Senior Living Volume 3, Issue 1, Winter 2022

Winter 2022 Volume 3, Issue 1

Senior Living

Where to Next?

Candy Porter’s Part-time Job Fuels Full-time Wanderlust River Garden Hebrew Home’s Culture of Caring Leads to Recognition as Florida’s Best Nursing Home

The Legendary Journey of the REAL “Ron Burgundy”

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W I N T E R 2022

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Contents

WINTER 2022 VOLUME 3, ISSUE 1

Cover Story Next: 20 What’s Candy Porter’s Part-time Job Fuels Full-time Wanderlust

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Whether it’s a wildlife safari on the African plains, the arresting beauty of the northern lights, or the stunning biodiversity of the Amazon River, Porter wants to soak it all in.

By Nick Fortuna

Features Truth: How a Search for Answers Led Mort Crim to Ask 8 The Questions His Movie Character, Ron Burgundy, Never Did

By Nick Van Der Linden, Director of Communications, LeadingAge Florida

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Values Straight from the Mountaintop: River Garden Hebrew Home’s Culture of Caring Leads to Recognition as Florida’s Best Nursing Home

By Nick Fortuna

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A Lifetime of Faithful Service: Penney Retirement Community Resident Dolly Hillman uses Boundless Energy to Help Others

By Nick Fortuna

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Policy Brief: Medicaid Prospective Payment System An examination of the shift in Medicaid reimbursement for nursing home providers.

By the LeadingAge Florida Staff

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26

Departments 7

24

Board Chair’s Message Shining a Spotlight on Our Provider Communities

By D. Bruce Jones, LeadingAge Florida Board Chair Legislative Roundup

By Hayden Dempsey, Greenberg Traurig, Chair, Florida Government Law and Policy Practice

LeadingAge Florida 1812 Riggins Road, Suite 1 Tallahassee, FL 32308 (850) 671-3700 www.leadingageflorida.org LeadingAge Florida Executive Staff President/CEO Steve Bahmer sbahmer@LeadingAgeFlorida.org

Support Our Advertisers

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Advertiser Index

About the cover Westminster Suncoast Resident Candy Porter shows off her impressive haul while piranha fishing in Peru. Read more on page 20.

›

Vice President of Operations Dawn Jimenez djimenez@LeadingAgeFlorida.org Vice President of Advocacy Susan C. Langston slangston@LeadingAgeFlorida.org

Janet Stringfellow, Affordable Housing Chair Kevin Smaage, ALF/HCBS Chair Scott Cairns, CCRC Chair Aimee Hilton, Nursing Home Chair

LeadingAge Florida Officers D. Bruce Jones, Chair Garry Hennis, Chair-Elect Joel Anderson, Immediate Past Chair Teresa Scott, Secretary Steve Kramer, Treasurer

Publication Team

Senior Living magazine serves as a LeadingAge Florida member resource that supports the LeadingAge promise: to advocate, educate, and serve aging services professionals.

Managing Editor Nick Van Der Linden Director of Communications, LeadingAge Florida For advertising inquiries, please contact Katie White at kwhite@thewymancompany.com or (352) 388-7031.

Senior Living is the official publication of LeadingAge Florida. All rights reserved.

Contents of this publication may not be reproduced without permission from LeadingAge Florida.

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Message from the Board Chair

Shining a Spotlight on Our Provider Communities

A

s the new chairman of LeadingAge Florida, it is my privilege to welcome you to the latest edition of Senior Living, a publication of LeadingAge Florida. It is a true honor to serve as chair of this organization of compassionate providers of care and services to thousands of outstanding older adults. We could fill several magazines with the heartwarming stories from our provider communities.

One of those amazing communities is River Garden Hebrew Home in Jacksonville. In this edition of the magazine, we feature three generations of leaders from that organization who have created and sustained a tradition of excellence that has consistently earned them top national and state honors. I have no doubt that in reading their words, you will feel the passion these leaders have for the seniors they serve and the extraordinary team they have built.

We also highlight three fascinating residents who live in LeadingAge Florida member communities. We are excited in this edition of Senior Living to tell the story of Mr. Mort Crim, a resident of Cypress Village in Jacksonville who was the inspiration for Will Ferrell’s character in the movie “Anchorman.” We also profile Ms. Dolly Hillman, a resident at Penney Retirement Community in Penney Farms. Retirement hasn’t slowed Ms. Hillman down as she serves as a guardian ad litem, a missionary, a campus volunteer, and an educator. Joining Ms. Hillman in her active ways is Ms. Candy Porter, a Westminster Suncoast resident who eschews retirement to fund her wanderlust. I hope these stories inspire you.

Finally, we will give you a preview of the 2022 legislative session. In addition to offering a sense of the political landscape in Florida and key priorities for the governor and leadership, we’ll also prepare you for a busy legislative session with an overview of LeadingAge Florida’s legislative priorities.

I sincerely hope you enjoy this edition of Senior Living. If you know of a story waiting to be told in a future issue, please let us know!

D. Bruce Jones LeadingAge Florida Board Chair

“It is a true honor to serve as chair of this organization of compassionate providers of care and services to thousands of outstanding older adults. We could fill several magazines with the heartwarming stories from our provider communities.”

S E N I O R L I V I N G • W I N T E R 2022

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Mort interviewing Philippine President Ferdinand Marcos at the Manila Summit Conference.

Mort covering news with producer Harvey Ovshinsky in Cairo, Egypt.

The Truth

How a Search for Answers Led Mort Crim to Ask Questions His Movie Character, Ron Burgundy, Never Did

By Nick Van Der Linden, Director of Communications, LeadingAge Florida

A

fter more than 60 years since he launched a career in broadcast journalism, Mort Crim still has stories to tell.

As a national ABC correspondent, Crim anchored the network’s highly-regarded morning news show. During that time, he covered America’s manned space program. When Neil Armstrong took his first step on the moon in 1969, millions worldwide listened while Crim described the historic event.

Interestingly, though, that is not what most people recognize him for today. Instead, most people know his name as the inspiration for

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the perfectly coiffed, irreverent television anchorman character Ron Burgundy.

“Will Ferrell saw an interview I did with Lifetime channel for a documentary about the late Jessica Savitch, which gave him an idea for the movie ‘Anchorman,’” Crim said. “He took the idea to [‘Anchorman’] co-writer and producer Adam McKay, who not only knew who I was but located some old video of my broadcasts. Jessica Savitch was one of the first female anchors of primetime local television in America, maybe the first. Adam and Will sat down, watched old footage, and saw this competitive tension between the male and female

broadcasters. That gave them the idea for a parody, and thus ‘Anchorman’ was born.”

