Become an Advocate for Long Term Care

Sign Up for FHCA's Lobby Wednesdays 2013

Legislators are in Tallahassee this week for their first round of committee meetings in anticipation of the 2013 legislative session, which begins March 5, 2013. Once again, FHCA is looking for long term care advocates to help bring our messages to the Capitol about the importance of preserving Medicaid funding to ensure continued delivery of high-quality care for Florida's most frail elders. FHCA members can do their part by signing up to participate in the Association's Lobby Wednesdays. This important grassroots initiative is your opportunity to connect with lawmakers in the State Capitol during session and stand up for your profession, your staff and your residents.

A limited number of dates are available for Lobby Wednesdays 2013, which begin March 7 (Thursday) and will run through April 17. Consider signing up yourself, your company or your FHCA district; bring your front line caregivers, family members and residents; and help us exceed last year's Lobby Wednesday participation of more than 500 long term care advocates. FHCA has once again selected the Aloft Hotel in downtown Tallahassee for convenient access to the Association headquarters and the Capitol, and as a member benefit, the Association will reimburse members' room night for the prior evening. Whether you're a seasoned professional or new to the Lobby Wednesday experience, please take time to watch our video and learn more about how you can get involved today.



For more information, including dates and online registration, click here.

New National Poll Finds Americans Don’t Want a Fiscal Cliff Deal that Cuts Nursing Homes

84% believe skilled nursing faces a ‘crisis’ due to cuts
87% believe sequester should not move forward  

A new survey released today by the American Health Care Association (AHCA) found that Americans overwhelmingly oppose budget cuts such as sequestration to fund any fiscal cliff grand bargain. Further, a plurality of registered voters surveyed (46 percent) said not only should the government not impose further cuts, but that lawmakers should provide additional funds to care for the aging baby boomer generation.

“When it comes to skilled nursing centers and the care millions of Americans receive every year, the people have spoken - fiscal cliff negotiations should not include further cuts to seniors," said Governor Mark Parkinson, President and CEO of AHCA. “We hope lawmakers heed these views that are important to their constituents. In fact, more, not less, funding should be the goal of policymakers as boomers continue to age. "

Conducted by New York-based polling house Opinion Access, the national survey of 806 registered voters (+/-3.4%) was fielded November 16-19. When given options on the least acceptable ways to cut the national deficit, a plurality of respondents (37 percent) said “cutting Medicare payments to nursing homes.”

When respondents were asked if a statement indicating inadequate funding to skilled nursing could increase financial hardships to the point where some facilities could close, 61 percent said they would be more likely to support increased funding for care.

View the summary and full poll on the AHCA website.

Flag Dedication Ceremony Honors Veterans Who Live and Work in Florida's Nursing Homes and ALFs

On November 12, Florida Health Care Association honored long term care professionals and residents who served in the United States Armed Forces during a Flag Dedication Ceremony at the Association’s headquarters in downtown Tallahassee. The event featured Lt. General Lawrence Snowden, retired Marine Corp veteran with more than 37 years of service, including combat as a Company Commander with the 23d Marines in the assault on Iwo Jima; Steve Murray, Lieutenant Colonel, United States Air Force (retired), representing the Florida Department of Veterans’ Affairs; the Lincoln High School NJROTC Color Guard and area skilled nursing facility (aka nursing homes) and assisted living facility caregivers and residents, several of who are veterans.



“Florida’s skilled nursing facilities represent more than 280,000 employees and care for over 71,000 residents statewide, and many of the men and women working and residing in those facilities served our great country,” said Emmett Reed, FHCA Executive Director. “We erected this flagpole and are proud to dedicate the flag this morning to honor these brave veterans for their service and the sacrifices they made for our freedom.”

The American flag dedicated as part of the ceremony was flown by American troops in Iraq, and embedded into the flagpole base is a remnant from Saddam Hussein’s palace. The flag and remnant were brought back from Iraq by FHCA Chief Lobbyist Bob Asztalos, a U.S. Navy reservist who was stationed there in 2005, serving as a senior chief hospital corpsman with the U.S. Marine Corps. “The flag is more than the fabric that it is made from. It has meaning for which people shed their lives,” said Asztalos.

Caregivers Gather to Celebrate Quality, Promote the Positive Images of Long Term Care

Over 100 caregivers from skilled nursing facilities (aka nursing homes) around the Broward and Palm Beach County areas were recently honored by former Sen. Ellyn Bogdanoff (R-Ft. Lauderdale) for their dedication and commitment to delivering high-quality, long term care to seniors. The Quality Care Celebration Event took place at Stratford Court of Boca Raton and featured seven local facilities which earned the American Health Care Association’s (AHCA) 2012 National Quality Award. Debra Howe, President/CEO of Airamid Health Services, also accepted an award on behalf of the organization having 100 percent facility enrollment in the Advancing Excellence in America’s Nursing Homes Campaign.



“Skilled nursing facilities employ over 280,000 people in Florida who deliver high-quality care to more than 70,000 residents and patients each and every day," said Emmett Reed, executive Director of the Florida Health Care Association, the state's first and largest advocate for Florida's skilled nursing/long term care providers and the residents under their care. "These caregivers matter, and today’s event is a celebration of the passion and commitment they bring to their residents and patients every day."

Thirty-eight Florida facilities received the 2012 AHCA National Quality Award. During the event, Sen. Bogdanoff recognized these local facilities: Boynton Health Care Center in Boynton Beach, which earned the Silver Quality Award; Bronze Quality Awards recipients Stratford Court Boca Raton; Whitehall Boca, Boca Raton; Wilton Manors Health and Rehabilitation Center, Ft. Lauderdale; Jupiter Medical Center Pavilion, Jupiter; Lakeside Health Center, West Palm Beach; and Rehabilitation Center of The Palm Beaches, West Palm Beach. The AHCA National Quality Award Program is centered on the core values and criteria of the Baldrige Performance Excellence Program and consists of an entry level Bronze Award, a more rigorous Silver Award and a final Gold Award.

