Gov. DeSantis signs bill that ‘modernizes’ nursing home law by lowering ‘nursing’ care requirements

hands-nursing-homes
Less 'nursing,' more 'other' care to be delivered in Florida nursing homes under new law.

The required minimum amount of direct “nursing” care that nursing home residents receive will drop by 20%, according to legislation that Gov. Ron DeSantis signed into law Wednesday evening

In signing HB 1239, the Governor brushed aside criticism from advocates for the elderly who said it puts nursing home residents at risk. and delivered a victory to Florida’s long term care industry, which has tried for years to pare back the mandatory nursing hour requirements.

AARP Florida State Director Jeff Johnson sent DeSantis a letter last month urging the Governor to veto the bill.

Johnson said in a statement Wednesday that it was “deeply disappointing” for the Governor to OK the law considering that 40% of licensed nursing homes are on an Agency for Health Care Administration watch list.

“Nursing home staff will have to do more with less help because of this new law,” Johnson said. “This legislation does absolutely nothing to address the industry’s chronic staffing crisis, and AARP anticipates even further increases in worker burnout and CNA job losses.” 

“Let’s be clear: Nursing homes won’t magically have fewer patients to care for, they will have fewer trained staff to care for them. It’s appalling, but not surprising, that the nursing home industry’s desperation to protect its profits means putting patients at even more risk in these facilities. Floridians deserve better.”

While AARP may have lost its veto fight, the organization continues to oppose the changes and will track how the reductions in required “nursing” care adversely impact residents.

“We will continue to raise awareness for people who may be considering long-term care and focus on boosting home- and community-based services. Our message is simple: do whatever it takes to keep your loved ones out of Florida’s nursing homes,” Johnson said.

DeSantis held a press conference earlier Wednesday at a Naples long-term care facility to sign into law a bill that guarantees visitation rights to long term care residents and hospital residents.

The Governor was joined by HB 1239 sponsor Rep. Lauren Melo at the press conference, but DeSantis made no reference at the event to the controversial bill he was going to sign into law, along with 41 others, hours later.

One of the more outspoken critics of the proposal, Rep. Carlos Guillermo-Smith, blasted DeSantis on social media for the stealth move.

“Hey Ronnie, Why no big signing ceremony on (Fox & Friends)? Why not sign (HB 1239) slashing minimum staffing standards for nursing home residents by 20% in front of lights and cameras? Why no media? What happened to #SeniorsFirst?” the Democrat from Orlando posted on his Twitter page Wednesday night.

Effectively immediately, nursing homes will be required to provide two hours of certified nursing assistant care per resident per day, a reduction from the current 2.5-hour requirement. The mandate that one hour of licensed nursing care be provided per resident, per day, remains in effect under the new law.

However, the requirement that 3.6 hours of “nursing” care be provided to each resident has been eliminated under the new law and replaced by a requirement that facilities provide 3.6 hours of “direct care” to the resident per day. The mandated three “nursing” hours can be included in the 3.6-hour requirement, but the remaining 0.6 hours can be provided by pharmacy, dietary, therapeutic, dental, podiatry, or mental health service workers and paid feeding assistants.

Leading Age Florida President and CEO Steve Bahmer said the new law will help nursing home providers reopen long-term care beds.

“The workforce crisis has forced high-quality providers to take beds offline, limiting and potentially jeopardizing Florida seniors’ access to high-quality care. This legislation gives providers the flexibility to utilize, and to be credited for, the highly trained and skilled professionals who are already on staff and are already providing high quality care. And it will help providers reopen beds and ensure Florida’s seniors have access to the high-quality care they need.”

Florida Health Care Association (FHCA) CEO Emmett Reed said by expanding the care beyond nursing, the law allows other trained professionals to work with the residents and allows for the delivery of what he called “more personalized care.”

“Every nurse, Certified Nursing Assistant, long term care staff member, and nursing center resident has Governor DeSantis to thank today for ensuring higher quality care for Florida’s elderly and people with disabilities,” Reed said in a prepared statement. “This legislation will bring more individualized, comprehensive care to residents while easing the burdens posed by significant staffing challenges.”

The FHCA, which represents most of the state’s for-profit nursing homes, had been pushing for nursing home staff reductions since before the start of the COVID-19 pandemic two years ago, arguing that the 20-plus-year-old staffing requirement is antiquated, and that today’s nursing home resident is more medically complex.

But until now, its efforts had been unsuccessful.

The game changer was when the FHCA reached an agreement this year with the Florida Justice Association (FJA), the group that represents the state’s trial lawyers, and traditionally has been at odds with the long-term care industry.

As part of the agreement, the FJA backed off its opposition to the reduced nursing requirements and, in exchange, the industry agreed to changes the trial attorneys sought.

One such change the FJA secured was a tweak to make clear that a nursing home’s compliance with the state’s mandated staffing requirements is inadmissible as evidence of compliance with federal standards.

Another change cracks down on nursing homes that change ownership to try to avoid paying outstanding settlements. When the new law takes effect, nursing homes with outstanding unpaid settlements will be required 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.

“Florida’s most vulnerable citizens and their families need to have the confidence that when they enter a care facility they will be well cared for and protected, even amidst increased health risks or staffing challenges,” said Jacksonville attorney and Chairman of the FJA’s Nursing Home Committee, Steve Watrel. The new law creates a more responsible, resident-centered nursing home industry and a driver for good behavior by providers by virtue of accountability in the court system.”

