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Federal Staffing Home Mandate Will Impede Florida’s High-Quality Care Progress, Undermine Existing Staffing Standards

Tallahassee, Fla. – The Florida Health Care Association strongly opposes the final nursing home staffing mandate announced by the Biden Administration today, stating that the rule will undermine Florida's existing staffing standards and the progress being made to enhance access to high-quality care for the state's growing aging population.

“Florida is a proud leader when it comes to high-quality long-term care. We recognize the importance of minimum staffing requirements, which is why Florida nursing centers already abide by a stringent set of standards to ensure residents receive the highest quality of care,” said Emmett Reed, CEO of the Florida Health Care Association (FHCA). “At a time when Florida’s long-term care profession is working tirelessly to overcome the labor challenges, this impossible and unfunded mandate will make it harder to recruit long-term care workers and ensure Florida seniors have access to the specialized and person-centered services they need.”

Florida’s staffing standards recognize the different needs of each resident and provide flexibility for centers to staff according to those unique needs. Along with required nursing hours, Florida’s standards also recognize the important role of social workers, activity staff, and therapists in delivering quality care. The CMS final rule would require 2.45 nurse aide hours per resident per day (HPRD), 0.55 registered nurse (RN) HPRD and 3.48 total nurse hours per day compared to Florida’s current requirement of 2.0 certified nursing assistant (CNA) hours, an additional .6 hour of direct care provided by specialty staff (may include a CNA) and 1 hour of licensed nursing services that are provided by a combined use of RNs and Licensed Practical Nurses (LPN). Under the CMS proposal, Florida centers would need to hire an additional 3,487 full time employees to meet the mandate.

An October 2023 analysis by professional services firm CLA (CliftonLarsenAllen, LLP) noted that the federal Centers for Medicare and Medicaid Services (CMS) proposed staffing mandate will cost Florida nursing centers an additional $188 million, despite Florida already having comprehensive staffing standards. In many categories, Florida standards already exceed what is required by the federal mandate.

 “More of our nursing center residents are living with complex chronic conditions and need skilled nursing care beyond what is called for in this one-size-fits-all staffing mandate. We urge Members of Congress to step up and support the bipartisan Protecting America’s Seniors’ Access to Care Act, which will prevent CMS from enforcing this unfunded and flawed mandate. We will continue to fight for more common-sense solutions and do everything we can to preserve access to care for Florida seniors.” 

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April 22, 2024

Kristen Knapp, APR
850-510-4389 or