The Quality Care Celebration Event also promoted the positive images of long term care in Florida. FHCA President Scott Allen debuted videos as part of a web-based public relations campaign which featured first-hand testimonials from family members and conversations with caregivers showcasing the quality care in Florida’s skilled nursing facilities. “Today we are sending a message to everyone across the state of Florida that quality in Florida’s skilled nursing and long term care facilities is good,” said Scott Allen.

“This event is an important opportunity to show our community that we are more than just a noble profession. We are delivering compassionate, quality health care to those who need it most," said Debra Howe, President/CEO of Airamid Health Services, a West Palm Beach-based organization which manages 44 skilled nursing facilities and five assisted living facilities across the state of Florida.

FHCA members showcase quality care through more than 100 facility tours statewide

Florida Health Care Association members continue to do an excellent job with educating legislators and political candidates about the important work they do. For the past several months, FHCA members have hosted over 100 facility tours, connecting legislators and candidates with residents and staff so they can see, first hand,  the high-quality care being delivered and how dynamic facilities have become in serving the needs of both short and long term care patients.

Last Friday, John Couriel, Republican candidate for Senate District 35, visited Berkshire Manor in North Miami, giving administrator JeNell Shephard and the staff an excellent opportunity to showcase the award-worthy quality care the facility is delivering.

Florida Presbyterian Homes in Lakeland, which is preparing to open a new assisted living facility, hosted Representatives Kelli Stargel and Seth McKeel, as well as representatives from the Pioneer Network and other long term care stakeholder groups. Administrator Maria Rivera, Executive Director John Hehn, together with FPH Chair Harry Pettit and other staff, joined these special visitors for a discussion of senior care issues. They also enjoyed lunch in one of the new family-style kitchen and dining areas in the new building.

Nursing homes offer compassionate, high-quality care for children in need

By J. Emmett Reed

Recent media coverage and opinion pieces on the Department of Justice's report related to children being cared for in nursing homes is another unfortunate attempt to demonize these facilities in the press. There are only six out of 685 nursing homes in Florida which specialize in serving children and young adults. The unfortunate reality is that these pediatric facilities are the safety net for children who cannot be cared for at home because either their medical needs are too complex or they have no family to rely on. “Fragile” does not begin to describe their care needs – they require ventilators, feeding tubes; they have traumatic brain injuries or may even be comatose. The staff dedicated to providing their 24-hour care is specifically trained in pediatrics. They include registered nurses, physicians, respiratory therapists, speech therapists, dieticians and social workers, to name a few. The reality is that good care costs money, as do the support services to ensure these children are given a nurturing and home-like environment. Medicaid doesn’t come close to covering the costs for what these children need, like 24-hour pulse and oxygen monitoring, specialized wheelchairs, off-campus outings with all the necessary staff so they can experience what it’s like to be a kid. Yet, despite a chronic funding shortfall, nursing homes continue to do all that it takes to deliver high-quality, compassionate care to those who need it most.

Pediatric nursing homes have a very specific set of requirements and regulations to care for children 21 and under. The areas where these children live are separate and secure, and yes, isolated away from the geriatric residents; however, they are designed specifically for children. You’ll find handicap-accessible playgrounds, toys, stuffed animals and a brightly-colored, kid-friendly living environment. Education is an important component, and through collaboration among the families, medical team and school system, each child’s schooling needs are met. You’ll also find more than twice the number of staffing hours per child than that which is required for seniors.

In many cases, staff are the only families these children know. They care for them and love them as if they were their own. Nursing homes have always been supportive of every individual receiving the most appropriate care in the safest and least restrictive settings, and we actively support programs that keep or safely transition these fragile children to a home and community-based setting. The unfortunate reality is that the DOJ report, and Mr. Grimm’s editorial, only focuses on the small fraction of children who are blessed to have a strong family support network. Many of these kids are there because someone in their life failed them, and their health deteriorated as a result. But just like they would with their own children, the staff working in these nursing homes experience joy and pride in their hearts when they see them thrive and, if they have somewhere safe to go, can return home. Wouldn’t our communities benefit if the news media took time to write about those stories and for once, give credit to these facilities for meeting an important need…I suppose those headlines wouldn’t be nearly as interesting though.

Florida Governor Rick Scott speaks at FHCA's 2012 Annual Conference

On August 1, Florida Governor Rick Scott spoke before a crowd of more than 400 long term care professionals during FHCA's 2012 Annual Conference & Trade Show in Orlando. Along with sharing his vision to get our state's economy back on track, the Governor told audience members about his positive experiences with his parents being cared for in nursing homes. He recognized the compassionate care being delivered to our state's seniors and the need for adequate funding to ensure that high-quality care remains a constant for years to come. He also echoed the messages of FHCA's leadership by encouraging audience members to get involved in grassroots advocacy and take time to come to Tallahassee to speak with their legislators about the important work they do.

After his presentation, FHCA presented Governor Scott with an award for his ongoing support of Florida's long term care professionals and the residents under their care.

FHCA Honors Governor Rick Scott for Protecting Florida's Frail Elders

On August 1 during FHCA's 2012 Annual Conference at the Hilton Orlando, the Association honored Governor Rick Scott for his ongoing support of long term care providers and the residents cared for in member facilities.

Governor Scott spoke in front of more than 400 long term care professionals, sharing his understanding of the challenges these dedicated caregivers face in light of shrinking reimbursements. He also spoke of the importance that job growth plays to the state's economic recovery. Long term care is the state's 14th largest employer, contributing over 259,000 jobs in both rural and urban communities.

