Challenges for Florida’s Skilled Nursing Facilities
The nursing home industry in Florida recently came under scrutiny in the aftermath of Hurricane Irma after a nursing home in Hollywood was unprepared for the hurricane’s effects. The nursing home lost power during the hurricane and did not make provision for alternate methods of generating electricity for the facility. As a result, the temperature in the facility spiked causing the death of twelve nursing home residents who died from medical issues related to overheating. In response, Governor Rick Scott issued a new rule requiring skilled nursing facilities and assisted living facilities in the state to make provision for four days’ worth of electricity through back-up generators.
In addition to state-wide regulations, however, the Centers for Medicare and Medicaid Services (CMS) also promulgate regulations and guidelines for nursing homes in the United States, which must be enforced by the states. Last year, CMS crafted new rules that sought to protect nursing home residents from theft and gave nursing home residents more control over when they can receive visitors and with whom they share a room. New legal protections were also crafted to protect individuals with dementia from a somewhat pervasive nursing home practice of sending individuals with dementia to the hospital and then refusing to readmit them to the facility.
Despite some of these positive changes, there are still aspects of nursing home regulation that remain unchanged. For example, advocates have sought to have CMS issue a regulation that requires at least one nurse to be on site at the nursing home 24 hours per day instead of the current regulation which only requires a nurse to be on site for 8 hours per day. The nursing home industry argues that such a regulation would increase costs and thereby increase the public dollars needed to pay for Medicaid recipients receiving nursing home coverage. Such a regulation is also more difficult to comply with for nursing homes located in rural areas with fewer trained workers such as nurses.
Although CMS seems unlikely to meet some advocates’ demands, CMS has provided financial support for OPTIMISTIC, a project aimed at finding innovative methods for improving the health care of nursing home residents and reducing hospital admissions among the nursing home resident population. Part of this endeavor involves embedding specialized clinical staff to focus on better training and education for nursing home staff as well as enhanced clinical care for nursing home residents. Such measures reduce hospitalizations for nursing home residents thereby better protecting their health and safeguarding public funds from being expended on unnecessary hospitalizations.