Florida House Panel Approves Nursing Home Reform Legislation, But Caps Punitive Lawsuit Damages

With the Florida Legislature hoping to "shore up" the state's "shaky" nursing home industry, the state House Council for Healthy Communities unanimously approved a bill (HB 1879) that would place restrictions on nursing home lawsuits and boost staffing ratios at the facilities, the Associated Press reports. The panel, however, continues to make a series of changes to the bill. An amendment passed by the committee deleted a provision that made the caps placed on punitive damages in lawsuits retroactive. The nursing home industry supported the provision, saying that it was necessary the "get insurers back in Florida selling affordable coverage" (Hallifax, Associated Press, 4/23). The state House Fiscal Responsibility Council will address the legislation today before the bill moves to the floor for a vote Wednesday (Associated Press, 4/23). In addition to setting limits on punitive damages, the bill would increase requirements on nursing home staffing from a minimum of 1.7 hours of care per day per resident to 2.9 hours starting next year.

Senate Slashing
The state Senate version of the bill (SB 1202), which would "phase" in the increase over five years, will likely reach the floor for a vote on Wednesday ( AP/South Florida Sun-Sentinel, 4/21). This follows a vote last Wednesday when the state Senate Appropriations Committee approved the bill on a 20-1 vote, but cut provisions that would have "guaranteed higher wages for caregivers" and "toughen[ed] laws against abuse and neglect" of seniors. In addition, the panel "killed efforts" to levy "steep fines" against "problem plagued" adult care facilities and cut a proposal requiring nursing homes to report lawsuit settlements to the state (Hollis, Orlando Sentinel, 4/20). While several state senators said that they "take no pleasure in axing proposals" that would boost the quality of care for seniors, they called the moves "necessary to balance the state budget." According to state Senate Appropriations Committee Chair Jim Horne (R), "There are a lot of things we would like to do, but we don't have the money in the budget." Still, the panel agreed to provide state health regulators with more than $5 million next year to hire an additional 76 workers to help implement staffing provisions of the legislation (Orlando Sentinel, 4/19). Both the state Senate and state House have allocated $46 million to improve care in nursing homes, with most of the funding "expected to go toward staffing." According to critics, however, the funding "likely isn't enough." State Rep. Jerry Maygarden (R) said, "We could throw $100 million at it, and it would burp and ask for more" (Florida Times-Union, 4/19).

Parry and 'Thrust'
In addition to the staffing issues, the "thrust" of the Senate bill -- a cap on nursing home lawsuits -- would limit punitive damages to "no more than" three times compensatory damages or $1 million. However, in cases where nursing home owners "'actually' knew" about wrongdoing committed "'solely' for financial gain," plaintiffs could receive punitive damages of four times compensatory damages or $4 million (Orlando Sentinel, 4/19). The proposed caps have "drawn the most attention" and "sparked the most heated debate (Bousquet, Miami Herald, 4/20). While nursing home industry officials maintain that they "need greater legal protections to fend off costly lawsuits," trial lawyers and advocates for seniors contend that nursing homes "should be forced to improve care," which would lead to fewer lawsuits (Florida Times-Union, 4/19).

'Stripped-Down' to the Bone
Meanwhile, several Florida newspaper editorial boards have commented on the state's nursing home bill debate. A sampling of their opinions appears below.

• A South Florida Sun-Sentinel editorial maintains that the Florida Senate should "restore some badly needed provisions" -- including increased Medicaid reimbursements for nursing homes, a requirement that would force nursing homes to "carry a certain amount of liability insurance," funding to hire additional staff members and mandatory reporting of legal settlements to the state -- to the "stripped-down" nursing home reform bill. According to the editorial, "Tort reform and a few crumbs for staffing aren't enough to curb the state's long term health care crisis" (South Florida Sun-Sentinel, 4/23);
• According to the Miami Herald, state lawmakers "appear poised to do the cheap, expedient thing" for Florida seniors, which would "go beyond shame." The editorial adds that the nursing home reform bill would "[make] it more difficult" for seniors to sue a nursing home for "being beaten by an aide than to sue a grocer over slipping on a banana peel," while "do[ing] too little" to improve the quality of nursing homes -- "the real issue for people who live in nursing homes and those who love them" (Miami Herald, 4/20);
• An Orlando Sentinel editorial maintains that the nursing home reform bill "misses the point," targeting lawsuits against nursing homes -- which "protects the financial interest" of nursing home operators -- rather than "beef[ing] up" the care for residents. The editorial concludes that the legislation would "betray some of Florida's fragile elderly people" (Orlando Sentinel, 4/23).