Norman Estes (left) with Northport Health Services presented Governor Scott with the award, thanking him for recognizing the need to protect Medicaid funding for nursing homes when he released his 2012-13 budget prior to the legislative session and for signing HB 787 into law, a bill that helps put patients ahead of paperwork by eliminating some duplicative requirements and regulations.

Rep. Daniel Davis Honors Jacksonville Nursing Assistants

Representative Daniel Davis (R-13) recently joined members of the Florida Health Care Association (FHCA) to honor three Certified Nursing Assistants (CNA) working in Jacksonville-area nursing homes as winners of FHCA’s annual CNA Essay Contest. Rep. Davis honored Teresa Base, CNA with Southlake Nursing & Rehabilitation Center (pictured below), as the Grand Prize winner for the 2012 CNA Essay Contest. Other winners honored during the presentation included Second Place winner, Carolyn Thompson, CNA, Heartland of South Jacksonville; and Third Place winner Mary Juen, CNA, Life Care Center of Hilliard. Along with recognition, this year’s winner and runners up each received a cash prize.


The event took place at Riverwood Center, a 240-bed skilled nursing facility located at 2802 Parental Home Road in Jacksonville. Maya Perez, administrator of Riverwood Center, Connie O’ Donnell, FHCA District IX President, and Emmett Reed, FHCA Executive Director, hosted the event.

FHCA’s CNA Essay Contest asked Certified Nursing Assistants working in the Association’s member nursing homes and assisted living facilities (ALF) to submit up to 500 words about their personal experiences surrounding a designated theme. This year’s theme, “CNAs Talk About Managing Falls,” focused on the CNA’s role in preventing and responding to falls in nursing homes and ALFs, including their understanding of falls as a particular risk to their residents and the interventions they’ve learned in their caregiving career that may prevent falls.

“These CNAs are excellent examples of what successful long term care nursing assistants contribute to the high quality care delivered to the residents in our FHCA member facilities. We are proud to honor them for their dedication and commitment to the profession,” said FHCA Executive Director Emmett Reed.

The annual CNA Essay Contest helps to raise awareness about the important role of Certified Nursing Assistants and their contributions to high quality care and quality of life for Florida’s more than 70,000 nursing home residents and patients. The winning entries were announced in conjunction with National Nursing Assistants Week, June 14 - 22, 2012. For more information about FHCA’s CNA Essay Contest, visit the Quality Improvement section of the FHCA website.

FHCA Statement on Supreme Court Ruling on Health Care Reform

The following is a statement from the Florida Health Care Association Executive Director J. Emmett Reed after today’s decision by the Supreme Court of the United States regarding the Affordable Care Act:

“Health care reform includes several components that affect long term and post-acute care providers. Skilled nursing facilities in Florida and across the country have been implementing the law and preparing for the provisions yet to come.

With the constitutional issues surrounding health reform now answered, we hope Congress will shift its attention to tackling the difficult challenge of how to care for a growing elderly population in an era of declining resources. In Florida, the shortfall in Medicaid funding for long term care needs reached $145 million and $6.3 billion nationally in 2011. Against a backdrop of rising health care costs, Florida long term care facilities have also suffered multiple rounds of Medicare cuts and reductions in the last few years. Florida Health Care Association supports initiatives that create incentives for quality care and help contain health care costs. We look forward to working with Governor Scott and the Legislature to address these critical issues that ensure access to skilled nursing and assisted living care for our state’s seniors.”

Member facility tours essential to FHCA's grassroots advocacy

FHCA members continued hosting facility tours this week with legislators and legislative candidates. These meetings are essential to the Association's grassroots advocacy, creating many opportunities for candid conversation about our long term care challenges.

On Wednesday, Rehabilitation & Healthcare Center of Tampa hosted Rep. Janet Cruz (D), candidate for House District 62 (pictured below). Administrator Jeff Nusbaum conducted a productive facility tour, during which the Representative visited with residents and staff and learned more about the important link between adequate funding and high-quality care.

Today, Rep. Doc Renuart (R), candidate for House District 17, visited St. Augustine Health & Rehabilitation Center. Administrator Daniel Crumb led the facility tour and provided an informative overview of the care they deliver and the many jobs they contribute to St. Augustine's area economy.

Also this week, Sen. Nan Rich (D-34) visited Plantation Nursing & Rehabilitation Center. Administrator Neil Sutton provided an extensive tour of both their geriatric and pediatric units to help her understand the complexities of and unique settings for providing care to adults, as well as children.

Take Action: Contact Congress to Protect Medicaid Funding for Nursing Facility Care

Once again, Congress is looking at skilled nursing care cuts to finance provisions in other areas of the budget. In an effort to “solve” the student loan crisis, Congress wants to reduce the Medicaid provider assessment threshold from 6 to 5.5 percent and apply the savings to subsidize the Stafford loan interest rates. Provider assessments are a key tool for states, including Florida, as they attempt to recover from budget crises and make up for the continuous underfunding of Medicaid. If this provision passes, Florida's skilled nursing facilities would see a $867 million cut to Medicaid funding over the next 10 years. Facilities are already struggling under previous reductions as a result of a productivity adjustment to pay for health care reform; then another two percent through sequestration; followed immediately by reducing bad debt to pay for the doc fix.

Please take action today, as Congress may move legislation containing this proposal as early as next week. Help us send an important message to Congress that the proposed reduction would cause more harm than good, as high-quality care for seniors and individuals with disabilities, as well as the jobs of their dedicated caregivers, would be put at risk. Click here to enter your zip code and send an e-mail to your Member of Congress today.

Nurses Speak Up and Advocate for Long Term Care

The same passion and skill nurses bring to their residents can be used to help make a difference in Florida's Capitol. FHCA kicked off its 2012 Nurse Leadership Program in St. Pete Beach today, encouraging nurse leaders in attendance to become advocates with Florida Health Care Association and help educate legislators about their contributions and the significance of what they do in caring for Florida's long term care residents and patients. Hear what these passionate caregivers have to say about getting involved and making a difference.

