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Nursing home bill raises staffing, limits lawsuits


© St. Petersburg Times, published May 5, 2001

TALLAHASSEE -- After three years of trying, state lawmakers passed a nursing home bill late Friday night designed to limit lawsuit awards against homes and improve the quality of care.

The bill, now headed to Gov. Jeb Bush, includes a $4-million cap on punitive damages in most cases and a dramatic increase in staffing requirements.

"It is a good compromise," said the bill's sponsor, Rep. Carole Green, R-Fort Myers. She urged her fellow representatives to accept the changes made by the Senate earlier in the day, the last day of the legislative session.

"If you do not accept this now and we start bouncing back and forth, we have nothing," Greene said.

The bill approved by both chambers requires a modest increase in staffing by 2002. But by 2003 nursing homes must provide 2.6 hours of nursing assistant care per resident per day, which translates into about eight residents per nursing assistant. By 2004 homes must provide 2.9 hours of that care, or about five or six residents per assistant.

The current state staffing requirement is 1.7 hours of nursing assistant care per resident per day.

But some House members argued that the bill would do little to help residents in the first year.

Democratic Leader Lois Frankel said the changes made by the Senate earlier in the day, notably pushing back the first deadline for increased staffing, turned the measure into "a shell of a bill." She also opposed the caps on punitive damages.

"We are giving up the opportunity to hold these nursing homes accountable," Frankel said.

But other members defended the bill, saying it was the best the Legislature could hope to pass this year.

"This is not a pretty baby, but it's the prettiest baby we're going to bring home this season," said Rep. John Seiler, D-Fort Lauderdale.

Much of the more than $70-million lawmakers put in next year's budget to fund the bill will help pay for the staffing increases, said Sen. Ginny Brown-Waite, R-Brooksville, the measure's Senate sponsor. That funding is a boost from the $60-million originally proposed for the bill, Brown-Waite said.

A proposed state insurance pool to cover some nursing homes that could not find coverage elsewhere was removed from the bill. But Brown-Waite said she thinks the bill does enough to lure insurers back to the state and read her colleagues a letter from a company saying it may apply to enter the state market within days.

"They are going to come back," Brown-Waite said. Insurers have raised premiums for nursing homes, and many have left the state. Both chambers agreed to give homes until next year to meet the insurance requirements of the bill.

No additional changes were made to the litigation portion of the bill. Punitive damages are capped at between $1-million and $4-million in most cases. The plaintiff must prove that the nursing home was "primarily" motivated by unreasonable financial gain to qualify for the upper level. There's no cap on punitive damages in cases where the nursing home is found to have "intended" to harm the resident. The bill also requires nursing homes to set up a risk management program to reduce the likelihood of injuries to residents. They must report accidents to the state, although those records are not public.

The bill was hailed by elder care advocate Karen Torgesen, head of the Florida Association of Homes for the Aging.

"This is the most aggressive and most comprehensive elder care legislation ever passed in Florida."

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