It wasn’t until the months leading up to the premiere of “Anchorman 2,” however, that Crim’s unlikely role in the “Anchorman” movies became known. In an interview with Rolling Stone magazine, Ferrell disclosed that Crim was the person who served as the inspiration for Ron Burgundy’s character.

After that, Crim was bombarded with interview requests, and in the months leading up to the premiere of “Anchorman 2,” he appeared on ABC’s “Good Morning America,” CNN’s “Piers Morgan,” “Fox & Friends,” “Live

with Kelly and Michael,” and countless other programs, describing what it felt like to be the subject of this parody.

“Will invited my wife and me to the [‘Anchorman 2’] premiere in New York and to the party afterwards,” Crim said. “And at the party, when I met him for the first time, he said, ‘I just want to thank you for the good humor you’ve shown. Some guys would be ticked off having their lives parodied that way.’ And I said, ‘Had this been a documentary, I would have been pissed. But as a parody, I enjoyed it as much as anybody.’ But it was all the publicity from this that gave me the idea to write a memoir to tell the real story about this anchor and the parody.”

The Calling At the age of 86, having covered news all over the world for decades, Crim leaned back in his chair, letting out a deep breath followed by “Oh, boy,” when asked the question: “Who is Mort Crim?”

“Well, I could start with the obvious,” he said. “He’s an old guy who’s a grandfather, a father and a husband, and now a great grandfather. He’s a guy who has always enjoyed life and been pretty optimistic. My grandmother had a motto on her wall that said, ‘All Things Work Together for Good to Those Who Love God.’ So, I kind of grew up with that belief, that if you did your best and lived your life the way you should, that ultimately, it was all going to be OK. It’s a philosophy that was ingrained in me from childhood.”

Crim was born into a family of clergy in West Frankfort, Illinois, about 50 miles from both the Kentucky and Missouri borders. His aunt was a

medical missionary, his dad and twin brother were both ministers, and Crim began following on the path of ministry when he was 16.

Before starting college, Crim took a summer job as a disc jockey at KLCN in Blytheville, Arkansas, to earn some extra money. And shortly after starting college to study ministry, it became clear he had too many theological questions to remain in the pulpit.

“Journalism seemed to be a good path to search for truth without any preconditions and where I didn’t have to satisfy a congregation or an audience,” Crim said.

It was his interest in broadcasting combined with the love of the microphone that drew him out of the pulpit and into the newsroom. It was, as Crim describes, “like having a front-row seat to the greatest show on Earth— the human condition and human drama.”

Almost three years to the day after marrying his high-school sweetheart Nicki, he announced to her his intention to leave the ministry. But resigning from the church also caused Crim to lose his ministerial draft deferment. After four months on the job at WTVOTV in Illinois, Crim enlisted in the Air Force.

Into the Wild Blue Yonder From the time he was 10 years old, Crim loved building model airplanes and reading aviation magazines. Airplanes were always a passion for him, a passion that sparked new meaning in his life when he got his private pilot’s license and bought his first airplane at the age of 17. It was a yellow two-seat Aeronca Chief made of wood and fabric and powered by a 65-horsepower engine. It cost $475—money

Mort working as a disc jockey at KLCN in Blytheville, Arkansas.

he had saved from revival meetings and summer construction work.

Crim went into the Air Force with the goal of becoming a pilot, but because he didn’t have 20/20 vision, he did not qualify for pilot training. During his time in the Air Force, he served as a reporter, writer, and broadcaster. At the end of his service, he not only had gained broadcasting experience but a clearer focus on where he wanted to go. At the age of 27, he was ready to fully pursue a career in broadcast journalism.

He completed graduate school at Northwestern University’s Medill School of Journalism, landed a job with New York’s top radio station, WNEW, and soon learned as a rookie that newsroom competition was fierce. He proved to be up to the task, however, and showed that he could write New York-style with the best of them.

After just a year, ABC Radio came calling and hired him to anchor ten network newscasts each week and to report from the field. He quickly became a familiar voice, and when Neil Armstrong took the first step on the moon, people either watched Walter Cronkite or listened on the radio to Mort Crim.

As a national correspondent, he also covered presidential summits and international news and conflicts, including the Yom Kippur War. With the support and help of his friend Walter Cronkite, Crim moved into television as news anchor at WHAS in Louisville, where he later turned down an offer to run for congress and moved to KYW in Philadelphia. It was here that he co-anchored news with the late Jessica Savitch. They were dubbed by the local press “The Dream Team.”

Mort and Will Ferrell at the “Anchorman 2” premiere.

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Crim’s wife Nicki used to say that “the only thing Mort loves more than being on air is being in the air.” She was right. Throughout his career, Crim’s love for aviation never faded. He made extensive use of his own plane to fly to different locations to cover stories, allowing him to be both a reporter and anchor on the same day. Crim later moved to WBBM in Chicago and WDIV in Detroit, where he spent nearly 20 years before retiring from television news in 1997. Sadly, in 1989 Crim lost his wife, Nicki, due to complications from breast cancer.

A New and Different Life Crim now lives in Cypress Village, a lakefront senior living community in Jacksonville, Florida, with his wife, Irene, nicknamed Renee (pronounced REE-nee). It should come as no surprise given Crim’s love for airplanes that he proposed on his airplane mid-flight, with Renee sitting next to him as his co-pilot.

“I made an X on my chart, marking the exact spot over Kentucky Lake where Renee and I had become engaged,” Crim stated in his memoir.

Now, with the luxury and amenities of Cypress Village, Mort says he and Renee enjoy a comfortable routine every weekday morning.

“We’re early risers, and whoever gets up first makes the breakfast trays,” he said. “We have two trays. We always eat in front of the television set while watching the morning news. But whoever gets up first sets out the cereal, the juice glasses, the spoons and napkins, coffee for me, and tea for her.”

After breakfast, Mort often finds himself sitting on the patio overlooking the pond, and he has developed a unique friendship doing so.

Mort’s plane allowed him to be both a reporter and anchor on the same day. He landed more than a plane that day after proposing to his love, Irene, nicknamed Renee.

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“We have a blue heron that is a regular visitor to our place,” he said.

“The pond is full of bluegill and bass, and I fish for bass. It’s all catch and release, but when I catch a bluegill, I’ll sometimes give it to Kevin. That’s what we named the blue heron. He will even come to the bedroom window in the morning and look in to see if we’re up. Sometimes Renee and I will be traveling a week or two weeks at a time. And when we come back within a day or two, he’ll show up. So somehow he knows.”