Facility Hosts Legislator As Part of National Nursing Home Week Celebration

On Monday, Rep. Gayle Harrell (R-81) toured Palm Garden of Port St. Lucie and took part in the facility's Tropical Day as part of their National Nursing Home Week celebration. Administrator Scott Cairns introduced her to residents and staff, giving her information about what they do at the facility and how the decisions made in Tallahassee affect the care they provide. The Representative shared with the group her belief in the family, her health care accomplishments and the challenges Floridians face going forward. She also helped present several nursing awards, after which Mr. Cairns presented her with an Honorary Angel tribute, asking her to be their Angel up in Tallahassee, to watch over them and keep the residents and staff in her thoughts when she is making important decisions.

Florida nursing homes “celebrate the journey” during National Nursing Home Week

By J. Emmett Reed, FHCA Executive Director

Beginning yesterday, May 13, through May 19, nursing homes across Florida and the nation will be Celebrating the Journey in honor of National Nursing Home Week 2012. Facilities have activities planned that will honor the lives - and milestones - of the people they care for and the staff who serve them.

Celebrating the Journey reminds us that every life should be honored, every life’s story needs to be told and that every day we have the chance to begin writing a new chapter. Whether the day is filled with comedy or drama, nursing home residents and caregivers are co-authors and leading characters in each other’s life story.

All of us should strive to live life to the fullest, irrespective of our age or medical condition. In the long term care profession, there is no fixed formula to follow, just the quiet routines of daily caregiving, meals, activities, and, hopefully, visits from family and friends. They bring the joy that comes from the heart of a loved one.

Many of our Florida Health Care Association member nursing homes are embracing the Culture Change movement as a means to help residents live their lives to the fullest. Culture Change focuses on change from within. The purpose is to help improve residents’ quality of life with more choices and more involvement in the day-to-day planning of their activities. It is called “person-centered care” and is for all ages. Residents have more choices in meal selections and other activities of daily living. Additionally, the front line workers who provide the bulk of the care are being given greater autonomy with their assigned residents to encourage staffing consistencies and strong friendships with residents.

During this special week, we’re reminded of Ralph Waldo Emerson’s famous sentiment that “life is a journey, not a destination.” Long term care professionals working in our state’s nursing homes have dedicated their careers to serving others. They understand that the experiences they share with residents and patients are truly a journey. Families and friends should take comfort in knowing that they are here for them every step of the way – when they are striving to maintain or build relationships amid memory loss or coming to terms with the challenges that come with growing older.

Rest assured that all of us working in long term care have the same goal in Celebrating the Journey, and that is for residents to feel satisfied at the end of each day that staff cared for and about them – not just as patients - but as people with stories to tell and new chapters yet to write.

FHCA Members Host Facility Tours With Local Legislators

FHCA members' active involvement in our grassroots initiatives is critical to advancing our legislative agenda. Staffing working in the facilities are the informed, on-the-ground experts that legislators are inclined to listen to, putting a local face on state issues. FHCA wants to encourage members to invite legislators in for a facility tour and the opportunity to meet residents and staff. Follow our posts to learn more about how our members are connecting with lawmakers this summer.

Sen. Elizabeth Benequisto (R-27) visited Coral Trace Health Care Center. Administrator Tracy Hooks gave the Senator an extensive tour, after which she met with Resident Council members, as well as the facility's leadership team, to discuss a number of important long term care issues.

Rep. Jim Frishe (R-54) visited Palm Garden of Pinellas, where he toured the facility and met with residents and staff. Rep. Frishe was the House bill sponsor for HB 621 and was a tremendous help with the passage of HB 787, which will eliminate some duplicative paperwork and requirements. During his visit, he met with the facility's nurses, who cheered after he spoke about his role in getting these important provisions for nursing homes passed this session.

Rep. Dennis Baxley (R-24) toured Palm Garden of Ocala, meeting with their medical director and visiting with residents and staff. He took time to answer residents' questions related to Medicaid funding and other broad health care issues, making for an informative visit.

If you need assistance setting up a facility tour, communicating our long term care issues or getting involved in our grassroots advocacy in the months to come, please contact a member of FHCA's legislative team.

Special FHCA Provider Program - Watch Today and Get Involved In Grassroots Advocacy

The 2012 legislative session ended with several victories for long term care providers. FHCA worked diligently to help preserve nursing home Medicaid reimbursement rates and pass legislation which contains important provisions that will offer member facilities regulatory relief, giving staff more time to focus on resident care.

This special Provider Program features an in-depth interview with the members of FHCA’s legislative team, including a review of 2012 session outcomes and a discussion of the top issues that we expect to be addressed among the 2013 Legislature, including Certificate of Need, Medicaid and Medicare reimbursements, managed care implementation and much more.

FHCA members' active involvement in our legislative initiatives is critical to our success - no one can replace their grassroots voice and the effectiveness they have in addressing the local issues and concerns of the long term care profession. Please take time to watch this video, which is an effective tool for communicating important long term care priorities with legislators and legislative candidates in the coming months.

Governor-approved legislation clarifies resident referral process

Governor Scott's recent approval of HB 787 will have a positive impact on the referral process for persons seeking senior care and services options. Effective July 1, 2012, the new law clarifies that certain referral and marketing services that help consumers find appropriate care and housing options do not violate statutes as long as the referred consumers are not Medicaid recipients and/or the referring agent or employee identifies themselves as representing the assisted living facility (ALF). HB 787 also green lights monetary rewards for facility residents that may refer a friend. FHCA's ALF members only may click here and review s. 429.195, F.S. for full regulatory guidance on this new exemption.

