En español | Two decisions by the Florida legislature to slash nearly $188 million from Medicaid nursing home funding and to reduce minimum staffing standards for direct care mean tens of thousands of vulnerable nursing home residents will receive less assistance.
See also: Will Medicaid pay nursing home costs?
The staffing changes surfaced on a take-it-or-leave-it basis the night before the legislative session ended earlier this year.
The cut in nursing home funding reduced anticipated spending by 6.5 percent for the year that began July 1 — a level less than was spent the previous year. Legislation also reduced the minimum amount of time a nursing home resident must receive one-on-one care. The change shaves 18 minutes off the required direct daily skilled nursing care, cutting the minimum to 3 hours 36 minutes.
The legislature also voted to force almost all Medicaid beneficiaries in Florida to be covered by managed care plans.
In another blow, the Joint Legislative Budget Commission rejected a $35.7 million, five-year federal grant designed to help move Medicaid-eligible nursing home residents to assisted living or home care facilities, which cost less than half as much, because the money was part of the federal Affordable Care Act.
The combined impact is that nursing home facilities are likely to reduce staffing levels as a result of the cuts, which means the quality of care received by both Medicaid and private-pay residents could diminish, said Jack McRay, AARP Florida advocacy manager.
"They're going to reduce their staffing, and they're going to continue to charge the private-pay patients the same amount of money," McRay predicted.
"Florida and the nursing-home industry must keep the 'nursing' in nursing homes," he said. "By relaxing state standards for nursing care, the state of Florida has opened a door that could put tens of thousands of very frail, vulnerable Floridians at risk."
Medicaid covers about 41,000 of the 72,000 nursing home residents in Florida.
Emmett Reed, executive director of the Florida Health Care Association, which represents long-term care facilities, said, "Nobody is happy with the budget cuts made by the legislature to nursing home care. We would have preferred legislators maintain the funding and mandated staffing requirements, and, in fact, nursing home employees from across the state were very vocal … advocating for adequate Medicaid funding.