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Understanding Nursing Home Care Requirements in Florida

Understanding Nursing Home Care Requirements in Florida
Elder Law
Jason Neufeld
May 19, 2025

Your loved one deserves the best possible care in a nursing facility. While many administrators provide excellent support, some may misrepresent Medicare coverage rules. This guide clarifies federal nursing home requirements and your rights in Florida.

Federal Requirements for All Nursing Facilities

Every nursing home in Florida must follow the Medicare Nursing Reform Act, which mandates that facilities:

  1. Provide services needed for residents to attain or maintain the highest practical physical, mental, and psychosocial well-being
  2. Deliver these services regardless of payment source (no discrimination based on Medicaid status)

The "Plateau" Myth in Therapy Services

The Truth About Continued Care: Many families hear this incorrect statement from nursing homes: "Medicare won't pay anymore because your loved one has plateaued in therapy."

This statement contradicts federal law. The Medicare Nursing Reform Act doesn't require improvement to justify ongoing therapy. The deciding factor is whether continued skilled therapy will maintain your loved one's condition or prevent decline.

The Landmark Jimmo v. Sebelius Settlement

In 2013, a class action settlement with the Centers for Medicare & Medicaid Services established:

"Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent further deterioration or preserve their current capabilities."

This means nursing facilities cannot discontinue therapy simply because a resident isn't showing improvement.

Advocating for Your Loved One

When a nursing home claims they must discharge your loved one due to "lack of progress," you can:

  1. Reference the Jimmo v. Sebelius settlement
  2. Remind them that federal and Florida state laws protect continued care for maintenance purposes
  3. Point out that lack of progress often indicates a need for more therapy, not less

Why This Matters

Ensuring your loved one receives appropriate therapy prevents premature removal from settings providing the highest practical level of care. Proper advocacy protects their rights and maintains their quality of life.

Additional Resources:

Contact our Florida elder law attorneys today for personalized guidance on nursing home rights and care planning.

Jason Neufeld

Jason Neufeld is a Board-Certified Elder Law Attorney and the Managing Partner of Elder Needs Law, PLLC, a Florida Medicaid Planning, Estate Planning, Special Needs Planning, Probate and Elder Law Firm.

Jason is an award-winning Elder Law attorney and leader among Medicaid Planning and Estate Planning attorneys (he is on the Board of Directors for the Academy of Florida Elder Law Attorneys and Co-Chairs the Broward County Bar Association Elder Law Section). The firm serves the entire State of Florida remotely or at any of our physical locations. Interested in additional free or low-cost information. Check out Jason's Book or free educational videos

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