Governor Signs Bill That Will Put Patients Ahead of Paperwork

On Friday, April 27, Governor Rick Scott signed important legislation that will help put patients ahead of paperwork by eliminating duplicative paperwork and regulations in Florida's nursing homes. HB 787 by Rep. Carlos Trujillo (R-116), for which FHCA and its members strongly advocated this session, will give caregivers more time to focus on delivering high-quality care to residents and patients.

The provisions in HB 787 will result in the following:

• Elimination of the 24-hour Adverse Incident report;
• Elimination of the quarterly staffing report;
• Clarification of eviction and nursing home discharge laws;
• Implementation of requirements to allow nursing homes to provide respite care;
• Placement of pediatric staffing standards into statute;
• Allowance of home-office audited financial records in the CON process; and
• Care plan and medical records revisions, as well as other regulatory fixes.

FHCA members only can click here for a more detailed list of these changes that go into effect July 1, 2012.

Landmark elder care reform passed in 2001 by the Florida Legislature (SB 1202) implemented tougher regulations and quality improvement programs that have resulted in measurable improvements in Florida nursing home care. The benefits of improved oversight, however, resulted in several outdated requirements and regulations. New federal regulations were trumping outdated state regulations and duplicative paperwork requirements were taking staff time away from the resident's bedside.

This new law will have a positive impact on residents, and  FHCA would like to thank Governor Scott and Rep. Trujillo, along with Sen. Ellyn Bogdanoff (R-25), Sen. Jack Latvala (R-16) and Rep. Jim Frishe (R-54), whose Senate and House bills offered the original language that was carried by HB 787, for their support of the thousands of employees working in long term care who are dedicated to meeting the needs of the residents and patients in their facilities.

Session results in minimal funding reduction, reduced paperwork for nursing homes

The 2012 session ended March 9 with nursing homes spared from significant funding cuts when the Legislature passed the 2012-13 Florida state budget. The final budget (HB 5001) reduced the originally-proposed 2.5 percent ($76 million) Medicaid funding cut to nursing home care to a lower cut of 1.25 percent ($35.2 million) and reflects full funding of price level increases (inflation). Additionally, the budget expands the Nursing Home Quality Assessment, which allows for some “buyback” of previous Medicaid reductions. “The stories that were shared by the hundreds of long term care professionals this session of how facilities have had to cope with cuts to Medicaid and Medicare over the past six months made a difference. We’re pleased that legislators recognized those challenges and were able to minimize the impact on nursing homes when the final budget passed,” said Emmett Reed, Executive Director of the Florida Health Care Association.

FHCA has always been proactive in offering suggestions to legislators that would help the state with its growing Medicaid budget. A member-driven priority for FHCA this session was the concept of allowing life insurance policies to be used for payment of long term care services. FHCA commissioned Florida State University's Center for Economic Forecasting and Analysis to examine the use of life insurance policy assets as a means of private funding in order to pay for long-term health care needs. The study found that annually there are approximately 4,272 to 4,486 residents with the potential to convert their life insurance policies into long-term health care benefit plans. According to the study, that would represent a net savings to the state's total Medicaid budget of approximately $138.3 - $157.4 million.

This concept was the premise behind SB 1756 by Sen. Joe Negron (R-28) and HB 1055 by Rep. Rachel Burgin (R-56), which received positive feedback in both chambers this session. However, given that it involves two very complicated issues – Medicaid eligibility and insurance – Rep. Burgin recommended that further study on this issue be conducted.

FHCA is pleased to report that the budget also included proviso language to establish a technical advisory workgroup to examine methods to allow an insured under a life insurance policy or the contract holder of an annuity, to convert the policy or annuity to a long term care benefit. The workgroup will include, but is not limited to, representatives from nursing home providers, life insurance companies, and life insurance agents. FHCA will keep members apprised of the outcomes of the workgroup, which will be important to helping address any technical issues before legislation is reintroduced next session.

Nursing homes will also see relief from duplicative requirements with a number of FHCA-supported regulatory changes that were passed as part HB 787 by Rep. Carlos Trujillo (R-116). These changes will have a positive impact on residents, as caregivers will have more time to focus on care rather than duplicative paperwork requirements. Provisions in HB 787 include: elimination of the 24-hour Adverse Incident report and the quarterly staffing report; clarification of eviction and nursing home discharge laws; implementation of requirements to allow nursing homes to provide respite care; placement of pediatric staffing standards into statute; allowance of home-office audited financial records in the CON process; and care plan and medical records revisions, as well as other regulatory fixes.

Although the Legislature was unable to reach an agreement on assisted living facility reforms this year, FHCA was able to educate lawmakers about the differences between nursing homes and assisted living facilities, with a particular emphasis on the negative impacts that electronic monitoring devices ("granny cams") have on resident privacy.

FHCA is extremely grateful to all of those who joined us in advocating for our long term care priorities both before and during the 2012 legislative session. No doubt the outcomes of this session resulted from a combined effort by FHCA members and staff in fostering legislator relationships, building a strong and comprehensive strategy and taking a proactive and unified approach to convey our key messages. FHCA members can read a more thorough wrap-up report of the 2012 legislative session by clicking here.

Final Countdown of 2012 Session with FHCA Legislative Team

FHCA Executive Director Emmett Reed interviews members of FHCA's legislative team direct from the Florida Capitol in the final hours of the 2012 session. Also interviewed are Rep. Jim Frishe (R-54) and Rep. Will Weatherford (R-61).

Background Screening Bill Passes, Heads to Governor's Desk

FHCA is pleased to report another successful legislative outcome. HB 943 by Rep. Doug Holder (R-70), which makes several fixes to the background screening law enacted in 2010, has passed and is on its way to the Governor's desk for signature. FHCA has taken an active role on this issue, providing initial recommendations to the Governor's Interagency Background Screening Workgroup in December and supporting important legislative amendments to address several fixes as the bill made its way through the process.

