Defeated Bill in Florida Senate Would Have Diminished Quality of Care at Nursing Homes

Senator Albritton introduced a bill to the Florida Senate that would have changed rules for nursing home facilities. Though the legislation seemed like it would prevent nursing home abuse, many were worried that it would reduce the level of care by changing the guidelines for resident interactions. The bill, which was opposed by Steve Watrel, P.A. and other senior advocated, modified the current regulations by increasing the average amount of time spent with each patient but it changed who would be able to provide that care and what actions would be allowed. Here are some highlights from the 2019 Nursing Home Bill, which was defeated due to public opposition to the planned changes.

Nursing homes have to provide medical services for a large group of residents. The proposed bill increased the minimum number of contact hours to ensure that their facilities are devoting enough time to the patients in their care. Nursing homes would have needed to provide 3.9 hours of direct daily care, which would have been a 10 percent increase from the 3.6 hours that are currently required. In the proposed legislation a week was defined as Sunday through Saturday. These positives would have come at the expense of quality care, as the definitions of staff would have changed.

The 3.9-hour requirement applied to “direct care staff,” whose definition would have expanded to include “those individuals 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 revised regulation also limit what kinds of interactions can be counted toward the 3.9 daily hour minimum. Even if someone was considered “direct care staff,” not everything they did would be included in the daily hour requirement. The bill stated, “Direct care staffing hours do not include time spent on the following functions: nursing administration, staff development, staffing coordination, and the administrative portion of the minimum data set and care plan coordination.”

Aside from the 3.9 hours of direct care staffing, the bill has requirements for other responsibilities in nursing homes. Facilities must provide 2.5 hours of nonnursing direct staffing per resident per day. There’s also minimum staffing for licensed nurses are 1 hour per resident per day.

However, the most important change from the bill sought involved certified nursing assistants. The minimum levels for certified nursing assistant staffing were clarified in the revised proposal. Nursing homes would not be allowed to fall below one certified nursing assistant per 20 residents at any time. Similarly, facilities would not be allowed to fall below one licensed nurse for every 40 residents at any time.

Another fundamental change that would affect the quality of care at nursing homes involves the use of nursing assistants. Under the current rules, nursing assistants can be used to meet the minimum requirements for a certified nursing assistant under certain circumstances. Sen. Albritton’s proposed revisions to the statute would have allowed more situations where CNAs could be used instead of better-trained staff members.

Though the legislation was framed in a positive light, the cumulative effect would be negative for nursing home residents. As Steve Watrel, P.A. explained, “Passing a bill like this would be devastating to our seniors in long-term care facilities. Seniors have the right to have access to effective medical care and this bill would essentially turn nursing homes into daycare centers with unskilled laborers. These are the frailest of our citizens and need the best, most skilled care.”

If approved, these changes would have diminished the quality of care for nursing homes and Florida, as could have lead to an increase in instances of elder abuse. Thanks to the overwhelming opposition from Steve Watrel and other advocates for seniors, this bill was dropped and will not go into effect.

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