Florida lawmakers moved closer Monday to revamping staffing standards in nursing homes, amid criticism that the proposed changes could reduce hands-on care for residents.
The debate centers on the amount of time that certified nursing assistants spend providing care to residents. Certified nursing assistants play key roles in nursing homes, but the industry says it cannot find enough of the workers — resulting, at least in some cases, to unfilled beds.
The House Health Care Appropriations Subcommittee on Monday approved an industry-backed bill (HB 1239) that would reduce from 2.5 hours to 2 hours the minimum direct care that certified nursing assistants must provide per resident per day. Proposed changes also would factor in time spent by workers such as occupational therapists, respiratory therapists and mental-health professionals.
Sponsor Lauren Melo, R-Naples, said the proposal would provide more flexibility to nursing homes to meet the needs of residents.
“Each patient is different, and they each have a different standard of care, and I think this bill allows us to address that,” she said.
Supporters also pointed to the worker shortage.
“There are beds that are empty throughout the state where people are not receiving care because of the staffing crisis we’re in,” Rep. Sam Garrison, R-Fleming Island, said. “And that’s just the reality of the situation. Whether for-profit, not-for-profit, there are facilities that have the capacity to treat more seniors that aren’t able to do it because they can’t get the staffing to make it happen.”
But Democrats on the House panel and groups such as AARP Florida and the Service Employees International Union, which represents nursing-home workers, opposed the change and contend it will harm care for residents.
“This is a race to the bottom, is what this legislation is,” AARP lobbyist Zayne Smith said.
Rep. Carlos Guillermo Smith, D-Orlando, said nursing-home residents still will need help with such basic activities as bathing and going to the bathroom — help that certified nursing assistants provide.
“The 2.5-hour staffing minimum itself in current law I don’t think is enough,” he said. “But this bill wants to slash those standards further.”
Minimum staffing requirements have long been a controversial issue. After a fierce debate, lawmakers in 2001 approved a measure that set standards, while also taking steps to help shield nursing homes from lawsuits.
The proposal this year is unusual in that the Florida Justice Association, which represents plaintiffs’ attorneys, has supported it. The association and the nursing-home industry have often battled in the past.
Blair Mendes, an attorney representing the association at Monday’s meeting, said nursing homes have used the minimum 2.5-hour standard as a “shield” in defending against lawsuits. He said the bill would eliminate “some of the shields that nursing homes can use to avoid accountability in courtrooms.”
In addition to the 2.5-hour standard, current law also requires that certified nursing assistants and licensed nurses provide a weekly average of 3.6 hours of direct care per patient per day. The House bill would keep that 3.6-hour average, but it would allow time spent by other types of workers to be factored into the calculation.
The bill, which was approved Monday in a 9-4 vote, needs to clear the House Health & Human Services Committee before it could go to the full House. A similar Senate bill (SB 804) needs approval from the Rules Committee before it could go to the full Senate.
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