The Senate Health Policy Committee on Thursday approved a “compromise” bill between the state’s trial lawyers, the nursing home industry and a powerful Republican Senator that reduces the number of nursing hours long-term care residents must receive.
The bill also adds increased consumer protections for those who sue nursing homes. But representatives from AARP Florida and SEIU 1199 United Health Care Workers continue to oppose the measure. Representatives testified they weren’t always included in negotiations between bill sponsor Sen. Ben Albritton, the Florida Health Care Association, LeadingAge Florida and the Florida Justice Association (FJA).
SB 804 cleared the committee with just one “no” vote, cast by Sen. Shevrin Jones, a Democrat from Miami.
The amended bill requires nursing homes to provide each resident 2 hours of certified nursing assistant (CNA) care a day, down from the current 2.5 hours mandated in law. The current requirement that one hour of licensed nursing care be provided per resident stays the same.
But the amended bill strikes an additional requirement of 3.6 hours of “nursing” care and instead says nursing facilities would have to provide 3.6 hours of “direct care” to the resident.
The bill defines “direct care staff” as individuals who supply care and services to allow residents to reach or maintain the “highest practicable physical, mental and psychosocial well-being.” Such staff includes, but is not limited to, physicians, occupational therapy, activities staff, speech therapy, mental health service workers and others.
Additionally, nursing facilities can include in the 3.6-hour direct care requirement the time paid feeding assistants and direct-care providers spend feeding residents.
A handful of senators who voted in favor of the bill Thursday still encouraged Albritton to continue to meet with opponents in an effort to gain support from AARP Florida and the union that represents the certified nurse assistants.
Albritton told Florida Politics he would “dig in” more with the union and AARP to understand their perspective.
“I’m going to listen to them, and I am going to see what it is, with the caveat that it can’t be, ‘Don’t change anything,’” Albritton said. “That doesn’t work. We have to change something to build balance or else you have people looking for a bed.”
There has been discussion of a potential sunset of the two-hour CNA mandate, nursing home industry representatives told Florida Politics. But Albritton said the sunset discussions are around a section of the bill that makes clear that state staffing standards aren’t admissible as evidence of compliance with federal law.
The Florida Justice Association, which represents the state’s trial lawyers, signed off on the legislation after the bill was altered to make clear that nursing homes’ audited financial reports will be a public record. Lawmakers this year are advancing legislation to require nursing homes to give audited financial reports to the state.
Another provision that cemented the FJA’s support was the inclusion of language meant to crack down on nursing homes that don’t pay final judgment or settlements. To that end, the bill would require nursing homes with outstanding unpaid settlements to inform each pending claimant or the claimant’s attorney of a pending change of ownership. Claimants or their attorneys have 30 days to object to the change in ownership. The agency would have to consider the objections when it decides whether to approve or deny a change in ownership application.
The nursing home industry and the trial bar association generally are at odds with one another. The apparent agreement between the disparate groups did not go unnoticed at the committee meeting.
Meanwhile, a House panel earlier this week approved HB 1239 by Rep. Lauren Melo, a Naples Republican. The bill is similar but not identical to the Senate bill.
The difference: the Senate bill creates a “Nursing Home Sustainability Task Force, composed of nursing home representatives and “other interested stakeholders.” The task force is charged with reviewing and analyzing the sustainability of the “state’s model of providing quality nursing home care” and making recommendations by Jan. 1, 2025, to the Agency for Health Care Administration and legislative leaders on how the system can be improved.