Turning to More Highly-Trained Specialists Will Meet the Evolving Needs of Residents
A recent Tallahassee Democrat guest column by the Florida Health Care Association Chief Executive Officer Emmett Reed highlights the data pointing to the significant changes in the physical and mental health of the nursing center population over the last two decades. Reed also points to the workforce shortages facing Florida’s nursing centers and with the significant number of Certified Nursing Assistant vacancies in long term care, staffing modernization legislation would allow care centers to turn to more highly-trained specialists to meet the evolving needs of residents.
Staffing Legislation Would Get Nursing Center Residents the Care They Need
Tallahassee Democrat | Column
By Emmett Reed
Two decades ago, many nursing centers were seen as places where people sent their aging relatives to live out their final years. The Florida Legislature set nursing center staffing requirements mostly reflecting that view, focusing on how much time nurses and nursing assistants spent with residents each day.
The idea of required hours of care was sound then, and it remains so today. However, the nature of nursing center residents has changed significantly since 2001 – and the standards have not kept pace. As a result, nursing centers are limited to the types of residents they can admit, given that the staff they employ must reflect a standardized model rather than one that takes into account the kinds of specialized care that would support each pe
SB 804/HB 1239 would change that, and that’s why the Florida Health Care Association is urging the Legislature to pass this important staffing modernization bill.
Critics have filled the air with misinformation about this legislation, inaccurately suggesting it would cut the total number of hours of care or would replace skilled staff with untrained workers. This is simply not true – in fact, the legislation will help make sure the care our residents receive is more tailored to their individual needs.
The legislation would incentivize nursing centers to hire more highly-trained specialists to be part of the interdisciplinary care team. This means that instead of only being served by broadly trained nurses or certified nursing assistants (CNAs), our residents will also be seen by, for example, respiratory, occupational, or speech therapists, or by mental health or social services professionals – whichever is appropriate to address the individual needs of particular residents.
Because of the changing nature of nursing center residents over the years – fueled in part by a shift away from institutionalization – these specialties are needed far more today than they were when the current staffing standards were put into law. This change can be seen by comparing some of the more challenging characteristics of the nursing center population at the end of 2012 versus the end of 2019:
- The portion of residents diagnosed with schizophrenia has more than doubled, from 4.2% to 8.7%.
- The percentage suffering from delusions has almost tripled, from 4.6% to 13.3% — nearly 1 out of every 7 residents.
- The percentage needing dialysis while in a nursing home, while relatively small, has increased by one-fourth, to 1 out of 40 residents.
- Residents with asthma or COPD have increased by 12.4%.
Anyone who thinks RNs and CNAs can handle these significant physical and mental health challenges, while also providing regular nursing care, clearly has not spent much time in a long-term care center.
Some critics suggest that the answer is simply to hire more CNAs. Our member nursing centers would love to do this – if only more CNAs were available in the workforce. Unfortunately, fewer and fewer individuals are getting licensed as CNAs.
In 2012, a total of 5,090 Floridians passed the test to be certified. In 2020, that number had fallen by more than one-third. Add the fact that over 95% of Florida’s nursing centers are experiencing CNA vacancies, and you’ve got a workforce problem with lingering effects.
The workforce shortage facing Florida’s nursing centers is real, and it will not be resolved anytime soon. Instead of asking our limited pool of nurses and CNAs to extend far beyond their training, we should turn more to highly trained specialists to meet the evolving needs of nursing center residents.
The legislation before the Legislature would allow that to happen. It’s what is needed, for Florida’s nursing centers and for those vulnerable residents entrusted to their care.
Emmett Reed is the Chief Executive Officer for Florida Health Care Association. He can be reached at [email protected].
ABOUT THE FLORIDA HEALTH CARE ASSOCIATION
The Florida Health Care Association (FHCA) is a federation that serves nearly 1,000 members and represents more than 500 long-term care facilities that provide skilled nursing, post-acute and subacute care, short-term rehab, assisted living, and other services to the elderly and individuals with disabilities in Florida. The mission of FHCA is to advance the quality of services, image, professional development, and financial stability of its members. As Florida’s first and largest advocacy organization for long-term care providers and the elderly they serve, the Association has worked diligently since 1954 to assist its members with continuously improving quality of care and quality of life for the state’s growing elder care population. For more information about the Florida Health Care Association, visit http://www.fhca.org.