Florida House Passes Nursing Home Reform Bill That Would Cap Punitive Damages

With an 112-8 vote, the Florida House on May 2 approved a nursing home reform bill (CS-SB 1202) "after weeks of struggling" over the legislation, the Florida Times-Union reports. In what has been the Legislature's "most controversial issue of the year," the nursing home industry and trial lawyers have "waged a bruising battle" over the plan, which would protect nursing homes from lawsuits while "forc[ing]" them to improve patient care. The "surge" in nursing home lawsuits in recent years has "helped drive the industry into a financial crisis," and the industry has lobbied for "strict limits" on damages nursing homes pay in lawsuits. Meanwhile, trial lawyers and the senior advocacy group AARP have urged lawmakers to mandate measures to improve care, "which they say would reduce the number of lawsuits" (Saunders, Florida Times-Union, 5/3).

Punitive Damage Caps
The House-passed bill and a companion measure that has already passed the Senate (SB 1202) establish similar litigation limits, with the House "simply adopt[ing] agreements worked out in the Senate," House Speaker Tom Feeney said. The bills include a $1 million to $4 million cap on punitive damages, and the plaintiff must prove that the nursing home was "'primarily' motivated by unreasonable financial gain to qualify for the upper level." Caps do not apply in cases where the home is found to have "intended" to harm the resident. The bills also require plaintiffs to notify nursing homes 75 days in advance if they plan to sue, and both sides "are urged to reach a settlement during that time."

Beefing Up Patient Care
To improve nursing home care quality, the House bill would mandate a "dramatic increase in staffing requirements" (Ulferts, St. Petersburg Times, 5/3). The House bill would require certified nursing assistants to spend 2.6 hours per day with each resident by next year, compared to the current requirement of 1.7 hours. By 2003, the staffing requirement would increase to 2.9 hours per patient per day. The Senate version would require CNAs to spend 2.3 hours per patient per day next year and "gradually increase" to 2.9 hours by 2005. Legislators are prepared to spend about $60 million next year to help nursing homes meet staffing requirements (Florida Times-Union, 5/3). Under both versions of the bill, nursing homes would be required to maintain "internal risk management policies" and report residents' injuries to the state. A home repeatedly cited by the state may lose its licence. House bill Sponsor Rep. Carole Green (R) explained, "This makes it easier to shut down bad facilities" (St. Petersburg Times, 5/3). As the House-passed bill contains some changes to the Senate bill that was passed last week, it must go back to the Senate for approval before heading to Gov. Jeb Bush's (R) desk. Both houses indicated that they "should be able to work out their differences before the legislative session ends tomorrow" (Florida Times-Union, 5/3).

Reluctant Compromise
Florida lawmakers have been working for three years to devise a measure that would reduce lawsuits against nursing homes, with this year's bill taking "a number of twists and turns" in the Legislature, the St. Petersburg Times reports. Some lawmakers were unhappy with the end result, such as Republican Rep. Nancy Argenziano, who joined seven Democrats in voting against the bill (St. Petersburg Times, 5/3). Argenziano said, "There are probably things that I could never, ever agree with and one of them is providing relief to the worst" nursing homes, referring to the changes made in the bill that would "mak[e] it harder to prove in court that nursing homes have neglected residents and capping punitive damages even when abuse is proven unless the resident in intentionally harmed" (Hallifax, AP/Florida Times-Union, 5/2). House Republicans dealt a blow to Democrats on May 1, when they used "a rare parliamentary procedure to block all efforts by Democrats to make further changes and cut off debate." House Minority Leader Mike Fasano (R) said, "This bill is much too important to allow the Democrats to kill it with political games. The time for political grandstanding is over." Rep. Dan Gelber (D) said of the GOP action, "In your rush to crush the lawyers, you are visiting harm on our frailest elders" (Hollis, South Florida Sun-Sentinel, 5/2). Green said, "This bill does not fix everything. In all honesty, we will have to continue to work and make refinements" (Follick, Tampa Tribune, 5/1). To read past coverage of this issue, click here.