AARP Study: Florida Nursing Homes Show Decline in Nursing Staffing

AARP Florida recently released a comprehensive report of staffing levels in Florida nursing homes that shows a significant decline in nursing professionals without a matching increase in other types of staff. The findings indicate that legislative changes in 2022 have led to nursing homes operating with fewer staff to care for high-need residents. The new law, effective April 2022, reduced the required nursing care provided by Certified Nursing Assistants (CNAs) to 2.0 hours (down from 2.5) and created a new category of non-nursing direct care staff to fulfill part of the overall 3.6 minimum staffing requirement.

Non-nursing direct-care staff include other employees who play a direct role in resident care, such as physical and occupational therapists, therapy assistants, speech-language pathologists, social service and mental health personnel, activities directors and assistants, dietitians, and feeding assistants. While adding new categories of personnel has increased the numbers now counted toward the minimum staffing requirement, it does not appear to have increased the actual numbers of people available to caring for residents, except in a few categories, such as activities staff.

The AARP report is part of an ongoing study commissioned in collaboration with Dr. Lindsay Peterson, an assistant professor at the University of South Florida (USF), Director of the Long-term Care Administration and Aging Sciences Internship Program, and Interim Director of the Florida Policy Exchange Center on Aging.

Read the full report here.

“The decreases of state mandated patient-contact hours in Florida nursing homes are a very disturbing trend, given the clear relationship between staffing and quality of care,” said AARP Florida State Director Jeff Johnson. “It is a huge concern that the new categories of personnel included in direct care have not increased the numbers of people available to care for residents overall or address staffing shortages. To improve quality of care in nursing homes, cooperation is needed among researchers, policy makers, lawmakers, and providers to explore the full range of possible approaches. AARP Florida is the voice of our state’s most vulnerable older adults, and we feel it’s necessary to have a state-level conversation about how to address the rising needs of nursing home residents and be a resource in helping solve the nursing home industry’s staffing crisis.”

“We know that hands-on, personal attention from nursing staff is critical to the health and well-being of people who need care in nursing homes,” said University of South Florida Assistant Professor Lindsay Peterson, Ph.D.  “For decades, Florida has been a leader in ensuring a high level of staffing, compared to other states. Many nursing homes staffed at levels above Florida state minimum requirements, but this appears to be changing as minimum staffing requirements drop.”

There is an urgent need to better understand staffing in nursing homes and how to increase the time devoted to resident care. Nearly two years after the creation of the PCA program, it appears that staffing shortages have not been relieved as expected. AARP Florida recommends coordinated efforts from lawmakers and researchers to find policy solutions and attract more people into the long-term care workforce.

Read AARP's First Comprehensive Snapshot of Nursing Home Staffing in Florida