Florida’s Agency for Health Care Administration is the state agency that licenses nursing homes. The number of nursing homes in the state is strictly regulated through a “certificate of need” program, which greatly limits the number of new nursing homes in the state. Creating an artificially low number of nursing homes is adverse to the free market and has a very negative effect on consumers of nursing home care. As lawyers handling nursing home cases throughout the greater Jacksonville area, we have seen this firsthand.
The free market should dictate how many nursing homes are in operation through standard principles of supply and demand. If there are too many nursing homes and they are having trouble filling their beds, investors will not be encouraged to open new ones. On the reverse side, if investors see that poor quality nursing homes are essentially full, they will open new nursing homes to provide better care and obtain a significant market share. This is how almost all commerce happens in the United States,whether it be restaurants, gas stations or new home construction.
However, this is not the case with nursing homes. The total number of nursing home “beds” in the state is keep at such a low level that even the worst nursing homes have high occupancy rates. This is because the nicer nursing homes are full and people are left with no other option but to reside in an inferior, underfunded and often outdated facility.
Here in the greater Jacksonville area, AHCA has received the highest number of new applications for nursing homes in St. Johns County, one of the fastest growing counties in the entire United States. Close to 20% of St. Johns County residents are over 65 years old. There are currently 8 skilled nursing facilities in operation in the county. Applications have been filed for six additional facilities in the county. So far, only one application has been approved despite the quickly growing population.
One would think the State of Florida would be very accommodating to its senior population as the state derives significant economic benefit from the huge number of retirees that move into the state. It is not. This is because the nursing home lobby dwarfs the voices of the elder population. That lobby, with its extensive connections and funding, has kept Florida friendly to nursing home operators at the expense of the quality of care provided to nursing home residents.
One example, is that, while the Florida legislature felt the obvious pressure to require that nursing homes carry professional liability insurance, it passed a law requiring such insurance; however, there is no minimum level of coverage required by the statute. Technically, a single dollar of coverage satisfies this condition, and, frankly, this is essentially what we see.
An insurance policy of nominal value, say $25,000.00 of single limit aggregate coverage for multiple nursing homes, is very common and satisfies the requirement yet provides no meaningful coverage whatsoever. Sound farfetched? In the majority of cases handled by our Jacksonville nursing home neglect attorneys, there is no recovery made from an insurer. Rather, the recovery must come from the nursing home operators directly.
Many of the nursing home operators are merely shell companies designed to limit the parent companies’ legal exposure. A shell company with little to no assets cannot fund settlements or pay verdicts in the event of neglect or abuse resulting in injury or death. The end result is that the consequences of nursing home neglect are minimized resulting in a decreased incentive to provide high quality care. Continue reading