Larry Sherberg, a member of the state commission studying elder care, listens to one of the hundred speakers addressing the availability of affordable long-term care at a hearing on August 25 in Tampa.

Nursing home woes burden state

TAMPA - Florida's reliance on nursing homes to care for its elderly is causing trouble now that the industry is faltering.

Florida has created a care system that offers few alternatives to nursing homes at a time when the industry is collapsing under the weight of bad business decisions and verdicts over bad care, a state commission heard Friday.

The outlook for Florida's 678 nursing homes and its growing population of frail elderly remains grim: The state lags far behind its need for nursing home alternatives while the facilities are struggling to pay bills and keep staff.

The commission - appointed by Gov. Jeb Bush and the Florida Legislature - is charged with developing some solutions to the problem by January.

While hearing public testimony and presentations Friday, panel chairman Lt. Gov. Frank Brogan said various remedies will be needed to address the complicated problems.

"There is going to be a shake out," said Larry Polivka, director of the Florida Policy Exchange Center on Aging at the University of South Florida, which is assisting the panel.

"We'd like to avoid some kind of catastrophic collapse."

A new USF study presented to the panel said the demand for long-term care is growing.

More than 1 million older Floridians have no family nearby to take care of them and 347,000 elderly in the state need assistance with daily living, but aren't getting it, the study said.

The study showed that over the last decade, Florida spent less on programs that would have provided home care while spending more on nursing homes.

Even with Florida's reputation as a haven for retirees, the state spends just 25 percent of the national average on long-term care per elderly citizen - about $60 annually for those between the ages of 65 and 85, and $569 for those even older.

Nursing home companies took a cue from the state's spending policy and started building homes to the point that there's now a glut of beds in most urban counties. Now the homes, in debt from adding so many beds and not bringing in the money they'd anticipated, are struggling.

About 13 percent of Florida's nursing home beds are vacant. More than two-thirds of the people in nursing homes depend on Medicaid to pay their bills.

One in four of Florida's nursing home beds are operated by a company in bankruptcy, although none of the homes have closed because of their financial difficulties.

Adding to that problem is that homes are struggling to find and afford insurance to cover their operations. Some nursing home administrators said Friday they are considering going without insurance or selling their Florida homes.

Ed Towey, a spokesman for the nursing home industry's trade group, the Florida Health Care Association, said nursing homes made business decisions to build additional beds at a time when government reimbursements were higher. In 1997, the federal government cut its reimbursements to the homes drastically in an effort to curtail health care spending.

Towey said the public's fear of nursing homes is keeping those who should be in a home from moving into one. People who can afford other types of care, such as an assisted living facility, are taking that option.

The panel also heard from scores of nursing home workers, administrators and even a few patients in wheelchairs that crowded the meeting to plead for help for the homes.