Two new bills push for financial accountability in Florida nursing homes


Nicole Pasia


Legislators are leading a bicameral effort to require Florida nursing homes to be more transparent about how they spend their funds—particularly Medicaid funds. Advocates say funds for staffing recruitment and caregiver pay should be prioritized to help respond to the diminishing care quality in Florida’s long-term care facilities resulting from its health care workforce crisis.


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House Bill 1237, filed by Rep. Carlos Guillermo Smith (D – Orange), and Senate Bill 1596, filed by Sen. Audrey Gibson (D – Duval), would require nursing homes to spend at least 75% of the Medicaid funding it receives on patient care costs. Specifically, 55% of the funds must be spent on direct patient care services. If a facility fails to comply with this rule, it must pay the remaining balance to the Agency for Healthcare Administration (AHCA) by Jan. 1 of the following fiscal year. 

While nursing homes are required to disclose their Medicaid expenditures, there are no requirements to disclose exactly where the funding goes, according to American Association of Retired Persons (AARP) Florida Associate State Director of Advocacy Zayne Smith.

The bills follow at least a dozen emergency suspension orders AHCA issued to assisted living facilities over the last year due to staffing issues. One facility was found to have only one or two full-time care staff at any given time. Another facility, according to the order, was unable to fully implement a fall prevention policy, leading to 27 residents suffering a total of 46 falls within a two-month period. 

While the bills push for greater financial accountability in Florida nursing homes, AARP Florida State Director Jeff Johnson said the state should focus on building a quality long-term care workforce. He particularly criticized a training program the state implemented last year that provided people who are not certified nursing assistants (CNA) with less than 24 hours of instruction before placing them in a facility. 

“Currently it’s about two and a half hours of CNA care a day that residents get afforded … a significant portion of that—that we don’t know at this point because nobody’s measuring it—could be from these [uncertified] people.”

Nursing home workforce support in the state budget will likely include pay raises for current providers. Gov. Ron DeSantis’s latest budget recommendations include $65 million in general funds for AHCA assisted living facilities. Legislators will review the governor’s allocations over the next several weeks before drafting the state budget bill near the end of the 2022 session.