Nursing Home Reform (CS/CS/SB 1202; CS/HB 1879)

                                                                                             April 25, 2001

The Honorable John M. McKay          The Honorable Tom Feeney
President, Florida Senate                     Speaker, Florida House of Representatives
320 Senate Office Building                   420 The Capitol
Tallahassee, FL 32399                         Tallahassee, FL 32399-1300

RE: Nursing Home Reform (CS/CS/SB 1202; CS/HB 1879)

Dear President McKay:                         Dear Speaker Feeney:

   We are mindful and appreciative of the huge expenditure of time and effort by you and your staff to find a fair solution to Florida’s long-term care crisis.

   There are in Florida thirty-eight specialized residence facilities operating under the auspices of the Catholic Church. Ten of these homes are nursing facilities with 1,800 beds serving Catholics and others throughout our state.  These homes are accredited by JCAHO and several have been rated as superior by the state.  Formal risk management programs are in place to monitor key clinical indicators of resident care.  There are two rehabilitation hospitals and one rehabilitation center with more than 180 beds.  There are more than thirty homes for the elderly offering assistance to more than 7,500.  Catholic facilities in Florida employ approximately 2,300 people and on a daily basis care for approximately 7,000 residents.

   Staffing ratios in our facilities exceed state minimums and our facilities have in excess of 1,000 volunteers who help to enhance the quality of life for residents by assisting with social, recreational and pastoral care services.  Last year in the Archdiocese of Miami alone, facilities subsidized over $2 million in care to residents whose payment programs did not meet the full cost of services.

   These facilities have a history of quality care in the faith-based community. Recently, St. John’s Nursing Home in Broward was awarded the best nursing home in South Florida.  The mission of our facilities is to provide health care and services to those in need, to assist people to wholeness, and to nurture an awareness of their relationship with God.  These facilities are not immune to the increased costs resulting from lawsuits against Florida’s nursing homes and assisted living facilities.  In order to continue the quality of care, and in some cases even remain open, they are dependent on certain of the reforms contemplated in proposed legislation.  We are supporting quality care enhancements, regulation to rid the system of bad providers and increased Medicaid reimbursement to pay better wages and benefits for staff.

Litigation Reform

   We are in support of litigation reform that adopts a negligence standard for defense against unfair lawsuits.  This reform should also include caps on attorneys’ fees and limits on punitive damages.  We are in support of the language in both CS/CS/SB 1202 and CS/HB 1879 related to litigation relief, especially the negligence standard, the elimination of add-on attorneys’ fees, and the caps on add-on attorneys’ fees for injunctive or administrative relief in cases that do not involve damages.

Electronic Monitoring Devices

   We have particular concerns with proposals to allow for electronic monitoring devices.  We do not object to their use for monitoring or improving care, but we are concerned about use primarily for lawsuits.  Our fundamental concern is for the privacy and dignity of residents where these devices may be used.

Contemporaneous Charting

    We have reservations about proposals to require contemporaneous charting by CNA’s.  Our homes are already known for the high quality of care they provide; existing care plans include provisions for charting.  CNA’s are the primary providers of direct care in a nursing home and such a requirement runs the risk of taking these workers from their main responsibility, unnecessarily minimizing care, without guarantee for improved service.

Medicaid Reimbursement

   We are supporting the recommendations of the legislatively created Medicaid Reimbursement Panel which allow higher payment rates in the critical patient cart area.  An increase is critical in order to allow for the hands on care that nursing home residents require.  Staffing is the most important component in providing high quality care in the long-term care industry.  Unless adequate funding is realized for existing requirements, especially in the patient care and liability insurance areas, and for the additional specifications now being considered, some of our homes are in jeopardy. Present reimbursement rates do not cover the costs of doing business in Florida.  Please take the necessary steps to allow Catholic and other nursing homes to have the funds necessary to compete for high quality nurses and CNA’s.

   Thank you for your consideration of these concerns.

                                                                                             Respectfully yours,



                                                                                             D. Michael McCarron
                                                                                             Executive Director

cc:  All Members of the Florida Senate and House of Representatives
       Florida Association of Homes for the Aging
       Florida Health Care Association