Bill Bypassing State Nursing Homes Rules For Certain Retirement Communities Raising Concerns

Apr 15, 2013

A bill that would allow certain Florida nursing homes to bypass state rules to create new nursing home beds has cleared another committee. But, the Republican backed proposal that could create a special exception for one retirement community in particular is raising concerns among other Republicans and nursing home stakeholders.

Since 2002, nursing home providers must go through what’s called a Certificate of Need, or a CON review process before establishing a new nursing home or adding nursing home beds.

According to the Florida Health Care Administration, the agency which oversees the review, that process could take up to three to four years. Republican Senator Alan Hays of Umatilla says that’s too long if there’s an immediate need.

“The thinking at that time did not realize the tremendous growth that was going to take place in several of our communities across the state, and what we have today is a marked need for more nursing home beds. And, for them to go through the Certificate of Need [CON] process will not allow them the proper time to alleviate the acuteness of this need,” said Hays.

So, Hays sponsored a bill that would allow a retirement community that meets certain criteria to avoid having to go through the CON review process if there’s evidence more nursing home beds are needed.

“As a matter of fact, I have a letter from a constituent in The Villages, who expressed her dismay that this legislation was not going to be passed early enough for it to affect her. Her husband had ALS and had to spend the last seven months of his life in a skilled Nursing Facility. And, so she had to drive Leesburg, which as 14-20 miles of construction type traffic, and it was a very unpleasant experience for her,” added Hays.

Hays says the resident in his district is hoping the legislation will help to bring more nursing home beds to her area, so she can stop driving that long distance. But, despite that story, some charged the bill is creating a special exemption for The Villages, a Central Florida retirement community and a major Republican donor, a notion that Hays tried to quash.

“This bill is not a bill just for the Villages. This bill applies to communities in Collier County, communities in Indian River County, which is on the opposite coast, and it also applies to Marion County’s Top of the World,” said Hays.

But, Republican Senator Rene Garcia of Hialeah is one lawmaker who isn’t buying it. He spoke at a press conference Monday in opposition to the bill.

“We should protect all seniors, not just a single community in our state. These rules are in place for that simple reason to protect the quality of health care delivered to these seniors. If we do have an issue with the CON process. Let’s look at the CON law to have a comprehensive approach at reforming it, not just for the basis or the economics of one basic community,” said Garcia.

And, Deborah Franklin with the Florida Health Care Association, agrees.

“We hope legislators will recognize the need for a more inclusive approach to health care planning that consists of the full continuum of long-term care services, not just the needs of private developers,” said Franklin.

Franklin adds while the bill appears to have a limited impact on certain communities, she says her group has grave concerns that this could have unintended consequences across the entire state.

“It fails to adequately recognize the long-term care needs of the residents in the surrounding counties which exist outside The Villages development. In addition, nursing homes and seniors will soon be affected by the implementation of Medicaid managed care and the uncertainty about how we will be affected is also important to this issue," Franklin added.

But, Rheb Harbison, a lobbyist for The Villages, says all they want is to meet a need for the state’s growing elderly population.

“The data, which we’ve run five different ways, indicate that there is still a shortage of beds, of a minimum of 260 beds, or greater. That’s why we’re here today. We have no option, but to come back to the Legislature and get relief under the moratorium for a community that has grown by 400 and three-percent since the moratorium was enacted in 2002,” said Harbison.

Harbison made those remarks in the Senate Judiciary Committee Monday.

While Republicans voted in favor of the proposal, some only agreed to move the bill along to make sure that the bill’s sponsor took everyone’s concerns into account before it got to the next stop.

The bill passed along party lines with Democrats opposed. It has one more stop to go before it heads to the House floor.

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