New Nursing Home Regs For Patient Safety Culture Surveys Are In The Works

By Christine Sexton, Florida Phoenix

August 1, 2025

Florida health care regulators are developing rules to implement a new law that requires nursing homes to anonymously survey their staff about their patient safety culture — a move being heralded by one of the largest watchdog groups in the state.

The Agency for Health Care Administration announced Thursday thatit was drawing up the rules to carry out the new law that was included at the last minute as part of the Legislature’s budget negotiations.

The agency has not released details about the proposed regulation. The notice of rule development is the first step in the process, which can include a public meeting if requested.

AARP Florida State Director Jeff Johnson views it as a “good sign” that AHCA is moving ahead and said AARP will track developments.

“The devil is in the details. Let’s see how the survey is administered. The implementation is really key, and if they’re implemented in such a way that they’re able to actually get what people think is going right and what may not be going right in facilities, then that can be really helpful,” Johnson told the Phoenix.

“And if they’re easily gamed, or if they don’t go into a level of detail as helpful, then it won’t be as helpful. So, there’s still, I think, a real need for us to see what the details of the process looks like and to make sure that it is one that gets the results they want.”

Sen. Colleen Burton filed SB 170 in the 2025 session, a nursing home regulation bill that was a priority for Republican Senate President Ben Albritton. The Senate passed the bill unanimously on April 9. The House, though, never considered the proposal.

AARP supported SB 170 plus additional nursing home bills, including a proposal that would have allowed long term-care facility residents to install electronic recording devices as long as they are willing to foot the bill for installation, removal, and the internet needed to run them. Although endorsed by a House health care subcomittee, the bill ultimately died.

The requirement for the patient safety surveys and administrative fines was passed in SB 2514 after legislators agreed to extend the session to pass the state fiscal year 2025-26 budget. The budget guides state spending from July 1 through June 30, 2026 and includes about a $276 million hike in Medicaid payments for nursing homes.

Patient safety culture refers to the values, beliefs, and norms that are shared by health care practitioners and other staff throughout the organization that influence their actions and behaviors to support and promote patient safety, according to a legislative staff analysis of the bill. Patient safety culture can be measured by staff surveys that assess the values, beliefs, norms, and behaviors related to patient safety that are rewarded, supported, expected, and accepted in an organization.

The new law requires long-term care facilities to conduct patient safety and culture surveys biennially. The surveys must be conducted anonymously “to encourage completion of the survey by staff working in or employed by the facility.” The nursing home industry is required to submit the findings to AHCA and must include in those data the survey participation rate.

Also, the new law authorizes the state to levy a $10,000 administrative fine per violation against nursing homes or headquarters of nursing homes that don’t submit their financial data to AHCA’s financial reporting system. Legislators in 2021 required the nursing homes to start submit finances to the state so legislators can gain a better understanding of the billions spent on nursing home care.

They tweaked the law later to require that the facilities to provide audited financial data that must include the fiscal year-end balance sheet, income statement, statement of cash flow, and statement of retained earnings.

In addition to pushing ahead on the rule for the patient safety culture surveys, AHCA announced Thursday that it’s developing a rule allowing the state to assess the fines.

Johnson said the tandem of changes should help the state gain a better understanding of what’s going on at Florida nursing homes.

“I will say this, given the amount of money that we do commit as a state to nursing homes and the fact that it seems to be increasing rather than shifting into home- and community-based alternatives, it is critically important that we as taxpayers know that we’re getting good value for the money, the tax money, that we’re committing to it,” Johnson said.

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