Mort has since also retired from flying his own airplane but still finds ways to stay busy.

“One of the things I do, I guess, that people might not know is in my retirement from television, I’m producing a lot of videos for my family,” he said. “I spent my career, of course, in front of the camera.

But I also spent a lot of time in edit suites, putting stories together and doing documentaries, so I learned a lot about production and editing.”

Mort said he had old videotapes and films of his kids and grandkids digitized to help with the production.

“For my daughter’s last birthday, I put this together and made a video about her life,” he said, smiling while holding up a CD case with a personalized cover. “I narrated it and put in music and made a real production out of it.”

All of this is, of course, during the rare spare time he and Renee have when they are not traveling in their RV and promoting his latest book, a memoir titled “Anchored: A Journalist’s Search for Truth.”

Those interested in learning more about Mort and his life’s search for the big questions can find and purchase an autographed copy of his memoir at www.MortCrimSpeaks.com.

5/24/21 2:41 PM

Life Just Gets Better at The Glenridge!

Architect’s rendering, subject to change.

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And now, as we evolve to meet the needs of today’s and tomorrow’s older adults, we’re embarking on a major expansion that includes new construction and major refurbishments to our existing campus. Site work is well underway on our brandnew Northside Neighborhood, which will comprise single-family Club Homes and Villas with homesites offering views of lakes, wetlands and upland preserve areas.

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Philanthropic support from the community helps River Garden sustain its mission. Here, (L) Marty Goetz, CEO Emeritus; Mauri Mizrahi, CEO; and (R) Elliott Palevsky, retired CEO Emeritus; stand with donors Linda and David Stein.

Values Straight from the Mountaintop River Garden Hebrew Home’s Culture of Caring Leads to Recognition as Florida’s Best Nursing Home

By Nick Fortuna

A

dministrators at River Garden Hebrew Home for the Aged say there’s no secret ingredient behind the community’s decades-long tradition of excellence—just a steadfast commitment to doing right by people, whether they’re patients, families, or the dedicated employees who consistently provide the highest standard of care to residents.

Nevertheless, the Jacksonville skilled nursing and rehabilitation facility, which

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celebrated its 75th year in 2021, must be doing something special because the accolades keep pouring in.

River Garden was named the best nursing home in Florida according to Newsweek’s 2021 rankings, making it one of 25 nursing homes in the nation to receive the news outlet’s highest possible mark. Similar recognition came from U.S. News & World Report, which assigned River Garden its “best nursing home” designation for 2021-2022.

River Garden is consistently rated a five-star community by the Agency for Health Care Administration and the Centers for Medicare and Medicaid Services, and it has earned the Joint Commission’s Gold Seal of Approval for Nursing Care Center Accreditation and Post-Acute Care Certification.

On the state level, River Garden continues to make headlines. The facility has held the Governor’s Gold Seal Award for Excellence in Long-Term Care every year since the award was

created in 2001—nine times in all. And in January 2021, Gov. Ron DeSantis appeared at the facility to tout the success of the state’s COVID-19 vaccine rollout to long-term care residents. The visit was in recognition of River Garden having vaccinated 97% of its residents and 77% of its staff within the first month of vaccine availability.

Mauri Mizrahi, River Garden’s chief executive since March 2021, said the awards come from infusing the daily work of eldercare with the principles of compassion, conscientiousness, and gratitude. Consistently showing appreciation for hardworking employees has contributed to a winning organizational culture, she said.

“It’s not an accident that this agency has been consistently identified as excellent—not perfect, but excellent,” Mizrahi said. “We are relentless in pursuit of excellence, and we’re uncompromising in support of doing things the right way, and in nurturing and sustaining organizational excellence.”

Built on Jewish tradition With a lush, 40-acre campus in the Mandarin section of Jacksonville, River Garden is a not-forprofit agency sponsored by the organized Jacksonville Jewish community. Its stated mission is to serve residents from diverse religious and ethnic backgrounds while maintaining an environment supportive of Jewish identity and informed

by Jewish values.

The campus includes a 180-bed skilled nursing and rehabilitation facility; an 80-unit independent-living community; a Florida-licensed homehealth agency; a facility for short-stay rehabilitation and outpatient physical, occupational, and speech therapies; an adult daycare; and a charitable foundation providing financial support to residents who otherwise couldn’t afford to live there.

The current size of the facility and the scope of services it provides belie River Garden’s humble origins. The facility began in a remodeled, twostory mansion equipped to care for only about a dozen residents. Active engagement of board

River Garden has a long history serving generations of families. Creating and maintaining strong communication with families is an important ingredient in the quality of care.

members, donors, volunteers, and families has been key to its growth.

Elliott Palevsky, who served as CEO from 1979 to 2004, said River Garden’s organizational philosophy is built upon the Jewish understanding of the Fifth Commandment, which states: “Honor thy father and thy mother, that thy days may be long upon the land which the Lord thy God giveth thee.” To Palevsky, the commandment speaks directly to an intergenerational responsibility to care for the needy and foster a spirit of community.

“It says that if you don’t honor the folks who brought you here, your community cannot last; it will be ruthless,” Palevsky said. “But if you do, then your community will endure. That means making sure that folks who can’t quite do it on their own have a decent place to live, have reasonable care, can maintain their dignity, and can live with purpose. That’s the interpretation in the Jewish tradition, and that was behind the founding of River Garden.”

The River Garden Foundation subsidizes the care of patients on Medicaid, Palevsky said.

“At River Garden, you won’t know the financial class of a person because the value of that person is not based upon their checkbook,” he added. “The value of that person is based on their humanity, and the staff knows it. Rich or poor, you get the same level of care here.”

Long-Tenured Employees Organizational stability in key leadership positions and among staff is one big reason for River Garden’s success, said Martin Goetz, chief executive from 2004 to 2021. He was the community’s associate administrator under Palevsky for 25 years before succeeding him as CEO in 2004.

With an eye toward the future, River Garden recruited Mauri Mizrahi as associate administrator in 2017, and she spent four years working with Goetz before taking the helm in 2021.

During his tenure, Goetz received the 1994 Young Executive of the Year Award and the 2016 Dr. Herbert Shore Award of Honor from the Association of Jewish Aging Services.

LeadingAge Florida also recognized him with its 2003 Distinguished Service Award and 2007 Chairman’s Award.

