It was praised as a solution to Florida’s nursing home staffing crisis.
Thanks to a state budget provision, employees of long-term care facilities receiving Medicaid funds would earn $15 an hour minimum wage, starting in October.
But months later, nursing homes and workers’ groups are still arguing over which employees should be paid the higher rate.
The state’s largest health care worker union has accused Florida nursing homes of wage theft, claiming at least 40 facilities statewide are not paying subcontracted staff the mandated rate.
Long-term care facilities, in turn, have said these workers aren’t technically their employees.
The stakes are high. As of this month, nursing home workers who believe they’re being underpaid, in violation of the new rule, can sue their employer for back wages.
At the start of 2022, Florida nursing homes faced a dire staffing shortage.
In January, the industry group Florida Health Care Administration told the Tampa Bay Times that more than 85% of its member nursing homes had to limit new admissions because they didn’t have enough staff.
Lawmakers proposed a possible compromise in the state budget: In exchange for additional Medicaid funding, nursing homes would be required to pay workers a minimum $15 an hour.
Favored by the nursing home industry and worker unions alike, the higher pay was designed to encourage employees to seek out — and stay with — long-term care facilities.
Lawmakers passed the increase to support staff and ensure nursing homes could be competitive, said Kristen Knapp, spokesperson for the Florida Health Care Administration, which represents over 80% of nursing homes statewide. “So with it comes the requirement that everybody goes to the $15 an hour wage.’ ”
Lawmakers hoped the increase would curb future requests for more money from the nursing home industry in 2026, then-Sen. Kelli Stargel told the Times in March, when Florida raised the minimum wage for all workers to $15 an hour.
“We’re trying to make them plan ahead and make sure that they’re prioritizing that $15 an hour now, as opposed to coming back to us with the sky falling in a few years,” Stargel said.
Which workers count?
Under the new rule, most providers receiving Medicaid money are now required to pay “direct care” workers $15 an hour.
But nursing homes need to pay their entire staff the higher rate — including “1099 employees,” a term that typically applies to independent contractors. Exactly who counts as this type of employee — and who is considered their employer — is at the center of the pay debate.
Nursing homes often rely on subcontractor companies to hire housekeeping and dietary staff. These workers are paid by the subcontractor, not the facility directly.
Service Employees International Union 1199, which represents health care employees, claims that these subcontracted employees are not being paid the new minimum wage at a handful of facilities where they have members statewide, including seven in Tampa Bay.
Because they’re working in a nursing home, the organization says, these workers must be paid $15 hourly under budget requirements — regardless of who is footing the bill.
“People are leaving these facilities,” said Karen Scott, an organizer with the union, which represents roughly 25,000 health care workers in Florida. “Because they can go down the street and get more.”
Knapp, of the Florida Health Care Association, said nursing home providers have no control over what subcontractors pay. The industry group contends that the new pay requirements only apply to direct hires of a facility.
“They’re not our employees,” she said of subcontracted staff. “They’re contracted employees.”
Untangling which workers need to be paid the new minimum wage is complicated, according to Jason Bent, a professor of employment law at Stetson University.
The budget language may allow room for interpretation, he said.
It’s a question of who the state considers the employer of these nursing home workers, Bent said. It’s possible only independent contractors who are paid directly by a nursing home are covered, not an outside staffing company.
But if a subcontractor and a nursing home are considered joint employers, these housekeeping and dietary staff might be protected under the $15 wage requirement.
The Agency for Health Care Administration, which regulates nursing homes operating in the state, did not respond to multiple requests for comment.
It’s possible these questions will be resolved in future lawsuits, Bent said.
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This story was originally published January 23, 2023, 1:58 PM.