nursing center beds are allowed without the careful scrutiny of the CON process, the new facilities will need residents to fill their beds — and the first place they will look is the ranks of those currently enjoying the benefits of home and community-based care.

It’s no secret that Florida is experiencing a nursing shortage, with more than 12,000 vacant nursing positions around our state. The problem is particularly challenging for skilled nursing centers.

Elimination of CON would lead to additional facilities competing for the same limited pool of Registered Nurses and Certified Nursing Assistants, thus spreading already limited resources even thinner.

If the CON repeal is enacted, it seems unavoidable that more seniors will be moved from home settings and into skilled nursing centers — a setting that is necessary for our most frail elders, but certainly not for everyone currently living in the less restrictive environment offered by home and community-based care. If it was your mother or grandmother, would you want her living in even the best nursing home before it was really necessary?

The Legislature has seen the value in allowing the nursing home CON process to remain in place, so why does the Constitution Revision Commission want to circumvent their authority by using our State Constitution to repeal CON?  Because of today’s CON laws, nursing care centers are able to continue to provide quality care at a level that is among the best in the nation.

Existing centers are able to focus on recruiting dedicated more health care professionals to the field, to serve residents who truly need the care they offer.

Every Florida resident should take a significant interest in this issue, for the sake of their elderly relatives — and, someday, for themselves.

I hope every member of the Constitution Revision Commission recognizes the need to protect our senior citizens by leaving the nursing home CON process in place.

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Deborah Franklin is Senior Director of Quality Affairs for Florida Health Care Association. She has more than 20 years’ experience working as a nursing home administrator, most recently overseeing renovations and expansions for the not-for-profit Florida Living Options, which operates the Hawthorne Village continuing care retirement communities in Florida. She can be reached at [email protected].

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