Florida Moves Closer to Repealing Certificate of Need Law for Nursing Homes

The Florida House last week approved House Bill 21, which would repeal certificate of need (CON) laws for health care facilities in the state, including hospitals, nursing homes, and hospices.

The bill now goes to the state Senate, which has historically opposed CON repeal, the Tampa Bay Times noted. The Senate bill, however, does not include nursing homes in the language to eliminate CON, and the House and Senate bills would have to be reconciled at the end of the session so they could actually pass, a spokeswoman for the Florida Health Care Association (FHCA) noted to Skilled Nursing News.

The FHCA is a trade group representing for-profit nursing homes in the Sunshine State; it is the local affiliate of the American Health Care Association (AHCA).


In a statement describing HB 21 as a “bad bill,” FHCA executive director Emmett Reed said the group would continue to tell representatives about CON repeal’s negative effects.

“Repeal of Certificate of Need requirements in other states has done real harm to elder care there,” Reed said in the statement.

The rules limit the number of health care facilities that can be built in a specific state or region. Opponents of the laws argue that they artificially cap competition in the health care space; just last year, three prominent members of the Trump administration called for the repeal of CON laws, characterizing them as detrimental to consumers and anti-competitive in a report on health care reform.


Florida House Speaker Jose Oliva, a Republican from Miami Lakes, has prioritized the bill; he and other House Republican leaders argue that ending CON rules is a crucial part of keeping health care costs down, the South Florida Sun Sentinel reported.

CON boosters, meanwhile, typically note that health care shouldn’t be treated like any other consumer good, with unchecked construction of nursing facilities potentially leading to oversupply — while also diluting the overall quality of care by attracting subpar operators.

Reed pointed to the effects of CON repeal in Indiana, which he said led to the development of new skilled nursing facilities with beds that ultimately went unfilled. This overproduction and lack of demand put a strain on the state’s Medicaid budget, he said, ultimately leading lawmakers to backtrack and reinstate its CON law in 2018.

“Empty beds don’t exempt the centers from the high cost of remaining open — and the burden ultimately will fall to the taxpayers,” Reed said.

At present, 38 states and the District of Columbia have some type of CON law, according to a report from the National Conference of State Legislatures dated February of this year.

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