HB 943 will fix the "volunteer" issue that caused Gov. Scott's veto last year, as well as the redundant background screening issue that affects DOEA direct-service providers and many of FHCA's ALF members. The bill also allows employers to hire a person for training and orientation prior to having a screening complete with certain caveats, and reduces duplicative screenings for CNAs. It also clears the way for sharing background screening information across agencies through the Agency for Health Care Administration’s new clearinghouse and sets up a new requirement for employers to report employment status changes to the clearinghouse. LiveScan fingerprint vendors will now be asked to meet certain practice thresholds and will be approved by FDLE.

FHCA wants to thank all those members who spoke to legislators throughout the session to encourage their support of this bill. The bill becomes law upon signature by the Governor, and we will keep you updated once that happens.

Important Amendment Fixes Prescribing Controlled Substances Issue

FHCA is pleased to report that, this morning on the Senate floor, Senator Ellyn Bogdanoff (R-25) amended HB 1175 to include language that will fix a serious problem being experienced by physicians prescribing controlled substances to residents in nursing homes. FHCA had previously reported that these problems were resulting from the "pill mill" legislation that passed last year.

The amendment modifies 456.44, Florida Statutes, to state that the subsection "does not apply to a physician who treats a patient who is admitted in a nursing home or related health care facility or receiving hospice services as defined in chapter 400."

This is a great victory for FHCA, and we want to thank all of those who have worked so hard for this important issue, including our FHCA members along with representatives of the Florida Medical Directors Association. The bill now goes back to the House for a floor vote, and we will keep you informed of its progress.

Nursing Home Budget Update

Last night, House and Senate budget negotiators came to an agreement on issues contained in the Health and Human Services budget, including funding for nursing home care. Budget conferees have agreed to meet in the middle on the funding cut, meaning the House's originally proposed 2.5 percent has been reduced to 1.25 percent (approximately $35 million). As previously reported, both chambers’ budgets had fully funded price level increases (inflationary increases), and that has not changed.

Barring any major holdups, the 2012-13 budget is expected to be finalized by late this evening to allow for the three-day cooling off period before the vote is taken on Friday and the 2012 Legislature can sine die. And while we have not quite reached the finish line, FHCA is extremely grateful to its members for their ongoing support both before and during this year’s session. Time and again, our members rose to the call and the voices of long term care were heard. Over 500 long term care professionals took part in FHCA's Lobby Wednesdays this session, sharing stories with lawmakers that resonated, as was made evident by the budget outcome.

As we enter this final week of the 2012 session, FHCA will continue to advocate for the remaining legislative issues that impact the long term care profession. Stay tuned for updates on the progress of the bills we're tracking.

FHCA Provider Program - 2012 Lobby Wednesdays a Wrap

FHCA welcomes its final group of members in town for Lobby Wednesday, including representatives from Airamid Health Management and Summit Care. Also, Executive Director Emmett Reed discusses conferencing on the budget and progress of the bills we're tracking.

FHCA Provider Program - Over 200 Members Hit the Hill on Lobby Wednesday

Hear from FHCA Executive Director Emmett Reed about the more than 200 FHCA members taking part in Lobby Wednesday this week. Representatives included Airamid Health Management, Opis Management Resources, Florida Health Care Activity Coordinators Association, the Association of Nutrition & Food Service Professionals and FHCA Districts III, IV, V, VIII and XIII. Interviews with frontline staff, district officers, first-time participants and seasoned visitors show the importance of getting involved in this grassroots initiative.

Patients Ahead of Paperwork Bill Passes House

FHCA is pleased to report that HB 621 by Rep. Jim Frishe (R-54), the Nursing Home Quality Efficiency Act, has passed unanimously out of the House of Representatives. Thanks to the collective work of our staff and lobby team, along with the hundreds of FHCA members who traveled to Tallahassee, for helping lawmakers understand how this legislation will put patients ahead of paperwork by eliminating some duplicative paperwork and reporting requirements.

Also passing out of the House was HB 943 by Rep. Doug Holder (R-70). This bill makes several fixes to the background screening law enacted in 2010, including a duplicative screening issue that affects DOEA direct-service providers and many of FHCA's assisted living facility members.

We're watching the Senate companions to both these bills as they make their way to the final committee stop and will keep you informed of their progress.

FHCA Provider Program - Week 6 of 2012 Session Highlights Importance of Grassroots

FHCA Executive Director recaps the week, while members in town for Lobby Wednesday and state lawmakers talk about the importance of grassroots and getting involved early and often to have the voices of long term care heard. Special thanks to Healthcare Services Group for their Lobby Wednesday sponsorship.

HB 621 Advances - bill will help caregivers focus more time on resident care

This morning, the House Health & Human Services Committee passed HB 621 by Rep. Jim Frishe (R-54), the Nursing Home Quality Efficiency Act which helps put patients ahead of paperwork by eliminating some duplicative paperwork and reporting requirements. Thanks to the hard work of our bill sponsor, and the collective efforts of FHCA and its members, there was significant bipartisan support for the bill. We’re also watching the Senate companion, Senate Bill 482 by Senator Jack Latvala (R-16), and will keep you updated on its movement.

FHCA Provider Program - Senate Budget Update, Lobby Wednesday Interviews with Cypress Health Group

FHCA Executive Director Emmett Reed reports on the Senate's zero (0) cut to nursing home funding in its budget. Also, members in town for Lobby Wednesday include Cypress Health Group, Airamid Health Management and Pines of Sarasota. Interviews with FHCA Senior VP Scott Allen and Cypress President Rich Kase give a perspective on this important grassroots intiative and the work also being done at the federal level.

