With the anniversary of Hurricane Irma upon us, FHCA Executive Director Emmett Reed has released the following statement regarding residents’ safety, member center compliance, and continued preparations in the wake of Irma’s destruction. [Read more…] about FHCA’s Emmet Reed on Irma Anniversary
Statement from Emmett Reed, FHCA Executive Director, on CRC Proposal 88 hearing
“In today’s hearing, a committee of the Constitution Revision Commission approved the misguided Proposal 88. The proposal claims to strengthen the rights of long term care residents throughout Florida, but in reality it is nothing more than an avaricious ploy by trial lawyers to profit from increased lawsuits against nursing centers.
“Ultimately, Proposal 88 fails to focus on what is important for Florida’s nursing center residents and caregivers. Its provisions undermine the hard work of thousands of health care professionals who provide outstanding care for some of Florida’s most vulnerable citizens. Existing state and federal laws guarantee the rights of nursing center residents and these laws have been working well to support the advances in quality that are being made in Florida nursing centers today. We are always working with state leaders to improve the quality of care for our residents and understand what resources are needed for our caregivers to truly make a difference. Our members strive every day to provide those resources to improve the lives of those under our care.
“In approving this ill-advised proposal, committee members ignored a significant amount of data presented today about the quality of Florida care centers – including the fact that Florida is among the best in the nation in nursing and Certified Nursing Assistants staffing ratios; that reforms in 2001 led to more systemic approaches to delivering care, including risk management and quality assurance programs, grievance policies and procedures, and resident-centered care; and that new federal rules announced in November make major updates in residents’ rights, care planning, quality assurance, and assessments. I am tremendously disappointed to see Proposal 88 advance. Still, I hope the full Constitution Revision Commission will see that these unreasonable provisions do not belong in the Florida Constitution. In the long run, this will do more harm than good for the caregivers and residents in Florida’s nursing centers.”
“A committee of the Constitution Revision Commission will meet today to discuss a truly bad proposal, one that is bad on its face and most certainly does not belong in the Florida Constitution. I hope the information members receive during this discussion makes it clear just how much Proposal 88 deserves to be rejected.
The measure claims to help enhance protections for nursing home residents, but it is really little more than a money grab by trial lawyers who are hoping to increase the number of lawsuits against nursing homes. Thousands of dedicated, hardworking professional caregivers are making a difference in the lives of nursing home residents, improving their health outcomes and providing resident-focused care in a way that promotes their dignity. Existing state and federal laws guarantee the rights of nursing home residents, and the Florida Health Care Association is committed to working with state leaders to implement any reasonable strategies that enhance their care and well-being.
This proposal is wrong for the Florida Constitution, and it is wrong for the people of Florida. Increasing lawsuits against nursing homes does nothing to improve quality, having the resources to invest in caregivers is what makes the difference. Commissioners should see it for what it is and reject it.”
Members of the Florida Health Care Association (FHCA) today provided members of the Constitution Revision Commission (CRC) with invaluable information and insights to help preserve a crucial policy affecting the care of Florida’s most frail residents. In presentations to a CRC panel, FHCA speakers detailed why nursing centers should be removed from any repeal of the Certificate of Need process.
FHCA, Florida’s largest advocacy organization representing 82% of Florida nursing centers and the elderly they serve, told the CRC General Provisions Committee that both the quality of care for the state’s seniors and the health of the nursing centers that care for them could be significantly impacted by a proposal under consideration. The association is advocating for an exemption for nursing homes from a proposed Constitutional Amendment (Proposal 54) that would eliminate the Certificate of Need (CON) process for all health care facilities.
“Repealing nursing home Certificate of Need will most certainly result in unmanaged growth, low occupancy rates, inefficiencies in how buildings operate, and a reduction in the value of our state’s nursing centers. All of this will greatly impact how quality care is provided to our state’s seniors,” Brian Perry of HCR ManorCare, which operates 29 nursing centers in Florida, told members of the committee.
“CON repeal has affected elder care in other states,” Perry noted. “For example, Texas operates twice as many nursing centers as Florida but is plagued by facilities that have beds that remain empty and deliver a poor quality of care. Indiana was forced to impose a moratorium on building nursing centers due to unmanaged growth 16 years after it repealed its CON process.”
Jeff Marshall of Omega Healthcare Investors, a real estate investment trust with the nation’s largest portfolio of nursing home investments, told committee members that limiting the supply of nursing home beds to meet demand through the CON process represents a very important element of stabilizing nursing home value, encouraging both initial investment and subsequent reinvestment to enhance quality of care and environment for residents.
