Objecting to a “one size fits all” model, Florida’s largest nursing-home industry group is opposing a federal proposal that would set staffing standards.

Emmett Reed, chief executive officer of the Florida Health Care Association, sent a letter last week to the federal Centers for Medicare & Medicaid Services that warned most nursing homes could not meet the proposed standards.

“Arbitrary and unfunded mandates such as proposed in this rule will only create access issues, because the staff required in this proposal do not exist, are not projected to exist, and the proposed requirements certainly cannot be met if CMS (the Centers for Medicare & Medicaid Services) is unwilling to provide any additional funding for centers to hire the staff needed to comply,” Reed wrote. “Providers will be forced to limit admissions, at a minimum, and may be forced to close when they simply cannot afford to meet the requirements proposed.”

The federal agency issued the proposal Sept. 1, saying it “seeks to establish comprehensive nurse staffing requirements to hold nursing homes accountable for providing safe and high-quality care for the over 1.2 million residents receiving care in Medicare and Medicaid-certified LTC (long-term care) facilities each day.”

Nursing-home staffing has been a heavily debated issue in Florida for more than two decades, with lawmakers in 2022 revamping state standards.

A key issue has been standards for the amounts of time that certified nursing assistants — workers who provide much of the hands-on care in nursing homes— must spend with each resident. Under the 2022 law, certified nursing assistants must provide a minimum of two hours of direct care per resident per day.

The law kept a requirement that staff members, including certified nursing assistants and licensed nurses, provide a weekly average of 3.6 hours of direct care per patient per day.

But it allowed time spent by other types of workers, such as physical therapists and occupational therapists, to be factored into the calculation.

The federal proposal, for example, would increase the nursing assistants requirement to 2.45 hours of care per resident per day.