TAKE ACTION! Tell Congress to Oppose Reductions to Nursing Facility Bad Debt Reimbursement

U.S. House and Senate Conferees are meeting daily to resolve the payroll tax cut controversy, provide a doc fix and possibly extend the therapy cap exceptions process. One proposal being considered by the Committee, which was part of last year's House-passed legislation, includes a measure which reduces the federal reimbursement of bad debt to skilled nursing facilities. The full impact of this cut is estimated to be $500 million a year, or a 1.6% cut in Medicare rates, when fully implemented in 2015. Florida, however, greatly pays for a disproportionate share of the entire proposal - our state's long term care facilities would see a funding cut of as much as an estimated $150 million over the next three years. With facilities already experiencing significant reductions in state Medicaid and federal Medicare funding, more cuts will severely impact providers' ability to provide high-quality care to our state's frail elders.

The Conferees have a March 1st deadline to resolve this issue. With that date getting closer with each passing day - we must weigh in on the impact of bad debt on our profession.

We need your help with voicing your concerns to the members of Florida's Congressional delegation. Please contact them TODAY and tell them to oppose the reduction of bad debt reimbursements for skilled nursing facilities. Click here to enter your zip code to find your Member of Congress and send them an e-mail with this important message. You can use this link to see the impact of the proposal on your Congressional district.

For more information, review the brief, “Medicare Bad Debt Coverage to Skilled Nursing Facilities: A Critical Lifeline.”

Senate budget contains no cuts to nursing home funding

Yesterday, the Senate released its initial proposed 2012-13 budget with a zero (0) cut to nursing home Medicaid reimbursement rates. The proposal funds price level increases (inflationary increases) and transfers funding for nursing home case load growth to fund additional Nursing Home Diversion slots. Sen. Joe Negron (R-28), who chairs the Senate Budget Subcommittee on Health and Human Services Appropriations, has indicated publicly on several occasions that he had no intentions of cutting nursing home funding in his budget this year, and we want to thank him, as well as Sen. Don Gaetz (R-4) and Mike Haridopolos (R-26) who were vocal supporters, for being champions for the frail elders cared for in our member facilities.

As we've previously reported, the House cut to nursing home Medicaid funding is 2.5 percent ($76 million). While we are in good standing with the Senate budget at this point, there is still a long way to go in the budgeting process. Both chambers will have to agree on a final budget, and it's important we keep reiterating the message that preserving Medicaid funding is critical to facilities' ability to maintain high-quality care.

While FHCA's member facilities continue focusing on delivering that high-quality care, the Association is meeting daily with lawmakers to help them understand the need for adequate funding. As budget negotiations between the House and Senate continue to unfold over the last few weeks of session, we'll need your active involvement to be a strong voice at the Capitol. We look forward to seeing more FHCA members in Tallahassee over the next few weeks for Lobby Wednesdays and will keep you informed on this important issue.

FHCA Provider Program - Lobby Wednesday with Gulf Coast Health Care

FHCA Executive Director Emmett Reed talks with members of Gulf Coast Health Care, and Lobby Wednesday sponsor, Ponce de Leon, about their meetings with lawmakers and the impact of being involved in this important grassroots initiative.

Bills that put patients ahead of paperwork on the move this week

On the agenda this week were several bills that contain similar language as that which is in the Nursing Home Quality Efficiency Act (HB 621 by Rep. Jim Frishe, R-54 and SB 482 by Sen. Jack Latvala, R-16), the FHCA-supported bills which put patients ahead of paperwork. HB 1419 by Rep. Jason Brodeur (R-33) is the Agency for Health Care Administration-supported bill which would eliminate some duplicate and unnecessary reporting requirements for nursing homes. The bill was heard in the House Health & Human Services Quality Subcommittee on Tuesday and passed.

During that same Committee meeting, FHCA stood up in support of HB 787 by Rep. Carlos Trujillo (R-116), which contains similar proposals to eliminate duplicative requirements.

SB 1884 by Sen. Rene′ Garcia (R-40), the companion to HB 1419, was heard that same afternoon in the Senate Health Regulation Committee. The bill passed, but without the language reflected in SB 482, due to the fact that SB 482 is moving along through the process.

FHCA will continue tracking these important bills which put patients ahead of paperwork by eliminating some outdated and duplicative requirements, allowing caregivers more time to focus on delivering high-quality care to long term care residents.

FHCA Provider Program: House Budget Released, Members Recap Legislator Visits

FHCA Executive Director Emmett Reed reports on the impact the House proposed budget has on Medicaid funding for nursing home care. Also, both first-time and experienced Lobby Wednesday participants talk about their lawmakers visits.

House Releases Initial Budget

Today, the House released its initial proposed budget, which contains a 2.5 percent cut to nursing home Medicaid reimbursement rates ($76.1 million). The proposal fully funds price level increases (inflationary increases) and transfers funding for nursing home case load growth to home and community-based programs (no negative impact to nursing home rates). The initial documents released today do not indicate changes in the amounts to be collected via the Nursing Home Quality Assessment Program; however, it is anticipated that the program will be fully maximized at the 6 percent statutory level. The budget uses the transferred case load funds to provide for an additional 1,000 Nursing Home Diversion slots, an additional 207 Assisted Living Medicaid Waiver slots, 1,250 Aged and Disabled Adult Medicaid Waiver slots, and 150 new PACE slots for Lee and Collier counties. The proposed budget also reduces the Nursing Home Diversion rates by 4 percent and uses those savings to fund an additional 1,415 Diversion slots.

The Senate is expected to release their proposal later this week, and FHCA will have more information when that becomes available.

FHCA Provider Program Update: Nursing Home Quality Efficiency Bills Advance

Executive Director Emmett Reed speaks with Rep. Jim Frishe (R-54), HB 621 sponsor, along with FHCA's Lobby Wednesday participants during week two of the 2012 legislative session.


 

SB 482 advances

Today, SB 482 by Sen. Jack Latvala (R-16), The Nursing Home Quality Efficiency Act, passed favorably out of the Senate Committee on Health Regulation, despite opposition from trial attorneys and other opponents who are misinformed about this issue. Neither SB 482 or its House companion, HB 621, impact resident care; they simply eliminate requirements that duplicate federal law, with some of those requirements being as much as ten years out of date. FHCA will keep you updated on the progress of these important bills, which put patients ahead of paperwork, as they continue making their way through the process.