“Elimination of the nursing home CON process would ultimately lead to the unintended consequence of reduced access to nursing home care for Floridians covered by Medicaid,” said Marshall. “As newly built nursing homes focus on admitting profitable Medicare, insurance, and private-pay patients to cover construction costs, Medicaid residents will increasingly be restricted to older nursing homes. Those facilities that serve the highest percentage of Medicaid residents will suffer the most upon elimination of the CON process – not a desirable outcome.”
FHCA speakers also noted that by promoting an environment in which new nursing centers would have to lure elders to fill costly beds, repeal of CON for nursing centers would run contrary to Florida’s long-standing commitment to enabling elders to remain in their homes or in community-based care for as long as possible.
“Florida has attained a system that strikes the right balance. Those who can be cared for in a home and community-based setting are receiving it there – and those who come to my nursing center and others around the state do so because that is the only place they can safely receive the more specialized care they need,” said Joe Mitchell, CEO of mid-size nursing center operator Summit Care.
More information on how the Certificate of Need issue may affect the care of Floridians in skilled nursing centers can be found at cqrcengage.com/ahcafl/CONProcess.
In testimony to the House Select Committee on Hurricane Preparedness, Florida Health Care Association (FHCA) chief lobbyist Bob Asztalos urged lawmakers to look beyond issues related to emergency generators as they consider legislation dealing with nursing home procedures in disasters.
Asztalos told legislators FHCA is committed to implementing the governor’s mandate that nursing homes and assisted living facilities have generator capacity to keep their residents cool and safe during a disaster. He offered a set of recommendations that would strengthen the emergency procedures in nursing centers and ALFs and help them meet the Governor’s goal in a careful, timely manner that ensures the work is done correctly and safely.
In his remarks to the committee, Asztalos vowed, “We stand ready to work together with the Legislature, agencies and the Governor’s office to get this right.” His other comments included:
“The debate must extend beyond generators and fuel. Nursing homes care for residents whose medical needs are extremely complex – many depend on ventilators, oxygen, dialysis and other life sustaining mechanical support. … We don’t understand how power restoration is prioritized in the state. I ask that the Legislature formalize the system for determining power restoration, and that priority restoration be given to our centers. “
“We found a disconnect between the local emergency management personnel and the long term care providers. Nursing homes seek to harden in place, and evacuation is a very last resort. The local emergency managers want to evacuate people quickly because they have a much bigger scope than just our facilities. I believe we need to foster open dialogue between the two groups to better coordinate when nursing homes should be evacuated.”
Special Needs Shelters
“Nursing home residents cannot just be loaded on a bus and dropped off at a shelter. They are too frail, many are in wheelchairs and they must travel with their medications, records, staff, and other life-sustaining equipment. If a bus pulls up to a shelter and the seniors on it walk off, they are not from a nursing home. The reality is that, during storms, nursing homes are called upon to take occupants from special need shelters when they are full or when the county is trying to close them after the storm. I believe this process can be better formalized.”
“FHCA is extremely disappointed with the Agency for Health Care Administration (AHCA), which today chose to use the media as a vehicle to release unfavorable information about nursing homes that are in fact working to comply with the Governor’s Emergency Power Plan Rule. Several facilities on the list not only submitted their documentation, but those variance requests have also been published on the AHCA website since October 16. The agency appears to have made no attempt to contact facilities in advance to verify the accuracy of this ill-conceived list before releasing it to the public.
FHCA has consistently stated its willingness to work with the agency to strengthen the emergency procedures in nursing centers and assisted living facilities in order to ensure that residents are safe during disasters. It appears AHCA is more interested in generating news stories than in gathering facts and arriving at a place of consensus to will ensure that nursing homes meet the Governor’s mandate, despite its unrealistic timeline. Despite this disappointment, we remain committed to working with the Governor and his administration to adopt workable procedures to protect the well-being of those entrusted to our care.”
Florida Health Care Association Executive Director Emmett Reed issued the following statement after Constitution Revision Commission member Brecht Heuchan filed a proposal (0088) that would weaken protections for nursing home residents:
“Some things simply do not belong in the Florida Constitution, which is the core document that sets out the basic structure of our government. With a glaringly bad proposal, one Constitution Revision Commission member would wipe out more than 30 years of meaningful and thoughtful progress designed to ensure that nursing home residents have the right to quality care and the services they need. Unfortunately, this member appears to have lost sight of the fact that the select members of this august body have a profound duty not just to those in their workday lives, but indeed to all Floridians.