Despite all the individual awards, Goetz said he’s most proud of River Garden’s consistently low staff turnover, which allows the facility to provide residents with personalized care.

River Garden has approximately 250 employees, and many have been there long enough to know residents’ preferences without looking at their meal cards.

Staff and donors, young and old, join to celebrate ongoing success during the River Garden Foundation Gala, last held in 2019.

The event raises approximately $250,000 each year to help offset the shortfall of Medicaid reimbursement.

River Garden prides itself on offering staff fair pay and robust benefits packages. The facility was providing health insurance, retirement savings accounts, and paternal leave long before those benefits became common in the eldercare industry, Goetz said.

“It’s delusional for management to talk about excellent patient care when their staff doesn’t believe that management cares about them,” he said. “If you want good patient care, you have to take care of the people who are providing that care.”

“Anybody can have a good year, but to be able to sustain it over time speaks to the organizational culture, and that’s the key to this

Employees who achieve 25-plus years of service are recognized by the team with special gifts.

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Staff appreciation events are held regularly, helping everyone feel more like family.

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work because you depend on people to buy into your mission, your vision, and your values,” Goetz added.

River Garden recognizes staffers for their hard work in a variety of ways.

More than a dozen workers have reached the 25-year mark with the community, and each one gets a party in their honor, complete with flowers, gifts, and a visit from the CEO. Employees also get a handwritten note of thanks from the CEO each year on their anniversary, showing them that management knows who they are and acknowledges their contributions.

Employees who go above and beyond may receive a “merit gram” from patients, their family members, or fellow staffers. The note of thanks isn’t just given to the worker and forgotten about, however. Merit grams make their way across the management desk, into agency publications, and land in employees’ personnel files, representing one component of annual performance reviews.

“That kind of feedback is part of building up our staff,” Mizrahi said. “Our staff members stay because they want to be a part of something bigger than themselves, they want to do good for the community, they feel compelled to take care of seniors, they have respect for seniors, and they feel appreciated.”

“The emphasis is on taking care of people—all people,” she added. “You don’t win these awards without being trained to do your job. That’s very important.

But what makes us different is that when you talk to staffers who have worked at other facilities, they say they like working here because of our culture.”

Welcoming the Outside Community The widespread availability of COVID-19 vaccines allows River Garden to showcase its organizational culture to a broader audience. Last September, the facility reopened its doors for Hebrew holiday celebrations, providing a place for several generations of family members to gather together. In November, they were able to host Thanksgiving dinners for families.

On March 27, 2022, River Garden expects to host more than 500 people for its Anniversary Day festivities, featuring a picnic and attractions such as pony rides for children.

“We invite the whole community to our campus,” Mizrahi said. “The purpose is to celebrate River Garden, but it’s a beautiful day of intergenerational fun together.”

Mizrahi said that this focus on providing a welcoming environment for everyone, including staffers, helps to explain River Garden’s success.

“Organizational culture is very tough to measure, but you can measure it by looking at outcomes,” she said. “You can’t just put it on paper; you have to live it, you have to do it every day, and you have to respect people. If you see your employees as commodities, and that’s easy to do in a field where turnover is high, you haven’t got any hope of sustaining the right kind of organizational culture.”

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A Lifetime of Faithful Service Sorority sisters Angela Banks and Clorinde Miller, MD, congratulate Dolly Hillman on becoming a Golden Sorer, representing 50 years of membership.

By Nick Fortuna

I

nspired by faith and driven by compassion, Evelyn “Dolly” Hillman isn’t about to let age or illness stop her from advocating for others. A former guidance counselor and school administrator who spent 15 years abroad as a missionary, Hillman remains focused on helping the less fortunate, and at age 87, she’s still making an impact.

Hillman, a longtime resident of Penney Retirement Community in Penney Farms, volunteers as a child advocate through the Guardian ad Litem program, serves on her CCRC’s board of directors, teaches English as a second language, educates fellow residents about the history of slavery, and provides career counseling to young people through her college sorority—the same one that counts Vice President Kamala Harris as a member.

Though she’s battling leukemia, Hillman said it just isn’t in her nature to slow down, especially since so many people need a helping hand.

“With most of the things that I do, I see that there’s a need, and I think I can make a difference,” she said. “That’s been my life. I’ve never been one to sit back and do nothing, and if I agree to do something, I’m going to do it the very best I can, even if circumstances are difficult.”

For more than a decade, Hillman has been a voice representing disadvantaged children in the Clay County Court system through Guardian ad Litem. Trained volunteers such as Hillman speak on behalf of children who have experienced abuse or neglect, with the goal of helping them find safe, loving, and permanent homes.

In some cases, that means returning children to their parents after they’ve satisfied the court’s requirements, but in many cases, kids are adopted by relatives or new families. In one recent case, Hillman represented an 18-month-old girl who had been removed from her home, helping the child’s aunt gain custody while the parents get their lives in order.

Penney Retirement Community Resident Dolly Hillman uses Boundless Energy to Help Others

Dolly helped Rev. Dr. and Mrs. Samuel Martin, who founded the Pilgrim Baptist Mission in Nigeria, realize their dream of going to Jerusalem.

As a child advocate, Hillman works to determine what’s best for each boy or girl, taking into account their wishes and the available options. The role requires monthly visits to each child’s home to assess their living conditions, an important task largely relegated to Zoom during the pandemic. Prior to that, however, Hillman could be found driving her “old but very reliable” car to homes around the county.

In any single case, Hillman’s recommendations may be the deciding factor in the judge’s decision.

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Volunteers Dr. Mary Albrecht and Judith Smith helped with teacher training in Haiti.

“My role is to be a friend to the child,” she said. “In my years as a guidance counselor in Detroit, I saw some of the difficulties that young people have to deal with, so being a voice for children suits me very well. I think that’s my calling.”

A Hard Worker from the Start Born in Hinesville, Ga., Hillman moved at age 10 to Detroit, where her mother worked as a housekeeper and her father found a factory job before eventually co-owning a gas station. She would graduate from Northwestern High School with honors in 1952. A talented tennis player, she declined to join the school team, choosing instead to assist her family by working as a mother’s helper and later at a butcher shop.

Next up was Wayne State University, where she studied home economics and earned a bachelor’s degree in 1956. While there, she picked up overnight shifts sorting mail for the U.S. Postal Service ahead of the holidays.

