Is Florida’s Assisted Living Bill a Model for the Nation?

| May 10, 2015

Four years after the newspaper claimed that Florida’s assisted living residents were being “neglected to death,” the Florida Legislature passed a reform bill aimed at increasing oversight of assisted living communities without placing undue burden on providers. Not everyone agrees the legislation meets those goals.

Four years after the Miami Herald newspaper claimed that Florida’s assisted living residents were being “neglected to death,” the Florida Legislature passed a reform bill aimed at increasing oversight of assisted living communities without placing undue burden on providers.

Supporters of the bill are suggesting that the legislation could serve as a model for the nation. But critics are worried that the bill doesn’t go far enough to provide oversight of assisted living communities caring for the state’s most vulnerable older adults.

Sen. Eleanor Sobel (D-Hollywood) and Rep. Larry Ahern (R-Seminole) sponsored House Bill 1001/Senate Bill 382. 

According to Senior Housing News, work on the bill began in 2011 after the publication of a Miami Herald series blaming lax oversight and enforcement for negligence and abuse that led to the deaths of some assisted living residents over a 10-year period.

Major Issues: Staff Roles, Licensing and Disclosure

The Florida bill addresses:

  • Staff roles: The legislation expands the types of services that can be provided by nurses in assisted living settings, reports Senior Housing News. Acceptable nursing roles now include administering medications and treating medical conditions like wounds.
  • Mental health licensing: The bill requires assisted living communities to acquire a mental health license if even 1 resident has a qualifying diagnosis of mental illness.
  • Full disclosure: The bill directs the state’s Agency for Health Care Administration (AHCA) to create a consumer website featuring comprehensive information about assisted living communities. Listings for each community would include a range of information, including survey and violation data, financial information, recreational programs, languages spoken by staff, and the organization’s religious affiliation, according to Senior Housing News.

Inspections and Enforcement

The most controversial part of the law would give AHCA more flexibility in targeting assisted living communities for inspections.

The provision is intended to reduce the frequency of inspections for communities with a good track record while increasing AHCA’s ability to inspect problem communities more frequently. According to the Tampa Bay Times, homes with a good track record would see inspectors every 2 years.

In addition, the bill calls for additional financial penalties for assisted living communities that don’t comply with regulations. For example, it would allow regulators to:

  • Charge assisted living communities $500 for every time they fail to provide background screening of staff.
  • Double fines on communities that fail to correct a serious violation within 6 months. 

Massachusetts Assisted Living Rules

The Florida legislation came just 5 months after new assisted living regulations went into effect in Massachusetts.

According to The Boston Globe, the new rules require expanded training for workers in 2 areas: 

 

  1. How to recognize and report elder abuse.
  2. How to manage and calm aggressive behavior. 
Regulators backed down on 2 issues that were raised during debates about the proposed rules:

 

  • They decided not to set minimum staffing levels for assisted living residences. Instead, the rules stipulate that it “shall never be considered sufficient to have less than 2 staff members in a Special Care Residence.” 
  • Regulators also decided not to pursue proposed rules prohibiting assisted living communities from accepting residents if those residents required more than 90 consecutive days of skilled nursing care. Current residents who met this criterion would not have been allowed to remain in their assisted living communities.