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Florida’s Dangerous Deregulation on Nursing Home Staff Requirements Puts Residents at Risk


— April 15, 2021

Bringing in previously unemployed non-health care professionals, with less than one day’s training, is a formula for carnage in our long term care facilities.


Florida’s Agency for Health Care Administration, the agency tasked with overseeing Florida’s skilled nursing facilities, may permit nursing homes to use ‘personal care attendants’ to staff facilities, permanently. 

These PCA’s are not nurses. They are not even Certified Nursing Assistants. Instead, PCA’s are caretakers that completed an eight (8) hour training requirement before caring for Florida’s most vulnerable patient population. That is not a typo. Eight hours of training.

Florida’s Use of Personal Care Assistants in Nursing Homes was Initially Due to COVID

Originally, AHCA intended on permitting PCA staffing only temporarily during the COVID crisis. However, now lawmakers are contemplating a bill that would allow PCA’s to replace traditional staff on a permanent basis. Senate Bill 1132 and House Bill 485 would allow non-certified attendants to begin working in long-term care settings after just eight hours of training. The bills were introduced by Sen. Aaron Bean, a Republican from Fernandina Beach, and Rep. Sam Garrison, a Republican from Fleming Island.

Mixed Reactions from the Nursing Home Industry, Citing the Obvious Danger to Residents

The bills would allow nursing homes to further reduce their already low staffing expenses, by replacing CNA’s with lesser paid PCA’s.

Most owners in the industry are applauding the proposed lowering of staff requirements, as it would allow the for-profit corporations that control Florida’s long term care industry to slash overhead and increase profits. But remember, these companies are owned by investment bankers, not doctors. The primary focus is on the bottom line, not resident wellbeing.

The impact on resident care is frightening. The change would allow nursing home corporations to hire laypeople, with less than a day’s training, and bring them into a facility to care for residents with advanced dementia, Alzheimer’s, oxygen tanks, feeding tubes, wheelchairs, that take a litany of prescription medication. Disaster is not just foreseeable; it is imminent.

Rear view of woman in wheelchair looking at blue sky with clouds; image by James Williams, via Unsplash.com.
Rear view of woman in wheelchair looking at blue sky with clouds; image by James Williams, via Unsplash.com.

Some facilities have voiced opposition to the law and the use of PCA’s, recognizing that a lack of training would lead to nursing home injuries and mistakes. Management at the Five-Star chain of long term care facilities has already voiced opposition to using PCA’s, stating:

“In our facility, we took the stance that we’d rather have someone with more advanced training who has finished their (certified nursing assistant) class . . . We just feel it’s a safer environment for our patients with the most highly qualified people we can provide.” — Louise Merrick, administrator of Five-Star rated Gulf Shore Care Center in Pinellas Park

The Take Home Message: This Law Will Kill Florida Seniors

Unfortunately, not all companies will take the high road on this. The opportunity to replace seasoned, experienced, and expensive staff members with cheap Personal Care Attendants will be too alluring for the profit-driven nursing home chains to pass up. Most will seize the opportunity to maximize profits.

The result will be felt, not only on the company’s budget sheet, but in Florida’s hospitals and morgues. This patient population is the most sick, the most frail, and the most in need. They deserve proper care. Bringing in previously unemployed non-health care professionals, with less than one day’s training, is a formula for carnage in our long term care facilities.

Florida’s seniors deserve better.

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