HB 621 Passes Second Committee

HB 621, the Nursing Home Quality Efficiency Act, passed its second committee stop this afternoon, with the Health & Human Services Appropriations Subcommittee voting 14-1 to pass the measure. Bill sponsor Rep. Jim Frishe (R-54) shared important information with the committee about how this bill eliminates outdated reports and requirements in nursing homes (some being 10 years out of date) that are duplicative of federal law/regulations. FHCA supports this bill which would help facilities alleviate some of the cost burdens that come with duplicative requirements and excessive paperwork, allowing staff to "Put Patients Ahead of Paperwork" and focus more time on resident care. The Senate companion, SB 482 by Sen. Jack Latvala (R-16), is expected to be heard by the Senate Health Regulation Committee on Thursday.

FHCA Provider Program: 2012 Legislative Session Begins

FHCA Executive Director Emmett Reed gives a preview of week one of the 2012 legislative session and the priorities for long term care providers this year.

Bill that puts patients ahead of paperwork passes House subcommittee

On Thursday, the House Health & Human Services Quality Subcommittee heard HB 621 by Rep. Jim Frishe (R-54), the Nursing Home Quality Efficiency Act which eliminates some outdated reports and requirements in nursing homes which duplicate federal law/regulations. FHCA supports this bill which would help facilities alleviate some of the cost burdens that come with duplicative requirements and excessive paperwork, allowing staff more time to focus on resident care.

Rep. Frishe, Matt Hudson (R-101) and Ronald "Doc" Renuart (R-18) spoke favorably on this important issue, and during the meeting, Florida Catholic Conference and Florida Association of Homes and Services for the Aging stood in support of the bill. Standing in opposition were AARP, SEIU and the Florida Justice Association.  Back and forth testimony during the meeting gave way to common misconceptions about the regulatory environments in nursing homes and assisted living facilities, causing Rep. Renuart to clarify for the committee and audience members present the differences between these two care settings, including the significant oversight process for nursing homes that have been in place since landmark elder care reform was passed in 2001 (SB 1202), which have resulted in substantial improvements in resident quality care.

The bill passed, and its companion, SB 482 by Sen. Jack Latvala (R-16), is expected to be heard in the Senate next week.

Protecting Medicaid funding, putting patients ahead of paper top FHCA's 2012 legislative agenda

Florida Health Care Association (FHCA) today released its priorities for the 2012 legislative session. Topping the list will be to prevent reductions to Medicaid funding for high-quality nursing home care, given the significant funding cuts long term care providers have experienced over the past six months. A 6.5 percent cut to nursing home Medicaid funding during the 2011 legislative session resulted in a $187.5 million reduction that took effect July 1, 2011. In October, federal regulation resulted in a $332 million cut to facilities’ Medicare reimbursements, and with Congress looking at more ways to reduce the federal deficit, facilities could see further reductions.

“Nursing homes have been hit with a tsunami of funding cuts to our Medicaid and Medicare reimbursements over the past six months,” said Emmett Reed, Executive Director of Florida Health Care Association, the state’s first and largest advocacy organization for long term care providers and the frail elders they serve. “If we see more cuts this session, many facilities will have to make difficult decisions which could restrict future access to care; our state’s seniors deserve better.”

Protecting Funding for Nursing Home Quality Care: Florida nursing homes lose an average of $23.97 per patient day or nearly $575,000 annually due to Medicaid under-funding. For a typical nursing home, 70 percent of costs pay for the staff working in the facility to deliver care, with 40 percent of those costs dedicated to direct-care workers. Funding cuts could mean layoffs for frontline caregivers and other employees at a time when Floridians need jobs. Lack of adequate funding could also mean sending seniors and people with disabilities to long term care hospitals or other higher cost settings for those services. With 60 percent of nursing home residents relying on Medicaid as their safety net for their long term health care needs, FHCA is urging legislators to preserve Medicaid funding to protect residents’ high-quality care, ensure future access to care and maintain the jobs of frontline caregivers.

Put Patients Ahead of Paperwork (HB 621/SB 482): Landmark elder care reform passed by the Florida Legislature in 2001 (SB 1202) has resulted in tougher regulation, increased staffing requirements and quality improvement and risk management programs, all of which are enforced through a combined state and federal survey process of the Agency for Health Care Administration. Nursing home care has steadily improved as a result. The benefits of improved oversight of the quality of care for residents, however, have resulted in duplicative requirements and regulations. FHCA supports HB 621 by Rep. Jim Frishe (R-54) and SB 482 by Sen. Jack Latvala (R-16) which would eliminate duplicative paperwork and outdated reports, allowing caregivers working in nursing homes to focus more time on providing resident quality care.

Alternative Funding Resources (HB 1055/SB 1756): FHCA supports SB 1756 by Sen. Joe Negron (R-28) and HB 1055 by Rep. Rachel Burgin (R-56), which would allow life insurance policies to be used for payment of long term care services and would help the state with its growing Medicaid budget deficit by providing alternative resources for individuals to pay for nursing home care.

“Our members are committed to caring for Florida’s most vulnerable population at a level of quality they expect and deserve,” Reed continued. “This session we’ll see hundreds of nursing home employees and family members join us at the Capitol as we continue educating lawmakers about the impact funding cuts are having on facilities' ability to maintain an adequate workforce and continue delivering high-quality care to our state's seniors.”

To learn more about FHCA’s 2012 legislative priorities, find resources to advocate for protecting Medicaid funding to nursing home care and learn more about being involved in FHCA’s Safeguard Our Seniors grassroots campaign, visit http://www.safeguardourseniors.org/