In addition to signing HB 1239 the Governor also signed into law HB 539, which, for the first time, requires nursing homes, and their home offices, to submit their audited “actual experience” with the state. The nursing homes will be required to submit a fiscal year-end balance sheet, income statement, statement of cash flow, and statement of retained earnings. Filed by Rep. Jay Trumbull, chairman of the House Appropriations Committee, the bill was a top priority for the House of Representatives.

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.


18 comments

  • Ian Fowler

    April 7, 2022 at 5:17 pm

    Hope everyone that voted for that psychopathic moron gets cancer.

    You just had to elect the absolute worst, most evil bastard you all could find. Now you want grannies to die? Sick trunts

    • Arien325

      April 9, 2022 at 5:18 am

      under the law the maximum acceptable load is 20 patients each care giver.
      normally 12-15 patients each care giver, when census is low you get 5-7 patients each. there are times i have to take care more than 20 patients. its not new to me.

      • Susan

        April 13, 2022 at 10:42 am

        I am so happy that to you its not hard to take care of 20 patients alone. How many of them did you need to feed? How many of them did you need to assist to the bathroom? How many was total care? As a CNA I can tell you this is impossible to care for 20 patients in 8hrs and them get the care they fully deserve.

        • John Miller

          April 13, 2022 at 5:13 pm

          You are 100 % correct

        • Lauren

          April 16, 2022 at 8:11 am

          We don’t have time to lotion everyone down and have they’re teeth brushed alone……I’m in shock with this still. More incidents will occur soon…..

          • Lauren

            April 16, 2022 at 8:16 am

            Their* ha

    • So hard to make

      April 9, 2022 at 1:26 pm

      Am I bad person for Hoping Ron and his wife get cancer?

      Or am I good one for hoping evil is destroyed?

      Ah moral choices

      • Geoff Yourself

        April 9, 2022 at 3:14 pm

        Let’s hope cancer doesn’t get Ron DeathSanta because I would feel bad for cancer.

  • MICHAEL LANGDON

    April 8, 2022 at 6:27 am

    The Republican’s solution to a labor shortage isn’t the free-market solution of raising wages, it’s the lowering of standards. Imagine that. Good luck. DeathSanta doesn’t care about nursing home residents just like he didn’t care about the tens of thousands who died of Covid.

  • slb

    April 8, 2022 at 12:27 pm

    Der Dwarf’s health care philosophy: die fast.

  • Johnfsu

    April 8, 2022 at 2:02 pm

    These people call themselves “pro life” with a straight face. Elder lives don’t matter?? We will all get older and need care. If anything we need more staffing in nursing homes, not less. This is nothing but a gift to campaign donors in the nursing home industry. Shame on you Ron DeSantis. I voted for you the first time around, never again.

    • Arien325

      April 9, 2022 at 5:07 am

      this is not new to nursing home its been like that ever since, no cns’s no nurses, agency nurses dont come back if the patients are crazy, the same way with the cna’s, even in the hospitals.

  • Thomas Cox PhD RN

    April 11, 2022 at 10:52 am

    FL already had the worst regulatory oversight of nursing homes and assisted living facilities – now, rather than compelling adequate care, these facilities will offer less care and lower quality care.
    Then, when people die, the overworked nurses and staff will be prosecuted for negligent manslaughter and abuse, while the investors will walk away with more profits.

  • Timothy J Lockard

    April 12, 2022 at 4:01 am

    Smooth move lower standards sobrhey can say their in compliance. Now what donyoubthink is gonna happen thebfew staff nurses left will jump boat an switch to agency just for money we can keep doing double assignments for 1/2 the price now you want to gouge us again!? Damn shame 32 years as a nurse thank god im just about retirement age. Maybe i can go back to truck driving for my last few years of working?

  • John Miller

    April 12, 2022 at 4:54 pm

    Nursing homes are so under staffed now and we are reducing it to increase profit.

  • John Miller

    April 12, 2022 at 5:25 pm

    Ok let’s figure this out, your not going to like what I say, lf your love ones nurse clocks in and spends 30 at hand off and 30 minutes for lunch if she gets one. And she does 2 hours of documentation and another 30 mins at the end of the shift thats 3.5 hours . THATS FOR A PERFECT DAY. In nursing a perfect day is RARE. That leaves leaves 13 minutes to see your loved one in a day. But thats not the end of the nurses day they have to do drug counts, place Iv’s, clean feeding tubes place orders , do admits, do discharges , read labs, answer phone calls, call Power of attorneys for changes, help pass dinner trays, help with feedings, talk to visitors and and family members,recieve medications sign off orders ,do wound care,, etc etc so at the end of the day your love one sees a nurse long enough to walk in hand them a pill and walk out. Almost 3 mins of care. . DeSantis just reduced this by 25 %. Our nurse has 38 patients a Day wounds don’t get done documentation is sloppy, labs are not looked at. Residents are not rolled and positions change to prevent bed sores and pressure ulcers and two cna’s so busy your love one might get her diaper changed once or maybe twice a shift. Thank you Ron DeSantis. No Balls to stand up to nursing homes making hundreds of million of $.

    • John Miller

      April 12, 2022 at 7:28 pm

      Time for all nursing homes to go union….

  • Susan

    April 13, 2022 at 1:16 pm

    That why everyone getting out of nursing

Comments are closed.


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