Nursing home staffing changes clear last House panel

nursing home
Nursing home staffing is a top issue for lawmakers in the 2022 Session.

Legislation to “modernize” nursing home staffing requirements by reducing the number of certified nursing assistant hours and allowing nonnursing care to be provided instead cleared its last panel Wednesday in a 15-5 vote.

The committee agreed to tag an amendment onto HB 1239, filed by Rep. Lauren Melo, before passing the measure. The bill requires nursing homes to conduct facility assessments to determine the staff needed “to provide the level and types of care needed for the facility’s resident population considering the types of diseases, conditions, physical and cognitive disabilities, as required by federal rule.”

The level of resident care required would be determined by the facility assessment as well as the resident’s direct care plan. At a minimum, the bill would require facilities to maintain 2 hours of CNA staffing, a reduction from the current 2.5-hour requirement.

“Modernizing staffing requirements to account for such needed specialists as occupational and respiratory therapists and dementia care or mental health professionals mean better outcomes for residents and an improved quality of care and quality of life,” Melo told committee members.

Reducing the number of mandated nursing hours has been a priority for the Florida Health Care Association, which represents the state’s for-profit nursing home providers, for several years. The bill maintains a requirement that residents receive 1 hour of licensed nursing care a day. But the 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.

“We’re in the midst of a staffing crisis and what that means is that we have to think differently about how we provide direct care staffing in the nursing home environment to ensure that residents get the quality care they deserve,” said LeadingAge Florida President and CEO, Steve Bahmer.

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 therapists, activities staff, speech therapists and mental health service workers.

Nursing facilities can include in the 3.6-hour direct care requirement the time assistants and direct-care providers spend feeding residents.

The industry says the changes are overdue.

“As someone who works on the frontlines of caring for our residents, I can tell you that the quality of care and quality of life of these precious elders is enhanced when we treat them as individuals, and we recognize that no two residents are the same,” said Courtney Urban, assistant business office manager at Palm Garden of Tampa.

The nursing home industry and the trial Bar association generally are at odds with one another. But the nursing home industry and the Florida Justice Association (FJA), which represents the state’s trial lawyers, have worked together on the proposal to find a compromise. The FJA has pushed to crack down on nursing homes that do not pay a final judgment or settlements.

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.

Meanwhile, the Senate Rules Committee on Wednesday deferred action on the companion measure (SB 804).

Staff Reports


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