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Nursing Home Staffing Changes Considered

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Florida’s nursing homes may be allowed to pare the amount of nursing care they are required to provide elderly residents under legislation that started moving forward Monday in the Senate. 

Despite opposition from AARP Florida and others, members of the Senate Health Policy Committee approved a bill that would eliminate a mandate that nursing homes provide each patient an average daily minimum of 3.6 hours of direct patient care, 2.5 hours of which must be provided by a certified nursing assistant.

Instead, the measure (SB 1088) would require nursing facilities to provide each resident one hour of direct nursing care per day and 3.9 hours of what is called “direct care staffing.”

The changes are being sought by the Florida Health Care Association, a group that represents many of the state’s largest for-profit nursing homes. If ultimately passed, the bill, filed by Sen. Ben Albritton, R-Wauchula, would take effect July 1.

A House version (HB 897) has been filed by Rep. Rick Roth, R- Loxahatchee, though It has not been heard in committees.

With time running short at Monday’s committee meeting, Senate Health Policy Chairwoman Gayle Harrell, R-Stuart, limited public testimony on Albritton’s bill.

But AARP Florida lobbyist Jack McRay told The News Service of Florida that the bill would give nursing homes the opportunity to reduce the amount of care provided by certified nursing assistants, something his group cannot support.

“CNAs are the absolute core of nursing home care,” McRay said.

The bill defines “direct care staff” as people who “through interpersonal contact with residents or resident care management, provide care and services that allow residents to attain or maintain their highest practicable physical, mental, and psychosocial states of well-being.”

The U.S Bureau of Labor Statistics recognizes three types of “direct care staff,” including certified nursing assistants, home health aides and personal care aides. CNAs assist residents with activities of daily living and perform clinical tasks such as range-of motion exercises and blood pressure readings.

Home health aides provide essentially the same care and services as nursing assistants, but they assist people in their homes or in community settings under the supervision of nurse or therapists. They may also perform light housekeeping tasks such as preparing food or changing linens.

Personal care aides work in private or group homes. In addition to providing assistance with activities of daily living, they often help with housekeeping chores, meal preparation and medication management.

The Florida Health Care Association said the changes would allow long-term care providers to offer additional services that are outside the parameters of what CNAs do.

Emmett Reed, executive director of the association, said the proposal offers nursing homes greater flexibility to staff their centers with specialists in mental health, activities, respiratory therapy, specialized feeding and other direct-care services.

“Florida has always been a leader in nursing home staffing, and the tremendous gains we’ve seen in quality care are a result,” Reed said in a prepared statement. “This good bill makes sense and will keep Florida in the forefront of caring for our state’s aging baby boomers.”

But Steve Bahmer, president and chief executive of the organization LeadingAge Florida, disagreed. His group also represents nursing homes, but his members want to keep the minimum 2.5 hour CNA requirement.

“CNAs are the people who deliver care in the nursing home. So grooming, bathing, feeding, toileting, the work that goes on to care for a senior in a nursing home is done by CNAs,” Bahmer said.

The bill cleared the Senate Health Policy Committee unanimously. But Sen. Lori Berman, D-Lantana, said some Democrats were concerned with the bill and that the initial support could wane if changes aren’t made.

“We may change our votes because we do have very serious concerns about that,” Berman said.