New nursing home staff rules would put residents at risk

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 PCAs are not nurses. They are not even certified nursing assistants. Instead, PCAs are caretakers that completed an eight-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 attendants in nursing homes was initially due to the COVID pandemic. Originally, AHCA intended on permitting only temporarily staffing of PCAs during the crisis. However, now lawmakers are contemplating a bill that would allow PCAs to replace traditional staff on a permanent basis. Senate Bill 1132 and House Bill 485 would allow these attendants to begin working in long-term care settings after just eight hours of training. The bills were introduced by state Sen. Aaron Bean, R-Fernandina Beach, and state Rep. Sam Garrison, R-Fleming Island.

The bills would allow nursing homes to further reduce their already low staffing expenses by replacing certified nursing assistants with lesser-paid personal care attendants.

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 well-being.

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 Alzheimer’s and other forms of advanced dementia; patients on oxygen tanks or feeding tubes; patients who take a litany of prescription medications. Disaster is not just foreseeable; it is imminent.

Some facilities have voiced opposition to the law and the use of PCAs, recognizing that a lack of training would lead to nursing home injuries and mistakes. Management at Gulf Shore Care Center in Pinellas Park has already voiced opposition to using PCAs.

“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,” Louise Merrick, Gulf Shore’s administrator, told the Tampa Bay Times. “We just feel it’s a safer environment for our patients with the most highly qualified people we can provide.”

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 people with less than one day’s training is a formula for catastrophe in our long-term-care facilities.

Florida’s seniors deserve better.

Michael Brevda is the managing attorney at Senior Justice Law Firm, a Florida-based firm narrowly focused on representing families impacted by nursing home negligence. He can be contacted at www.SeniorJustice.com.

By Michael Brevda