Nursing homes in Florida are meeting and often exceeding a new requirement to pay their staff at least $15 an hour, but some critics are raising concerns about lower wages being paid to contract workers.

The Florida Legislature last year passed a $293 million Medicaid increase for nursing homes, with the intent to drive higher payments to frontline workers and help address widespread labor shortages.

On Monday, the Tampa Bay Times reported claims by the state’s largest healthcare worker union that at least 40 facilities statewide have not been paying the mandated minimum wage to subcontracted staff.

But a spokeswoman for the Florida Health Care Association told McKnight’s Long-Term Care News that nursing homes were in fact following the letter and spirit of the law, with salaries of employees receiving under $15 an hour specifically exempt by the wage law because they are not directly employed by nursing homes.

“In terms of our certified nursing assistants, just talking to many of our members anecdotally, I don’t know many of them that were paying less than $15, even before the requirement,” said FHCA’s Kristen Knapp. “To be competitive, they needed to pay a higher wage.”

Among contracted CNAs today, Knapp says hourly rates of $18 to $20 are commonly dictated by market demand and ultimately set by staffing agencies. The same, she said, goes for housekeeping and dietary staff hired by service companies who contract with nursing homes.

“We’re in a workforce crisis. We have to be competitive. People have the ability to go down the street and work at the WaWa or Buc-ee’s here in Florida and make a higher wage,” Knapp added. “But the way the law reads, those are subcontracted employees. The law only requires individuals that are directly employed by the nursing home (be) subject to the $15 an hour.”

Service Employees International Union 1199, however, argues that subcontracted employees are also subject to the nursing home minimum wage. The union alleged underpayment at about 40 of the state’s more than 700 Medicaid-certified nursing homes.

That Medicaid contract triggers the wage rule, and it’s been one nursing home employers are happy to meet with the extra state support, Knapp said.

The $293 million in additional funding represented about a 7.8% increase, or about $18 more per patient per day to each skilled nursing facility. One of the state’s goals was to push nursing homes above the $15 hourly threshold before all employers are forced to meet it in 2026, one lawmaker told the Tampa Bay Times.

One legal expert told the newspaper that determining whether the nursing homes and service providers are considered joint employers of contract employees could eventually decide whether all workers should receive minimum wage. But that could require court action.

In the meantime, Knapp said the state’s nursing homes are committed to higher wages and benefits for all workers whose salaries they directly control.

“This is our goal: to be a competitive employer, to be able to recruit and retain,” Knapp said. “That’s why we were so grateful for the Legislature for giving us the ability to do that with the funding increase last session.”