Amid nursing home staffing crisis, Legislature approves industry-backed bill changing care requirements

Elderly woman is assisted by nurse at home
AAFRP Florida will ask Gov Ron DeSantis to veto the nursing home industry-supported bill.

The Legislature on Monday passed a compromise between the long-term care industry and trial lawyers that reduces the amount of mandated nursing hours that nursing homes must provide, but at the same time could allow for more lawsuits against providers.

The Senate approved HB 1239 by a 28-9 vote, following up on earlier approval from the House.

AARP Florida, though, continues to oppose the legislation and will ask Gov. Ron DeSantis to veto the bill, said associate state director of advocacy Zayne Smith.

“The bill puts Florida in the wrong direction,” Smith told Florida Politics on Monday. “We hope he sees this as nothing more than a giveaway, and a veto will protect our seniors.”

Filed by Rep. Lauren Melo, HB 1239 requires nursing homes to conduct facility assessments to determine the staff needed to provide the necessary type of care for the facility’s resident population. The facilities will consider the types of diseases, conditions and 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 daily staffing by certified nursing assistants, a reduction from a current 2.5-hour requirement.

The bill retains current law requiring 1 hour of licensed nurse direct care per resident per day, for a total of at least 3 hours of direct care per resident per day provided by CNAs and licensed nurses. The bill also continues a mandate to provide an average of 3.6 hours of direct care.

In order to cover the remaining 0.5 hours, the bill allows nursing homes to count care provided by any combination of the following categories of disciplines and professions: physicians; nursing; pharmacy; dietary; therapeutic; dental; podiatry; mental health; and paid feeding assistants.

The nursing home industry wanted the Legislature to eliminate a moratorium that bars nursing homes from taking on new residents if they can’t meet staffing requirements. But Sen. Ben Albritton, who sponsored the Senate version of the bill, said the House “felt a lot more comfortable keeping the moratorium as it is today in current law.”

The Florida Health Care Association has been pushing for nursing home staff reductions since before the start of the COVID-19 pandemic two years ago. This year, the FHCA, which represents most of the state’s for-profit nursing homes, reached an agreement with the Florida Justice Association, the group that represents the state’s trial lawyer.

The alliance was enough to give the nursing home industry a long-sought win to change staffing standards. It also marked a dramatic moment for a feud that once got so heated a lawmaker sent a bag of manure to a business lobbyist pushing a bill designed to limit lawsuits against nursing homes.

“We are so thankful to Sen. Ben Albritton and the Florida Senate, along with Rep. Lauren Melo and her colleagues in the House, for recognizing the urgent need for this critical legislation, which will help ensure that Florida’s nursing center residents can receive the best quality care possible,” FHCA CEO Emmett Reed said in a prepared statement. “We know Gov. DeSantis understands this need, and we strongly encourage him to make this issue a priority by signing this legislation.”

The Florida Justice Association, meanwhile, supports language in the bill that makes clear the staffing mandates are minimum requirements and that compliance with the requirements is not admissible as evidence of compliance with federal rules. The FJA also supports language in the bill that adds certain additional requirements for unpaid judgment or settlement agreements when nursing homes are sold or there is a change of ownership.

If signed into law, the bill would take effect immediately.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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