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Sarasota Herold-Tribune

Bills would require fewer nursing home inspections

Saturday, March 14, 2009

By KEVIN L. MCQUAID

Sen. Mike Bennett's "back to bedside" bills, introduced during both the 2007 and 2008 legislative sessions in Tallahassee, aimed small.

Mike BennettSenate Bill 686, as it was formally known last year, altered staff training and reporting requirements for so-called "adverse incidents" involving elderly residents. In both years, the bills proposed making state quality-of-care monitoring an annual event, rather than a quarterly one.
Buoyed by unanimous votes in the Florida House of   Representatives and Senate in 2008 and a wide margin of approval in both houses the year before, the bills sailed to Gov. Charlie Crist's desk.

Once there, the bills were vetoed. Twice.

"I believe that facilities responsible for providing care to our most vulnerable citizens must remain under strict scrutiny and existing law provides for this accountability and oversight," Crist wrote on June 23, 2008.

Bennett, however, appears undaunted.

This year, there is nothing small about the Bradenton Republican's plans for Florida's nearly 700 nursing homes, which care for more than 82,000 sick, frail and vulnerable people.

In Senate Bill 1562, Bennett has proposed eliminating Agency for Health Care Administration deficiency classes and fines; inspections by both the Fire Marshal and the state Department of Health; Long-Term Care Ombudsman volunteer assessments; a "gold seal" program that rewarded superior providers; and a state "watch list" that highlights problem centers.

A companion bill, HB 1387, introduced by state Rep. Ken Roberson, R-Port Charlotte, offers many of the same provisions. "We're trying to avoid duplication of inspections, and we're trying to streamline government, and this is a step toward doing it," Roberson said Friday.

In comparison with past offerings, though, Bennett's 2009 bill would represent a full-scale overhaul.

Even advocates for altering the amount of oversight -- duplication, in the Florida Health Care Association's view -- acknowledge the new Bennett legislation is wider in scope than in previous years.

"It seems to deal with more physical process, vs. training or paperwork," said Peggy Rigsby, a Florida Health Care Association lobbyist. "This is grander, bigger, more visual."

And, to opponents, more potentially damaging.

"I can't believe a senator in good conscience could try to exempt a nursing home from inspection by the Department of Health or the Fire Marshal," said Anna Spinella, chairman of Advocates Committed to Improving Our Nursing Homes, a Tampa consumer group. "The watch list, for instance, was very important, because you could look and see if a bad incident at a facility was isolated or re-occurring."

Several agencies and groups that would be directly affected by the Bennett and Roberson bills -- AARP, AHCA and the Fire Marshal -- said they are reviewing the legislation.

"The CFO supports adequate regulation of nursing homes and other facilities serving the elderly and expects the regulators to be zealous in their work," said Kevin Cate, a spokesman for state Chief Financial Officer Alex Sink, also the state Fire Marshal. "Any legislation that diminishes protections for seniors would be of concern. However, at this time, the office has reserved judgment."

Both AHCA spokeswoman Shelisha Durden and AARP legislative representative Leslie Spencer said their groups have yet to complete reviews.

Rigsby, the health care association lobbyist, noted that the state ombudsman, whose advocacy for residents dates to the Older Americans Act of 1965, would still be allowed access to nursing homes at any time if the bill passes. She said that the state's "watch list" largely duplicates a federal five-star rating system that provides consumer information on nursing homes.

While AHCA deficiency classes would be eliminated, fines would be maintained, at least under Roberson's bill.

Roberson, meanwhile, described his bill as "a work in progress."

"All bills are imperfect, and if this one would somehow hurt people in nursing homes, then we have to take another look at it," he said.


This story appeared in print on page BN1