The Florida House could be poised to take up a plan that would revamp staffing standards in nursing homes, as a debate continues about whether the changes would result in reduced care for residents.
The House Health & Human Services Committee voted 15-5 on Wednesday to approve the proposal (HB 1239), which came as nursing homes say they are grappling with staffing shortages that, at least in some cases, have forced them to leave beds unused.
But the bill has drawn opposition from the senior-advocacy group AARP, a union that represents nursing-home workers and the state’s long-term care ombudsman, whose job is to represent nursing-home residents.
That opposition stems from part of the bill that would reduce a required amount of time that certified nursing assistants must spend providing care to residents. Certified nursing assistants provide many of the hands-on services in nursing homes, such as helping residents with dressing, going to the bathroom and bathing.
The industry-backed bill would begin factoring into the standards time spent by workers such as occupational therapists, respiratory therapists and mental-health professionals. Sponsor Lauren Melo, R-Naples, said the changes would provide more flexibility to meet the needs of residents.
“Today’s nursing-center residents live with chronic conditions and need (a) more modern menu of care to help reduce re-hospitalizations, regain mobility, adopt their functional skills, manage cognitive abilities and behaviors and improve outcomes,” Melo said. “All of these services require various skilled specialists working alongside the nurses and CNAs (certified nursing assistants) to meet resident needs.”
But Michael Phillips, the state’s long-term care ombudsman, said certified nursing assistants provide 80 percent of the care in nursing homes and play an important role in repositioning residents in bed and performing other tasks to help prevent residents from suffering pressure sores.
“I know that there are going to be consequences in reducing this number of CNAs off the floor. These (residents getting pressure sores) will be the types of consequences,” Phillips said. “This will be the pain that will be inflicted if this bill passes.”
With Wednesday’s vote, the bill is ready to go to the full House. The Senate also has been moving forward with a similar bill (SB 804), but it was put on hold Wednesday in the Senate Rules Committee.
Rules Chairwoman Kathleen Passidomo, R-Naples, said Senate sponsor Ben Albritton, R-Wauchula, is continuing to work on the bill, which is expected to go before the committee next week.
Minimum staffing requirements have been debated in Florida for more than two decades. Lawmakers in 2001 approved a measure that set standards, while also taking steps to help shield nursing homes from lawsuits.
Current law requires that certified nursing assistants provide a minimum of 2.5 hours of direct care per resident per day. The bill would reduce that to 2 hours.
Also, current law 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, such as therapists, to be factored into the calculation.
Officials from the Service Employees International Union, which represents nursing home workers, said therapists and other types of workers are already providing services in the facilities. As a result, they said factoring those workers into the staffing requirements would not mean additional services for residents.
“You are reducing care if you vote for this bill,” Roxey Nelson, a vice president with the union, told the House members.
But Melo said the hourly requirements are minimum amounts and that nursing homes can exceed them. She also said the changes are designed to bolster the quality of life in facilities.
“Today, we have focused on standards of care,” she said. “We should focus on quality of life.”
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