As of July 1, 2011, the state has reduced required staffing levels in Florida nursing homes. This measure is part of efforts to help nursing homes deal with the $187.5 million in Medicaid cuts outlined in the state’s budget. The state uses a formula of required “direct care hours per patient”. Under the new rule, Nursing home residents will be entitled to a minimum of 3.6 hours of direct care per day, down from 3.9. Advocates for nursing homes claimed this was necessary because staffing rates had been raised, while budgets had been chopped.
Nursing homes must meet these minimum requirements, but can choose to staff at higher levels. With many relying on Medicaid for a big portion of payment, the state of Florida’s Medicaid budget cuts make a big impact and many appear to be cutting back on staff. They may look at other ways to improve care, but research has shown that higher staffing levels are associated with fewer falls and bedsores. Staffing requirements vary from state to state, and many states do not set minimum levels.
What can concerned families do to ensure good care when an elderly loved one is in a nursing facility?
• Consider hiring a geriatric care manager for the initial selection process of a care facility. A geriatric care manager can help you determine what type of facility can best meet your elder loved one’s needs and which offer quality care. The care manager can assist with the transition in a variety of ways, including understanding levels of care, payment options and what to expect. Even if your loved one is going from the hospital to short-term inpatient rehabilitation, a care manager can help you identify the best options which can greatly benefit your loved one’s recovery.
• Visit often and be involved. Get to know facility staff and check in regularly. Be alert to changes or concerns and constructively address them with appropriate staff. Attend care plan meetings. Ask friends and family to visit to help ensure your loved one has regular visitors. (If you are caregiving from a distance, consider having a care manager do monitoring visits in addition to having friends or neighbors check in.)
• Find out who to address concerns with and the chain of command if you do not feel your concerns are being addressed. All Florida nursing homes will have residents’ rights and complaint information posted, so that you also know where to address complaints not handled sufficiently by the facility. The Florida Ombudsman program offers volunteer advocates to help residents and families.
• Nights, weekends and holidays are the most problematic times for staffing at facilities. Visit during different times to get an idea of how things operate and any potential hazards. Find out how the facility handles management of these times.
• Keep apprised of changes by reviewing the chart and attending care plan meetings (or having a professional geriatric care manager, trained in these issues, involved in this process). While you should be informed of any significant changes, it helps to keep an eye on things and ask questions.
• Consider hiring a private duty caregiver for extra attention and care. Read more about how caregivers can benefit elders in care facilities.
CONTACT US if we can help you with eldercare advice and concerns, selecting a quality Florida eldercare facility or monitoring and advocating for your loved one in Florida.