Amid worker shortages, lawmakers mull changes to nursing home hiring standards

by | Feb 9, 2022

TALLAHASSEE — As nursing homes grapple with a worker shortage, Florida lawmakers began moving forward Tuesday with revamping staffing standards for the facilities.

The House Finance & Facilities Subcommittee approved a bill (HB 1239) that supporters say would provide more flexibility to nursing homes in meeting changing needs of residents. The Senate Health Policy Committee will take up the Senate version of the bill (SB 804) on Thursday.

“It gives the flexibility needed to provide person-centered care,” House sponsor Lauren Melo, R-Naples, said. “Direct care staffing would expand to include a broad mix of highly skilled, licensed and certified staff members.”

But the House bill drew opposition from AARP Florida and the Service Employees International Union because it would reduce a required minimum amount of time that certified nursing assistants spend providing care to residents. Certified nursing assistants play key roles in providing hands-on care in nursing homes.

Current law requires certified nursing assistants to provide a minimum of 2.5 hours of direct care per resident per day. The bill would reduce that to 2 hours, while also making changes to factor in time spent by workers such as respiratory therapists, occupational therapists and mental-health specialists.

“If that went back to 2.5 (hours), we’re onboard,” said Tanya Jackson, a lobbyist for Service Employees International Union 1199, which represents workers in nursing homes.

Staffing standards have been an issue in the nursing-home industry for the past two decades. But the debate this year comes amid the backdrop of a worker shortage during the COVID-19 pandemic.

Steve Bahmer, president and CEO of LeadingAge Florida, a long-term care industry group, told the House panel that worker shortages have caused some nursing homes to reduce their numbers of available beds.

“In addition to the financial pressures that are created by the workforce crisis, it’s also creating challenges in terms of seniors’ access to high-quality care,” Bahmer said.

Current law places a combination of staffing requirements on nursing homes that include the 2.5-hour requirement for certified nursing assistants.

It 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.

In arguing for such flexibility, Melo pointed to issues such as increased needs to care for people with dementia and mental-health issues.

“Today’s nursing center residents live with chronic conditions and need a more modern menu of care to reduce re-hospitalizations, regain mobility, adapt 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 the residents’ needs.”

The House panel voted 14-4 to approve the bill, which needs approval from the House Health Care Appropriations Subcommittee and the House Health & Human Services Committee before it could go to the full House.


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