By the end of 2018, the financial aspects of nursing home administration may have a significant impact on the kinds of patient mistreatment and nursing home abuse that take place at such facilities. This year’s budget increases Medicaid funding to long-term care facilities by almost $130 million. The Florida Health Care Association praised lawmakers for the increase. However, the added funds work out to a paltry $25 per patient. Such an increase may not be enough to make up for the two other changes which may cost nursing homes millions of dollars in the coming fiscal year.
In another legislative development, Florida lawmakers are poised to enact a backup generator requirement for the state’s nursing homes. After Hurricane Irma knocked out power in Hollywood, a dozen people died from heat exhaustion in a sweltering nursing home. Many politicians quickly took up the cause. However, the FHCA estimates that compliance will cost about $230 million. Medicaid may pick up more than half that cost, but the exact amount remains uncertain. Majority Leader Ray Rodrigues (R-Estero) said it was “inherently unfair” for “private companies to improve their bottom line at the expense of the public or their competitors.”
Finally, in October 2018, Florida’s Medicaid programs shifts to the controversial prospective payment plan. This scheme shifts reimbursement to a per-diem amount based on a complex number of factors. The plan also punishes nursing homes for poor results in terms of patient health and recovery times. One industry group attacked PPP as an “ill-conceived plan that would damage Florida’s highest-quality nursing care providers.” LendingAge convinced lawmakers to delay the PPP rollout for a year but could not stop its implementation.
How Economics Affects Negligent Hiring Claims
While all the numbers are not in, it appears as though Florida nursing homes could be in for a lean year. During these times, business owners can either trim expenses or increase revenues. The PPP approach means that taking in more residents may not necessarily increase revenues, particularly if they are high-risk patients.
In the past, such patients were very lucrative for nursing homes. Medicaid reimbursed according to the number of patient contacts. But with PPP, the nursing home gets a flat fee based on the patient population and not on the number of patient contacts. Furthermore, if the patient’s health deteriorates, the nursing home may have to pay a financial penalty.
So, expenses will most likely be cut. Payroll is usually an organization’s largest expense, so this area is a logical target. Cutbacks in this area often lead to negligent hiring. Essentially, a St. Petersburg nursing home cannot knowingly hire incompetent workers. Evidence of incompetence includes:
- Criminal Background: Normally, there must be a relationship between the record and the tort. For example, a DUI conviction is probably not relevant to an assault tort, but an assault conviction is almost conclusive proof of incompetency.
- Work Experience: Employers have a duty to investigate backgrounds in certain cases. That includes employees who routinely have contact with vulnerable elderly individuals. While there is no duty to hire a private investigator, the St. Petersburg nursing home must do more than perform a cursory reference check.
- Education Level: Patient care technicians cannot substitute for nurses, regardless of their respective experience levels. Under state law, there are certain things that only nurses can do.
Economics is a factor in all these areas. A Florida nursing home may hire people with criminal backgrounds, questionable work backgrounds, or lower educational backgrounds because such individuals are cheaper. Ultimately, nursing home residents usually pay the price for these inadequacies.
The Link Between Economics and Negligence
Negligent hiring and negligent supervision, which is discussed below, usually impacts intentional torts. This category includes acts like assault and theft. Unintentional torts, such as falls, also occur in St. Petersburg nursing homes. In fact, over half of nursing home patients slip and fall each year. In many cases, these injuries are very serious. The death rate from falls has increased about 50 percent since 2005.
To attract and retain patients, many Florida nursing homes are almost constantly under construction. For various reasons, nursing home residents are not always aware of “Keep Out” and other warning signs. As a result, they face an increased risk of falls and other injuries.
In a premises liability case, the owner is liable for injuries to business invitees (people who are on the land for commercial purposes) if the employer knew, or should have known, about the dangerous condition. To determine constructive knowledge, most Florida judges use a variation of the time-notice rule. Knowledge is directly tied to the amount of time the hazard existed.
For example, if a person slips on a piece of fresh lettuce in a grocery store, there may be no liability. But if the lettuce was wilted, liability may attach. Other factors come into play as well, such as the presence of slip-proof mats.
What is the Connection Between Economics and Negligent Supervision?
The duty to work with competent employees does not end at the hiring stage. St. Petersburg nursing homes must actively supervise these workers as well. That basically means setting rules and enforcing these rules.
Such active supervision is often absent in Florida nursing homes. Upper management is usually only onsite during daytime hours. Moreover, out-of-state conglomerates own many St. Petersburg nursing homes. So, there may be no upper management onsite at all.
If there is a link between lack of supervision and intentional tort, such as a staff-on-resident assault, the nursing home is usually liable for damages. There’s an old saying that “when the cat’s away, the mice will play.” This saying is not universally true, but it is generally applicable.
Count On Florida Experienced Nursing Home Abuse Attorneys
Even though nursing home residents have no control over nursing home economics, they often suffer as a result of economic negligence. For a free consultation with an experienced nursing home abuse lawyer in St. Petersburg, contact Burnetti, PA. We do not charge upfront legal fees in these cases.