Improving nursing-home care
© St. Petersburg Times, published March 14, 2001
Just as there is no single cause of Florida's nursing home woes, there is no single solution. State senators have picked a good place to start addressing the problem. A Senate health-care panel is expected today to approve a bill that would raise the minimum staffing at all facilities and force improvement at homes that have, through neglect or design, allowed the number of nurses and nurse's aides to fall to unacceptable levels. The vote -- the first major committee test for nursing-home legislation this year -- could prove a constructive, albeit only partial, response to what all parties agree is Florida's looming crisis in long-term care.
The bill, sponsored by Sen. Ginny Brown-Waite, R-Brooksville, builds on the simple reality -- one supported by research and common sense -- that staffing levels make a big difference in quality of care. Unfortunately, over the past decade, those levels haven't kept pace with the explosion in nursing-home beds, or with the health problems of the residents who fill them. According to the nursing-home task force created last year, inadequate staffing remains one of Florida's major problems and is the No. 1 complaint logged by the ombudsmen who monitor nursing-home care.
The amended bill, expected to be stripped of all but its quality-of-care provisions, would increase the daily time a nurse's aide must spend with every resident from 1.7 to 2.9 hours (and one hour for nurses) and give homes five years to adjust. The need for those increases is well documented, and the allotted transition time is generous, perhaps unduly so. Lawmakers should set the new standards in motion as quickly as possible.
No doubt many, if not most, homes will want help in paying for the improvements. While Florida's Medicaid reimbursement rate has not caused the crisis, it is widely regarded as low and in need of adjustment. Yet, in the last two years alone, the state has increased payments to nursing homes by a total of $90-million, with little apparent benefit. Instead of raising rates across-the-board, lawmakers should ensure that homes that seek more public money document the need and account for how they spend it.
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