Nursing homes with serious violations could receive fewer inspections under Florida bills

A patient at a Central Florida nursing home near The Villages died after being left out in the sun for three hours.

Another was rushed to a Melbourne emergency room after staff administered anti-psychotic medications at 80 times the prescribed dose.

And at a nursing home between Gainesville and St. Augustine, one patient died after staff waited five minutes before starting cardiopulmonary resuscitation, and another nearly died after he was overdosed on morphine.

Over the last three years, Florida’s Agency for Health Care Administration cited all three low-rated nursing homes with Class 1 violations – the most severe violations the agency can levy. By state law, AHCA was required to ramp up oversight, inspecting the homes every six months for two years.

But that oversight would be cut back under two bills making their way through the Florida Legislature that would reduce inspections at problem nursing homes. Advocates say it's a threat to patient safety. ACHA leaders say they're already going into poor-performing homes frequently and need more flexibility around inspections. 

And with fewer inspections, AHCA’s inspection fine would be cut in half from $6,000 to $3,000.

The nursing home provision is part of a larger legislative push by AHCA to give the agency more flexibility in how it deploys staff across the health care spectrum.

Other parts of the legislation would give AHCA leeway to extend inspection deadlines at highly rated assisted living facilities and exempt “low-risk providers” – nurse registries, home medical equipment providers and health care clinics – with excellent regulatory histories from regular inspections.

Mary Mayhew, secretary of the
 Florida Agency for Health Care
Administration (Photo: Florida
 Agency for Health Care
Administration)

The two bills – Senate Bill 1726 and House Bill 731 – have received little pushback in Florida’s regulation-averse Legislature.

AHCA Secretary Mary Mayhew said in an interview that the purpose of the legislation is to give AHCA the ability to spend less time in good health care facilities and more time inspecting problem providers. The agency’s resources are increasingly strained as the state’s population and the number of health care providers increase, agency leaders said.

“We wanted to make sure that as we look at our workload, that we are able to have a clear focus on higher-risk and poor performing providers,” Mayhew said.

But critics of the legislation worry about the ramifications of cutting back on AHCA’s mandates.

Rep. Margaret Good,
D-Sarasota (Photo: Florida
House of Representatives)

“In my opinion, oversight and inspections are critical to ensuring quality care and that residents are safe,” said state Rep. Margaret Good, D-Sarasota, who was critical of the legislation during an early February health care committee meeting. “I’m concerned that requiring fewer inspections could lead to worse outcomes to those that are most vulnerable.”

The state's nursing homes came under scrutiny in 2017 after 12 residents of the Rehabilitation Center at Hollywood Hills died following a power outage caused by Hurricane Irma.

A 2018 investigation by The News-Press and the Naples Daily News that found dozens of Florida’s worst nursing homes have long records of failing to meet state and federal standards and operate with little risk that regulators will shut them down.

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Nursing homes with serious violations could receive fewer inspections under Florida bills