Reports of abuse in ALF's could hurt nursing home dereg bill

Jan 13, 2012

Reports of abuse and neglect in some of the state’s Assisted Living Facilities has turned what was once a relatively non-controversial nursing home regulation clean-up bill, into something more.  A similar measure cleared the House last year on a unanimous vote.  But Lynn Hatter reports some lawmakers may be changing their position.

Republican Representative Jim Frishe’s bill would remove what he says are redundant reporting provisions on nursing homes. A similar measure cleared both chambers last year overwhelmingly, but got bogged down with last-minute amendments like one that reduced nursing home staffing levels, which ultimately killed it. This year, Frishe wants to keep the bill amendment-free.

 “This is a bill that has passed the house and senate repeatedly but it seems to be an attractor of amendments and so this year we’re going to try to keep it clean and get the up to this point, non-controversial stuff taken care of.”

Last year the bill cleared the house with a 119-0 vote. Unfortunately, what was non-controversial last year, isn’t so, this year. For example, Frishe’s bill removes a requirement that nursing homes report staffing level averages quarterly. But in other areas of state law, they have to report hard numbers by the year. Representative Mia Jones, a Jacksonville Democrat, took issue with the staffing level report removal.

“That’s something that, last year, we reduced the staffing ratios down, now we’re going to say we’re not going to report them at all. That’s a major concern for me. I actually have a bill that addresses that and I do think it’s something we need to discuss.”

And the Florida AARP isn’t a fan of language dealing with who—a nurse, doctor or family member—can sign off on a resident’s medical care plan. Right now, a nurse or doctor writes those plans, and the resident or their representative can see them. Frishe argues it’s not necessary for so many people to be involved in the process, but the AARP’s Jack McRay wants to keep the current law in place.

 “There are people who are in long-term care facilities who are not competent to sign for themselves. These persons generally would have a legal representative or family member who is capable of signing for them. If you look at my comments, if you can’t obtain a signature at that time, there should at least be an obligation to obtain that signature at the very first opportunity.”

The nursing home deregulation bill comes at a time when the state is grappling with what to do with the sister entity, the Assisted Living Facilities. Last year the media reported a string of neglect and abuse cases in those facilities. And the state has even set up a task force to find ways of improving conditions in the homes.

Assisted Living Facilities aren’t as heavily regulated as nursing homes because the patients in them tend to require less care. But there is a sign that the state is trying to crack down on them. The Agency for HealthCare Administration reported that from July through December of last year it imposed more than 600-thousand dollars in fines. It also revoked 13 facility licenses, and blocked 13 others from participating in Medicaid. Twenty-six others closed because of lawsuits and regulatory pressure.

 Still, given the ongoing situation with the Assisted Living Facilities, some lawmakers, mainly Democrats, like Representative Scott Randolph of Orlando, say they can’t vote for the nursing home bill this year.

 “I know this bill has been around. Sometimes it’s passed a lot, sometimes it hasn’t. But after last session we saw a huge story about Assisted Living Facilities. And I think we should err on the side of caution and of consumers in this state.”

 Representative Frishe, for his part, says all of the issues mentioned, like staffing levels, ownership disclosures and medical care plans, are all addressed in different sections of state law.

 “We are not doing something draconian to totally deregulate the nursing home industry. The rules are still out there.”

The bill passed the House Health and Human Services with Democrats in opposition, a reversal from last year when it sailed through its committee stops.