After graduating, Hillman returned to her old high school to teach business, arithmetic, biology, history, and family living, a subject that sparked her interest in becoming a guidance counselor. She began taking night classes at the University of Michigan’s satellite campus in Detroit, eventually earning her master’s degree in counseling, as well as a Ph.D. A devout Baptist who accepted Jesus Christ as her savior at age 10, Hillman also felt called to serve. So, after two years teaching in Detroit, she embarked on a mission trip to Nigeria. She spent three years in the rural village of Issele-Uku, teaching home economics and English and supervising extracurricular activities such as school plays, tennis instruction, and the school newspaper.

Though the village had no indoor toilets and only a hand pump for fresh water, Hillman said the experience was well worth a bit of hardship.

“It was incredible and very interesting,” she said. “I had so many different roles in that setting.”

Following that mission, Hillman returned to Detroit and spent two years as a high-school guidance counselor. She said her heart often went out to students facing personal difficulties, whether it was poverty, abusive or neglectful parents, or dating partners engaging in risky behaviors such as dealing drugs.

“The job was challenging,” she said. “The environment for a lot of these students was very difficult. It made me believe that it’s the responsibility of adults to do what they can to help young people when they’re struggling—not to dictate to them, but to give them the opportunity to work through their situations.”

Before long, Hillman became head of her department, supervising the school’s eight guidance counselors. More success quickly followed. She soon was placed in charge of about 30 guidance counselors spread out among several schools, a role she held for five years before becoming an assistant principal at a high school.

Hillman expected to stay in that position for a while, but during her very first year, opportunity knocked once more. She was hired as principal at the Herman A. Breithaupt Career and Technical Center, a new vocational technical high school in Detroit. She remained there for five years before retiring.

The faculty of the Teacher Training College in Issele-Uku, Nigeria, had one female member: Dolly.

Passport at the Ready

Dolly has held several educational workshops on Haiti.

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Having retired at 50, Hillman concluded that she still had decades of service within her. Through American Baptist Churches USA, she spent a year in suburban Paris learning French and then headed to Haiti, where she would live among the impoverished citizens in a home lacking hot water. Hillman traveled across the country providing instruction to school teachers, many of whom had only a sixthgrade education themselves.

Hillman spent eight years in Haiti and an additional year in the Congo before civil unrest required that all missionaries be evacuated. She then took on an administrative role with American Baptist Churches USA, supervising the work of missionaries throughout Africa, Europe, and the Middle East. She held that job for three years, working out of the organization’s headquarters in Valley Forge, Pennsylvania, and

conducting site visits twice a year to various countries where the group had missionaries.

After many years of service to strangers, Hillman finally retired for good, but her work wasn’t done. First, she served as a caregiver for her elderly grandmother in Detroit, and after she died, Hillman moved with her ailing mother to Savannah, Georgia.

Following her mother’s death, Hillman moved to Penney Retirement Community in 2009, and she’s been staying busy there ever since. In addition to her work with Guardian ad Litem, she’s currently serving her third three-year term on the CCRC’s board of directors and works on its nominating and marketing committees. As chair of the nominating committee, it’s her job to identify and recruit talented residents to serve on the board.

Hillman is active with Penney Memorial Church, the CCRC’s worship building, and serves on its scholarship committee, which awards $400 in aid for up to eight semesters to scholarship winners. She also serves as a chaplain, providing spiritual guidance to about a dozen residents.

When she does have spare time, she enjoys learning how to golf, bowling, and attending exercise classes twice a week. She’s also taken up arts and crafts such as stained glass, mosaics and pottery, and on a recent November morning, she was setting up the pottery exhibit for the community’s Christmas crafts show.

“I enjoy pottery because it’s creative,” she said. “We always laugh and say that you never know what’s going to come out of the kiln. I have no prior experience with pottery and no real skill with it, but I’m amazed at the interesting things we can make.”

Still Sharing Knowledge Even in retirement, Hillman is educating others. Once a year, she offers fellow residents a six-week class about the history of slavery, noting that her church in Detroit, Second Baptist, was one of the final stops on the Underground Railroad. In addition, she recently agreed to teach English as a second language to area residents through Bright Star Church.

Hillman remains active with her college sorority, Alpha Kappa Alpha, which has more than 320,000 members in 1,038 chapters scattered across 10 countries. She serves on the group’s awards committee, which honors members for their notable achievements; its connections committee, which helps to register voters and get out the vote; and its education committee, which awards college scholarships.

Through the sorority’s volunteer program, Hillman also helps students and job applicants with career counseling, résumé writing, and interview skills.

Dolly helps teach English as a second language to members of a Haitian church.

Hillman, whose ex-husband is deceased, has two children—Elise Daniels, a school psychologist, and James “Jim” Hillman, a chef—plus two grandchildren and a great-grandchild. She said seeing them, along with cousins in Georgia and South Carolina, is among her top priorities as the pandemic gradually abates. She’s also planning to visit Key West, with a possible second trip to Tybee Island, near Savannah, under consideration.

“You name a place in the world, and I’ve probably been there,” Hillman joked. “I love to travel, and I’ve been all over, but I’ve never gone to Key West, so a friend of mine is planning that trip.”

Looking back, Hillman, said she chose the perfect place to retire—a community that promotes lifelong learning and opportunities to serve others.

“We have so many wonderful activities here, and many of us will try something for the first time when we move here,” she said. “One of the things I like about living here is that the people are so friendly and welcoming. They’re more than ready to reach out, befriend you and assist you in any way they can.”

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WHERE TO NEXT?

Westminster Suncoast Resident Candy Porter’s Part-time Job Fuels Full-time Wanderlust 20

By Nick Fortuna

C

andy Porter was on quite an epic travel run prior to COVID-19, having visited Kenya, Iceland, and Peru within a six-month span before the pandemic shut down air travel.

Whether it’s a wildlife safari on the African plains, the arresting beauty of the northern lights, or the stunning biodiversity of the Amazon River, Porter wants to soak it all in.

Porter, a 74-year-old resident of Westminster Suncoast in St. Petersburg, said memorable experiences like those are the main reason she still works part time. After a successful career in marketing and public relations in Indianapolis, she now works about 10 hours a week for local attorney Stephanie Edwards, managing the website, newsletter, and advertising for a firm specializing in elder law.

A savvy shopper of online travel deals, Porter was always on the lookout for a discounted destination before COVID-19 struck. Now, as the world gradually reopens, she’s socking away her paychecks and eagerly awaiting her next big adventure.

In 2022, she hopes to visit two of her children in the Midwest and take a vacation to Costa Rica. And if another attractive travel package should happen to land in her inbox, well, there’s no time like the present.

