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Volume 13 Number 33 News: Nursing Homes A leading nursing home group is calling for changes to a proposed bill in the Senate that would toughen penalties against long-term care institutions and require greater disclosure about nursing home ownership and staffing levels. The American Home Care Association said on Feb. 15 that it supported efforts by Senate Special Committee on Aging Chairman Herb Kohl (D-Wisc.) and Senate Finance Committee ranking member Chuck Grassley (R-Iowa) to improve nursing home care, but said their newly introduced bill, the Nursing Home Transparency and Improvement Act of 2008 (S. 2641), failed to address the most critical needs among long-term care institutions and could impose unnecessary administrative burdens on homes. Kohl and Grassley on Feb. 14 introduced the bill, saying it would improve quality of care in nursing homes and would give consumers more and better information about long-term care institutions. The bill specifically calls for nursing homes to disclose their ownership to consumers and the government and would require annual independent audits of nursing home chains. In addition, Kohl and Grassley proposed new data be added to the Nursing Home Compare Web site, operated by the Centers for Medicare & Medicaid Services, including a standardized complaint form and links to nursing home inspection reports. Under the proposed legislation, nursing homes would be required to provide additional details in their cost reports to the government and provide more information about nurse staffing levels. Kohl and Grassley further called for a new range of penalties for nursing home violations, including fines of up to $100,000 when deficiencies result in death of a resident. Penalties for the least harmful deficiencies would be capped at $3,000. Accurate, Timely Data AHCA responded to the bill, saying that it concurred with Kohl's and Grassley's recommendations that consumers need "useful, objective, and easily understood information," about nursing homes, but cautioned that such information be "up-to-date, accurate, and easy-to-understand for it to be both meaningful to consumers and fair to care providers." AHCA said the quality of care at nursing homes should be determined by the case-mix of patients and the level of care patients require on a facility-by-facility basis. As such, the group recommended that the legislation call for a stronger assessment of nurse staffing levels and address shortages of nurses and other caregivers. In addition, AHCA said that the proposed financial reporting requirements would impose an administrative burden on facilities that would detract from patient care. AHCA also said that lawmakers should require CMS to better use its existing civil monetary penalty authority against nursing homes, rather than create a new penalty structure that could "significantly impair or event bankrupt some facilities." "We also agree that the system must be fixed, and look forward to working with Senators Grassley and Kohl, and all long term care stakeholders to help improve this bill in a manner that ensures the best interests of our residents and caregivers, and maintains care quality as our paramount objective," according to AHCA's statement on the bill. Kohl and Grassley introduced the bill shortly after CMS announced Feb. 12 the names of 136 nursing homes that had been targeted as part of the Special Focus Facilities program for underperforming nursing homes (No. 29 HCDR, 2/13/08 a0b6a7b3b0). CMS first announced in November 2007 the names of some of the nursing homes that were included in the Special Focus Facilities program, saying the list of poor performing institutions was compiled using data from health quality surveys. CMS will update the list quarterly.
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