The Florida legislature just approved two new bills affecting the operation and regulation of nursing homes in the state- the state’s upcoming fiscal budget and HB 1239.
Florida’s $112 billion state budget for the 2022-2023 fiscal year was approved Monday. Lawmakers included a 7.8% increase in Medicaid funding for nursing homes. That amounts to an additional $293 million in funding, or about $419,000 per facility. The state’s new fiscal year starts July 1.
At the same time operators are getting an influx of taxpayer funds, the state is lowering staffing standards. HB 1239 reduces the minimum number of hours of direct care per resident day provided by CNAs from 2.5 to 2. It also accounts for time other workers, including therapists, have spent with residents. Currently in Florida, CNAs and licensed nurses are also required to provide a weekly average of 3.6 hours of direct care per patient per day. The legislation would allow time spent by other workers, like therapists, to be factored into that weekly average.
What’s somewhat confounding is the fact that federal regulations require nursing homes to provide enough qualified staff to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psycho-social well-being of each resident as determined by resident assessments and individual plans of care and considering the number, acuity, and diagnoses of the facility’s resident population in accordance with the facility assessment. 42 C.F.R.§483.35. Florida’s new legislation is likely intended to obfuscate the true needs of nursing residents based on their individual conditions, and to create an artificial minimum staffing level that nursing homes and their attorneys can argue is a more appropriate standard when responding to allegations of understaffing during elder neglect and abuse litigation.
Notwithstanding, the idea that increasing funding to nursing homes so that those same nursing homes can increase their staffing levels, to presumably provide better care to residents, while simultaneously reducing the state minimum staffing level requirements is nonsensical. For-profit nursing homes have been flush with profits for years by way of related party transactions, fraudulent staff reporting, and concealment of revenue and management structures, regardless of their public cries for more help. Handing nursing homes additional tax dollars while not requiring higher levels of staffing so that residents don’t develop avoidable injuries such as bedsores, also known as pressure injuries or decubitus ulcers, is highly problematic to overall nursing home care.
The fight against lobbyist and politicians who are in the pocket of massively wealthy nursing home operators is just beginning. Governors such as Florida’s Ron DeSantis who sign legislation that hurts the rights of elderly and dependent nursing home residents across the state is disappointing at best- and despicable at worst. If states follow his lead, nursing home care in those jurisdictions will only get worse.
At Bedsore.Law, we specialize in holding nursing homes accountable for causing bedsores in nursing home and assisted living facilities nationwide.
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