“I’m just a curious kind of gal, I guess,” she said with a laugh. “I was very lucky because I was able to check off some items on my bucket list right before Covid slammed the door. I love to travel, and this job helps me do just that. As soon as Covid goes away, I’m going to be back out there.”

Even when she’s at home, Porter usually is on the move. In addition to her part-time job, she manages The Exchange, a thrift store at Westminster Suncoast that benefits the Residents’ Association. Proceeds are used primarily to fund the myriad recreational activities available to residents, but the CCRC’s approximately 200 employees also benefit, Porter said.

“We’re a very active community, and the thrift shop helps to underwrite the cost of a lot of what we do,” she said. “But to my heart, the real purpose is to give our staff members access to quality goods at an extremely low price.”

The Exchange is open for two hours each on Friday mornings and Tuesday afternoons, giving employees working different shifts an op-



Candy shows off her impressive haul while piranha fishing in Peru.

Candy with her granddaughter and “most excellent travel companion,” Taylor Morrison, at one of Iceland’s most iconic and beloved waterfalls.

portunity to shop. One key source of donations is new residents arriving with way too much stuff. More donations come when residents replace old items with new ones or transition to a more advanced level of care within the CCRC, making household items such as kitchenware extraneous.

Porter moved to Westminster Suncoast in 2014, and soon afterward, the three residents running The Exchange learned that she had supervised a thrift store for the Junior League of Indianapolis. Fast forward eight years, and Porter is running the show, supervising a small team of volunteers who sort through donations, price them, set them aside for donation, stock the shelves, and man the store.

“I stepped in and learned the ropes from those lovely ladies, and as they got older or passed, I took over,” Porter said. “A lot of it amounts to shuffling through donations. What’s good?

What’s not? It’s not rocket science, but it’s fun, and we have some great volunteers.”

Porter soon would find herself back in the Midwest, finishing up her bachelor’s degree in German at Butler University while her husband got his medical degree and postgraduate training at Indiana University Medical Center.

She worked as a physiology research lab technician at the medical center during the day, then skipped over to the Butler campus for night classes.

In 1974, the couple and their two infant sons headed to the Philippines, where Morrison would spend two years as an Air Force doctor.

A Midwestern Girl at Heart Born in East Liverpool, Ohio, Porter said she enjoyed an idyllic childhood in a small-town setting but was grateful for the opportunity to attend an all-girls boarding school in Michigan. The rigorous coursework, highlighted by a summer-abroad program in Germany, prepared her to enroll at Duke University, where she met the man she would marry, physician Andy Morrison.

Candy with her 3-year-old black cat, Cleopatra.

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Candy and Taylor pose for a picture while hiking in Iceland.

Stationed at Clark Air Base on Luzon Island, the couple was permitted to fly space available, or Space-A, on Department of Defense aircraft, so they took advantage of opportunities to visit Thailand, Taiwan, Hong Kong, and Japan and to take side trips to India and Nepal.

“It was an amazing, eye-opening experience for me,” Porter said. “It was absolutely terrific. I was in my late 20s when all this happened, and it lit a gigantic fire in me to further explore. I burn to experience all the many wonders and cultures the world has to offer.”

Once back in the United States, Porter began volunteering with the school PTA and local charities and organizations, which led to volunteer opportunities promoting high-profile amateur sporting events in Indianapolis, including the 1982 U.S. Figure Skating Championships and the 1987 Pan American Games. As a corporate-sponsor liaison for the Pan Am Games, she worked on promotions with major companies such as Coca-Cola, developing a reputation as a skilled event promoter.

In 1984, Porter took a job working on promotions for a new television station in Indianapolis, a role she held for two years. Buoyed by that experience, she decided to strike out on her own, establishing a marketing and promotions agency as a sole proprietor.

During that time, she worked on the movie “Hoosiers,” helping to “get butts in seats” for the climactic scene at Hinkle Fieldhouse featuring the state-championship game, an assignment Porter described as “no small task.” She also worked on Hands Across America, the 1986 public fundraising event, and the 1987 Indianapolis International Championships, a major water-skiing competition sponsored by Coors Light at White River State Park.

Eventually, she would merge her agency with that of a business partner who specialized in media and public relations. The new business thrived, attracting local and national clients, including Alcoa Corp., Dick Clark’s American Bandstand Grill, Eli Lilly and Co., USA Track and Field, and the GTE North Classic, a golf tournament on the Senior PGA Tour.

“I got to dabble in all sorts of fun projects and meet so many fascinating people along the way,” she said.

Falling Hard for St. Pete In 2010, Porter left Indianapolis to come to St. Petersburg and help her son Chris expand his medical business. Over the years, she’s enjoyed watching St. Pete grow into a “vibrant city” offering a wide range of activities.

“The restaurant scene is very diverse and creative, and there are numerous museums within a few square miles,” she said. “The cultural scene is just wonderful here, and there’s plenty to do, not to mention that we’re pretty much surrounded by water. The views are astounding, and the sky is almost always blue. What’s better than that?”

At Westminster Suncoast, Porter remains almost as busy as during her career. In addition to chairing the Residents’ Association for three years and running The Exchange, she’s involved with the Suncoast Employee Appreciation Fund, which raises money to give the CCRC’s workers a gift of thanks each holiday season. In 2021, the fund raised more than $100,000 to split among almost 200 staff members based on the number of hours each of them worked that year.

Porter said she “keeps her creative juices flowing by strutting the boards” with the Suncoast Players acting troupe and authoring monthly articles for the Suncoast Journal, a newsletter for residents. She’s also passionate about pets, including her 3-year-old black cat, Cleopatra.

“I come by it honestly,” Porter said. “My paternal—and a bit eccentric—grandmother devoted her life to animals, housing anywhere from 10 to 20 furry friends in her private kennel at any given time. I even had a pet Pekingese named after me.”

Her employer, attorney Stephanie Edwards, also has two office cats. Last year, Edwards established a nonprofit charity called the Caregiver Paws Connection that she runs with Porter. Together, they encourage seniors to adopt animals and provide care for the pets after the person’s passing if it’s stated in the person’s will.

Porter said that when seniors lose a pet, many choose not to adopt again because they fear they won’t outlive that animal, or they might not have the financial resources to care for it. Caregiver Paws Connection aims to help seniors in Pinellas County continue to enjoy the nurturing power of pets, she said.

Over the summer, Caregiver Paws Connection launched its Furry Godparent Program, bringing together local retirement communities, seniors’ church congregations, and no-kill animal shelters to quickly rehome pets. Westminster Suncoast was the inaugural retirement community partner in the Furry Godparent Program, and it recently was certified as the first pet-friendly senior living community in St. Petersburg by Mayor Rick Kriseman.