With this proposal, a professional lobbyist representing trial attorneys has ignored his broader obligations in order to serve the narrow interest of his clients. The proposed constitutional amendment is an egregious governmental overstep, one that overreaches to a monumental extent. Since the 1987 Nursing Home Reform Act, nursing home residents in Florida have had important rights and protections under both state and federal law. This amendment seems to contain every bad proposal rejected by the Legislature over the last several years. It would add nothing to the quality of life for our state’s frailest elders, nor would it solve the real issues of keeping nursing home residents safe during disasters. It would only serve the interests of greedy trial attorneys who continually attempt to cash in by suing nursing homes.
Quality care and quality of life are a top priority for the Florida Health Care Association and the more than 550 nursing home members we represent. By undermining the effective reforms enacted in recent years, this awful proposal would do nothing but create an open door for trial attorneys to file meritless lawsuits. It has no place in our laws, and it certainly has no place in our state’s constitution.”
Florida Health Care Association (FHCA) today affirmed their commitment to working with Governor Scott and the Legislature to take appropriate steps to protect frail residents of skilled nursing centers from the impacts of natural disasters.
In a statement FHCA Executive Director Emmett Reed said, “Governor Scott has taken the right course by asking state agencies to begin a rulemaking process so each skilled nursing center and assisted living facility has the means to maintain essential power in the aftermath of a disaster. FHCA, its members, and its partners look forward to providing meaningful input in this process as we work to ensure that our residents can be kept cool and safe in a disaster.”
In separate legislative testimony today, FHCA leaders detailed the challenges faced by long term care providers in the aftermath of Hurricane Irma and the solutions FHCA is proposing going forward.
Bob Asztalos, FHCA’s lead lobbyist, told the Senate Appropriations Subcommittee on Health and Human Services that the association fully supports the goal behind Governor Rick Scott’s call for emergency generators at all long-term care and assisted living facilities. However, he said, implementation must allow for achievable timelines that give centers sufficient opportunity to acquire and properly install the backup generators. “Experts have made it clear that the timeline that’s been put forth is simply not achievable. We have drafted changes to the rule and other recommendations that would give nursing homes and ALFs time and flexibility to meet the objective of keeping residents in a cool and safe environment during a disaster,” Asztalos said. “We share the same goal as the Governor and the Legislature – to ensure that our centers are as safe as possible, as soon as possible – so let’s work together to get this right.”
In remarks to the House Energy & Utilities Subcommittee, Reed noted that long-term care facilities face greater challenges than they did a decade ago because skilled nursing centers care for residents who until recently would have been in hospitals with powerful emergency backup generators – individuals who depend on ventilators, oxygen, dialysis, and other life-sustaining mechanical support. “We saw over 400 nursing centers across Florida lose power during Hurricane Irma,” Reed testified. Prioritizing nursing centers as critical facilities – similar to how hospitals are prioritized – will ensure that our residents receive assistance in a manner that is consistent with their medical needs.”
Statement from Emmett Reed, Executive Director of the Florida Health Care Association, following passage of Senator Kelli Stargel’s SB 682 by the Senate Appropriations Subcommittee on Health and Human Services:
“We want to thank Senator Flores and members of the committee for this important vote to remove long-stay nursing center residents from Florida’s managed care program. Our current system of managed care doesn’t work effectively for those residents who cannot take care of themselves or be safely cared for in the community because their medical needs are simply too complex. By making this common-sense change, Florida stands to save $68.2 million in fees the state is charged each year for unnecessary management services. Senator Stargel’s work on this important issue will also ensure nursing centers have access to managed care networks without fear of cancellation, so that residents and their families won’t have to make the difficult choice between their home and a benefits package that fits their needs.”
Emmett Reed, executive director of the Florida Health Care Association, issued the following statement after the Senate Appropriations Committee approved a plan to establish a prospective payment system (PPS) for nursing center reimbursement:
“The Florida Health Care Association strongly supports the Senate’s plan, which puts a top priority on providing high-quality care for the residents under our care. The Senate plan recognizes the value of establishing a funding mechanism the creates incentives for quality, and we applaud senators’ commitment to addressing reimbursement in a way that benefits our state’s most fragile citizens. We look forward to continuing to work with the Legislature to bring about positive change to health care through implementation of this PPS plan.”