While the nursing home industry blames lawyers for the rising cost of liability insurance, advocates for the elderly, the insurance industry and independent researchers argue that the volume of lawsuits against nursing homes indicates otherwise. Between 1993 and 1999, the percentage of homes caught violating Florida's minimum staffing standards for nurses and nurse's aides doubled. Violations of several other requirements increased, along with residents' dependence on staff for assistance with basic life skills such as using the restroom and eating.

The Florida Health Care Association, whose members include most of the nursing homes in the state, developed an ethics code in March 2001 for its members to follow. Approximately 75% of its members agreed to be bound by the code, acknowledging that failure to live up to its standards could result in being thrown out of the association.

Recent proposals in the legislature have addressed concerns about the quality of care in nursing homes. One of these proposals would require that nursing aides provide 2.9 hours of care per patient in a 24 hour period rather than the 1.7 hour current requirement. In addition, the proposal would require nurses to provide 1 hour of care per patient in a 24 hour period rather than the current 36 minutes.

Florida's minimum staffing requirements are below those of eighteen other states according to a California researcher who recently completed a federally funded study of nursing homes. The percentage of nursing homes caught understaffed in Florida increased from 5.6% in 1993 to 12.4% in 1999, more than double the national average of 5.7%.