“We’re delighted with the response we’ve had to our Furry Godparent Program and hope to offer it to more Pinellas County senior organizations as the year progresses,” Porter said.

Having lived at Westminster Suncoast for eight years, Porter said her initial impression of the community hasn’t changed a bit.

“It’s a place where people are friendly and look out for each other,” she said. “It’s just a happy place. That’s what I was looking for, and I found it. The reason I moved to Suncoast was that I wanted to be involved in things. This is a very active community, and it offers me all these wonderful opportunities to still be the best that I can be. I think that’s the key to life.”

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Legislative Roundup: A Recap and Forecast of Florida’s 2022 Legislative Session

By Hayden Dempsey, Greenberg Traurig, Chair, Florida Government Law and Policy Practice

L

egislators closed out the final week of interim legislative committee meetings in December, leading up to the 2022 session, which is scheduled to run from January 11 through March 11.

A number of bills began moving during the interim meetings that could materially

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affect senior living providers. One such measure, which LeadingAge Florida continues to strongly support, would extend the length of time that health care providers receive liability protections from COVID-19 related claims. Another bill would create a family caregiver certified nursing assistant program to both improve

the quality of care being provided by family members at home and offer some measure of relief on workforce needs.

Additional solutions to the workforce crisis—including critical changes to the Medicaid Prospective Payment System and funding for those changes, increased funding for nurse

and CNA programs, and measures to control the rates charged by nurse staffing agencies—are among LeadingAge Florida’s highest legislative priorities in 2022. In December, President and CEO Steve Bahmer was invited to present to the House Health Care Appropriations Subcommittee on the financial health of Florida nursing homes, and the workforce crisis loomed large in his comments.

“Workforce remains our members’ primary challenge, both in terms of the difficulty they have in filling open positions, and in terms of the significant financial impact the labor shortage has had on their operations,” Bahmer told the committee.

Another key bill, especially in the context of the workforce crisis, represents a rethinking of the statutory requirements for nursing home facility staffing. Senate Bill 804, filed by Sen. Ben Albritton, R-Bartow, would expand the list of caregivers who could be included in the calculation of required daily direct care hours. LeadingAge Florida supports the effort to provide staffing flexibility while remaining focused on ensuring the delivery of highquality care.

In November, just as CMS was issuing updated guidance that required nursing homes to allow all visitors at all times, Sen. Ileana Garcia, R-Miami, filed Senate Bill 988, which would limit the circumstances under which providers could restrict visitation. The bill includes a legislative finding that “it is in the best interest of the state and its residents that patients and residents of health care facilities be allowed visitation by visitors of their choosing during their hospitalization or residential treatment.”

The bill outlines six scenarios in which providers must allow visitation, including “any other circumstance [the Agency for Health Care Administration] deems appropriate.” Other bills of interest would address telehealth, ad valorem taxes, and the dispensing of medications in facilities.

During the interim meetings, Gov. Ron DeSantis called on the legislature to hold a special session on COVID-19 vaccination mandates and to strengthen the Florida Parents’ Bill of Rights. Beginning November 15, the legislature met for three days and ultimately sent four bills to the governor for approval.

HB 1B COVID-19 Mandates by Rep. Erin Grall (R-Vero Beach), prohibits private employers from mandating COVID-19 vaccination without providing the ability to opt out of the mandate. It allows employees

LeadingAge Florida Director of Communications Nick Van Der Linden participates as part of a Health Care Workforce Coalition panel discussion in Tallahassee to detail challenges and necessary steps to respond to Florida’s significant long-term care workforce challenges.

to opt out for specific reasons, including medical reasons, pregnancy or anticipated pregnancy, religious reasons, and COVID-19 immunity. Additionally, the bill authorizes Florida’s attorney general to receive complaints and impose administrative fines up to $50,000 per violation if an employee was terminated for refusing vaccination and the employer failed to follow outlined procedures. The bill’s provisions sunset on June 1, 2023.

The legislature also passed legislation that directs the state to develop a plan for state withdrawal from the Occupational Safety and Health Administration (OSHA) within the U.S. Department of Labor. The state plan would need to enhance occupational safety and health by implementing standards that reduce employee accidents, occupational diseases, and fatalities.

These bills and others relating to the governor’s agenda for the special session were signed on November 18, becoming effective immediately.

The new laws created a conflict that forced many providers to choose between complying with a CMS vaccine mandate or complying with state law. That conflict was resolved, at least temporarily, when a federal judge halted implementation of the rule nationwide.

Along with the COVID-19 vaccination protections advanced by Gov. DeSantis in the special session, the governor set his focus this session on boosting teacher pay and expanding workforce initiatives, protecting water resources and battling sealevel rise, and a gas tax relief proposal that exceeds $1 billion for Florida families.

On November 30, Gov. DeSantis announced $400 million in new funding proposals to increase the salaries of Florida’s law enforcement officers, correctional officers, and state special risk firefighters, and to provide $1,000 bonuses for first responders, including law enforcement officers, paramedics, emergency medical technicians (EMTs), and firefighters across the state. The governor also announced $5,000 bonuses to recruit and retain both state and local level law enforcement.

State economists continue to see revenue exceeding their projections, providing legislators with more general revenue to craft the fiscal year 2022-2023 budget. The September general revenue collections were 15.7% over the previous estimate, totaling $442.2 million. Economists are anticipating this growth to slow down, but they don’t believe it will reverse as it did during the height of the pandemic.

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Policy Brief: Medicaid Prospective Payment System By the LeadingAge Florida Staff

I

n 2017, the Florida Legislature adopted a major shift in Medicaid reimbursement for nursing home providers—a shift that altered a reimbursement system that had been in place for more than 30 years. The move was from a cost-based reimbursement system to a prospective payment system.

As its name suggests, the cost-based system generally reimbursed providers for the cost for direct care, indirect care, and operating expenses, subject to certain limitations for annual cost increases and costs within peer groups of facilities based on their size and location.

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The new prospective system (PPS) reimburses direct patient care, indirect patient care, and operating costs, but it does so at a median percentage of costs for nursing homes that serve Medicaid recipients. This means that the majority of facilities within two distinct geographic regions receive the same reimbursement for each component, regardless of what it costs each individual provider to deliver care. This approach aims to standardize the price paid to nursing homes for serving Medicaid residents.

