A serious shortage of workers at nursing homes affects every Floridian who wants a loved one to get quality care, and state lawmakers deserve credit for providing a straightforward solution to start addressing this urgent health care crisis.
Unfortunately, that commendable effort has not worked out as intended, and nursing home workers and their patients are being shortchanged by some supplemental staffing firms that have embraced a low-cost, high-risk business model using 1099 workers instead of W2 employees.
As the Tampa Bay Times reported, the Florida Legislature recently approved budget language that aims to ensure long-term health care facilities receiving Medicaid money pay workers a minimum wage of $15 an hour. This move was designed to keep more people working in long-term care settings. The change took effect in October 2022, yet many workers have not received the pay increase they deserve.
The reason: A dispute over the definition of who qualifies for the $15 an hour minimum wage. Is it only employees of the nursing homes, or is it also individuals hired by outside firms as independent contractors to work in the facilities?
Welcome to one of the potential hurdles of the gig economy. As a state, we need to get this right.
Given the shortage of available workers, the temptation to cut corners in staffing practices is palpable. With nursing home staff members facing extra health care risks and additional stress during the pandemic, the number of workers in nursing homes and other health care facilities dropped by 410,000 nationwide between February 2020 and November 2021, according to the federal Bureau of Labor Statistics.
This shortage has dire consequences for Floridians. An industry organization told the Times in January that 85 percent of its nursing home members limited admissions because they did not have enough staff. That puts a real strain on individuals and families searching for quality nursing home care.
As someone who has been on the forefront of health care staffing for three decades, I believe temporary staff who are working alongside a health care facility’s own employees should be W2 employees, as well. They should not be treated as 1099 workers, so the staffing company can avoid employee-related costs. But that’s what’s happening, and it’s putting health care workers and facilities at risk.
There are significant legal, financial and quality consequences to this practice. Health care providers opting to engage 1099 temporary staff may be subject to labor law and malpractice claims, unpaid payroll taxes and unpaid workers’ compensation liability. The 1099 workers, whose work-related tax and insurance obligations are not handled by these companies, are also in jeopardy.
However, health care providers and workers do not need to expose themselves to these risks. Health care providers that rely on W2-employed temporary staff ensure all workers have essential protections of employment, including minimum wage laws, overtime pay, health insurance options, Social Security, Medicare and federal income taxes are paid.
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Much-needed practitioners are leaving the industry in droves due to understaffing and overwork. By placing more nursing home staff in flexible working conditions with W2 protections, we can begin to chip away at the shortage and keep more qualified clinicians in the workforce.
Until that happens, more action is needed to ensure we can continue fulfilling an important mission that affects the lives of thousands of Floridians every year. The Florida Legislature convenes its annual session in March, and state lawmakers will have the opportunity to ensure that clinicians working in nursing homes are paid at least $15 an hour and working as employees, with all the protections that employment brings.
Ensuring all Florida clinicians working in long-term care facilities earn the minimum wage and other protections they deserve is an important step to ensuring people get the care they deserve. It will benefit those essential workers and all Floridians who are entitled to be treated with quality care and dignity in their time of need.
Tony Braswell is president and founder of Gale Healthcare Solutions, a health care staffing company based in Tampa.