The legislature emphasized the importance of the direct care component of the system by ascribing it the highest median

percentage of reimbursement among the patient care components, at 100% of the median. However, this also means that by design, 50% of providers will receive reimbursements that are greater than their cost of care, while 50% of providers will receive less than their cost prior to any additional adjustments for budget neutrality.

For the direct care component alone, the system shifts more than $108 million away from providers that have invested more in direct care staff and the food provided to residents. The majority of providers that lose funding, as a result, are four- and five-star providers in CMS’ Five-Star Quality Rating System.

Indirect patient care and operating costs are funded at amounts less than the median cost, at 92% and 86%, respectively. These components are clearly insufficient, with more than 50% of providers receiving reimbursements that are below their cost. Indirect patient care includes salaries and benefits for nursing staff who do not provide direct patient care, activities, and social work. The operating component includes medical records, housekeeping, and administrative expenses.

PPS uses these percentages of the median to calculate reimbursements because the legislature required the system to be budget neutral—meaning that existing dollars had to be redistributed among providers. Continued evaluation of these components, especially direct patient care, must be completed to ensure the funding levels are appropriate in light of the changing landscape.

In addition to direct and indirect care and operating costs, PPS includes an add-on component for nursing home quality that could help offset some of the losses from the patient care elements. However, even if providers received the highest possible number of quality points, some providers would still lose funding under PPS—the quality component does not generate enough of an add-on to make up the difference for those highquality providers.

Several of the metrics incorporated into the quality component echo the importance of staffing as it relates to quality. Two out of the 14 measures that make up the quality component are directly related to staffing levels. The direct care staffing measure evaluates the hours of licensed nursing and certified nursing assistant staffing. It was incorporated into the system because high nursing and CNA staffing is consistently associated with better quality in nursing home care and promotes improvement in several of the MDS long-stay measures for residents.

Staffing is at least one element of PPS that illustrates the system’s conflicting priorities.

The system includes incentives to reduce direct care costs, but it also recognizes direct care as essential to ensuring quality of care for residents.

Tom Bell, President of Solaris Health Care Properties, explains the impasse: “So, on the one hand then, the plan recognizes the importance of hours of direct care staffing while, on the other hand, the plan is overtly

penalizing providers that historically provided more direct care staff.”

Due to the significant changes in reimbursement anticipated from the move to the prospective payment system, a transitional methodology referred to as the hold harmless provision was established at the time of implementation with the goal of providing time for nursing homes to adjust to the changes in Medicaid rates.

A five-year phase-in period was adopted for the transition. During the first three years, providers would be reimbursed the greater of their prospective payment rate, or 100% of their September 2016 cost-based rate. In the fourth year after implementation, effective on October 1, 2021, the rates included a reduction to the hold harmless provision, requiring reimbursement of the prospective payment rate or 95% of the cost-based rate.

This 5% reduction will cause a cut in reimbursement for over 220 providers, totaling more than $43 million, or an average of $194,000 per building annually. Fifty-five percent of these providers are four- and fivestar providers in CMS’ Five-Star Quality Rating System. The hold harmless provision is set to expire entirely on October 1, 2023. If no changes are made to the current structure, over 120 providers will see a reimbursement cut of an additional $31 million, or an average of $250,000 per building.

Although the transitional approach was meant to allow time for providers to plan for their new rates, no amount of planning could have prepared providers to decrease costs during this time to account for the 5% decrease in Medicaid reimbursement. Operating expenses and staffing costs increased unexpectedly and substantially due to the COVID-19 pandemic. Nursing homes are in the midst of a staffing crisis.

Based on a survey of LeadingAge Florida members, 90% say they are experiencing workforce challenges, and 75% say workforce is their greatest current challenge. The issues continue to intensify, and LeadingAge Florida members have reported shifting away from using staffing agencies due to the excessive costs and instead are taking nursing home beds offline until they are able to meet residents’ needs and the current staffing standards with their own staff.

In addition to the current staffing challenges, changes are anticipated that could exacerbate the already severe landscape.

Florida’s minimum wage increased to $10 per hour beginning September 30, 2021, and will continue to increase by $1 per year until reaching $15 per hour in 2026. No changes have yet been made to the Medicaid reimbursement system to incorporate the increases in required wages.

The legislature has recognized the challenges nursing homes are currently facing by providing one-time emergency funding.

On November 4, 2021, the Joint Legislative Budget Commission authorized the release of funding to assist nursing homes in dealing with staffing and occupancy challenges caused by the COVID-19 pandemic. However, because the funding was distributed based on the prospective payment system, not all nursing homes realized relief from the additional dollars.

“LeadingAge Florida commends Gov. DeSantis and the legislature for recognizing the critical need for supplemental funding for nursing homes through the authorization of a temporary rate increase,” LeadingAge Florida President & CEO Steve Bahmer said at the time. “The increase in Medicaid funding will provide essential short-term relief for many nursing homes to address the ongoing

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impact of the pandemic, which has included dramatically increased costs, reduced occupancy, and a crisis-level workforce shortage.”

“However, there is still more work to do,” he said. “There are nursing homes throughout the state that will not receive any assistance from this funding increase, even though these facilities are also experiencing the same financial challenges as other longterm care providers. Legislative action is necessary to ensure the nursing homes that will not benefit from the temporary rate increase also receive the funding support that is consistent with the legislative intent of the budget amendment.”

The shifts in Medicaid funding and the COVID pandemic have caused a perfect storm for those providers who experience rate reductions under the prospective payment system.

“The timing of these cuts couldn’t possibly be worse,” said Bell. “Unlike other businesses, including staffing agencies and perhaps even the hospitals, skilled nursing facilities are essentially on a fixed income, with no meaningful mechanism available to ramp

up the rates we charge to offset rising costs.

Federal and state legislators, and the Agency for Healthcare Administration in Florida, set our rates.”

“In the case of Medicaid rates in particular, those rates have long been insufficient to cover the cost of providing care. The current workforce shortages, COVID, and other inflationary pressures on wages are only exacerbating and exposing an already problematic reimbursement shortfall. Because of low Medicaid reimbursement rates, we were never able to compete on wages with the hospitals, and that calculus has only gotten worse.

Now we are struggling to compete on wages with the fast-food chain down the street.”

The direct care component of PPS reimbursement must be increased—and that increase must be funded. That adjustment would help mitigate the increased costs driven by the workforce crisis and the loss of funding of up to 5% for more than 30% of Florida’s nursing homes. And it would help ensure that Medicaid residents in Florida continue to have access to high-quality nursing home care.

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