[4alabama] FW: US NEW - Nursing Home Reform Bill

[Judy R. Roy]

A Bill Aims for Nursing Home Reform
By Bret Schulte
Posted February 22, 2008


The byzantine world of the corporate nursing home industry may soon become a
whole lot clearer. A controversial new proposal by Republican Sen. Chuck
Grassley and Democrat Sen. Herb Kohl seeks to force nursing homes to provide
more information about ownership and accountability. If it passes, the
legislation will trigger the largest reform of nursing home care in 21
years. "More transparency, enforcement, and staff training are all needed,"
Grassley said in a statement. "That's what our bill addresses."

In a provision targeted primarily at for-profit homes, the Nursing Home
Transparency and Improvement Act would force nursing homes to file paperwork
clearly stating ownership-something that in recent years has become
increasingly complicated for outsiders to figure out, as private investment
groups have bought up nursing homes and enveloped them in labyrinthine legal
structures. The opaque ownership makes it difficult for regulators to
identify parties responsible for poor care and, more to the point, shields
owners from potential lawsuits. The trend in corporate care was outlined in
a September article in the the New York Times that concluded that care
declined at many facilities operating under such structures.
The bill also seeks to standardize complaint forms, improve reporting on
staffing information, and replace some self-reported information with that
gathered by independent audits. The primary goal is to make it easier for
the public to compare nursing homes, a growing concern as baby boomers age.

But the question of whether or not this bill would fix the problems has
created a rift in the industry and launched a new round of debate over
nursing home reform. The American Association of Homes and Services for the
Aging, an industry group that primarily represents not-for-profit nursing
homes, applauds the bill. That's for good reason. The nonprofit sector is
already required to produce much of the information about finances and
ownership to the IRS to qualify for its tax status. Not-for-profits also
look askance at their corporate peers. "You've got vulnerable people
involved...so the ownership ought to have more of a personal touch," says
Larry Minnix, president of AAHSA. "You can do that through all kinds of
ownership structures, but ownership has to be accountable for the actions of
a nursing home." In a dig at the many equity firms now controlling long-term
care, Minnix adds: "This is not a commodities business."

In particular, Minnix applauds the bill for requiring nursing homes to
provide more cost reporting and nursing staff information. "Nursing staff is
the best proxy for quality, and the public is entitled to that information
because it's [funded by] mostly public dollars" via Medicare and Medicaid.

Meanwhile, the group representing for-profit homes, the American Health Care
Association, is pledging to fight the bill. President Bruce Yarwood concedes
that corporate structures are complex and argues that the AHCA's opposition
is with good reason: Frivolous lawsuits, he says, are forcing nursing homes
to close their doors. "We're trying to move away the low-hanging fruit for
enterprising attorneys to sue us," Yarwood says. He recounts a visit to
Florida, where billboards lined the highways encouraging people to call
attorneys if they suspected wrongdoing at a nursing home. Owners began
shielding themselves from liability, he says. "We got kind of forced into
setting up different organizational structures." Many small owners saw an
opportunity to get out when big investment groups came knocking.

AHCA says the real crisis is not in nursing home transparency but in a
severe shortage of qualified workers. The need for more nurses is widely
agreed upon in the healthcare community. AHCA also argues that a higher
paperwork burden would take resources away from the primary mission of
providing care. Overall, Yarwood argues, nursing home care is improving even
in an environment that is shifting from an emphasis on long-term care to
short-term post-acute care, such as recovery from surgery.

The fight over nursing home reform will continue as the bill works its way
through Congress. Proponents like the bill's chances, in part because it's
authored by the respected Grassley, who is the senior Republican on the
Senate Finance Committee. But Yarwood and others are working on a
counterproposal. Even the AAHSA wants some provisions removed, such as the
bill's call for an increase in civil penalties of up to $100,000 for a
deficiency resulting in death. Delays likely to come from those and other
proposed changes mean, for those waiting for nursing home reform, it could
be 21 years and counting.

Judy R. Roy
Independent Living Resources of Greater Birmingham
206  13th Street S.
Birmingham, AL  35233-1317
Phone  205.251.2223  ext 102
Email  bhamilc1 at bellsouth.net
There are only four kinds of people in the world: those who have been
caregivers; those who are currently caregivers; those who will be
caregivers; those who will need caregivers. - Rosalynn Carter

-------------- next part --------------
A Bill Aims for Nursing Home Reform
By http://www.usnews.com/Topics/tag/Author/b/bret_schulte/index.html
Bret Schulte
Posted February 22, 2008
The byzantine world of the corporate nursing home industry may soon become a whole lot clearer. A controversial new proposal by Republican Sen. Chuck Grassley and Democrat Sen. Herb Kohl seeks to force nursing homes to provide more information about ownership and accountability. If it passes, the legislation will trigger the largest reform of nursing home care in 21 years. "More transparency, enforcement, and staff training are all needed," Grassley said in a statement. "That's what our bill addresses."
In a provision targeted primarily at for-profit homes, the Nursing Home Transparency and Improvement Act would force nursing homes to file paperwork clearly stating ownership-something that in recent years has become increasingly complicated for outsiders to figure out, as private investment groups have bought up nursing homes and enveloped them in labyrinthine legal structures. The opaque ownership makes it difficult for regulators to identify parties responsible for poor care and, more to the point, shields owners from potential lawsuits. The trend in corporate care was outlined in a September article in the the
New York Times
that concluded that care declined at many facilities operating under such structures.
The bill also seeks to standardize complaint forms, improve reporting on staffing information, and replace some self-reported information with that gathered by independent audits. The primary goal is to make it easier for the public to compare nursing homes, a growing concern as baby boomers age.
But the question of whether or not this bill would fix the problems has created a rift in the industry and launched a new round of debate over nursing home reform. The American Association of Homes and Services for the Aging, an industry group that primarily represents not-for-profit nursing homes, applauds the bill. That's for good reason. The nonprofit sector is already required to produce much of the information about finances and ownership to the IRS to qualify for its tax status. Not-for-profits also look askance at their corporate peers. "You've got vulnerable people involved...so the ownership ought to have more of a personal touch," says Larry Minnix, president of AAHSA. "You can do that through all kinds of ownership structures, but ownership has to be accountable for the actions of a nursing home." In a dig at the many equity firms now controlling long-term care, Minnix adds: "This is not a commodities business."
In particular, Minnix applauds the bill for requiring nursing homes to provide more cost reporting and nursing staff information. "Nursing staff is the best proxy for quality, and the public is entitled to that information because it's [funded by] mostly public dollars" via Medicare and Medicaid.
Meanwhile, the group representing for-profit homes, the American Health Care Association, is pledging to fight the bill. President Bruce Yarwood concedes that corporate structures are complex and argues that the AHCA's opposition is with good reason: Frivolous lawsuits, he says, are forcing nursing homes to close their doors. "We're trying to move away the low-hanging fruit for enterprising attorneys to sue us," Yarwood says. He recounts a visit to Florida, where billboards lined the highways encouraging people to call attorneys if they suspected wrongdoing at a nursing home. Owners began shielding themselves from liability, he says. "We got kind of forced into setting up different organizational structures." Many small owners saw an opportunity to get out when big investment groups came knocking.
AHCA says the real crisis is not in nursing home transparency but in a severe shortage of qualified workers. The need for more nurses is widely agreed upon in the healthcare community. AHCA also argues that a higher paperwork burden would take resources away from the primary mission of providing care. Overall, Yarwood argues, nursing home care is improving even in an environment that is shifting from an emphasis on long-term care to short-term post-acute care, such as recovery from surgery.
The fight over nursing home reform will continue as the bill works its way through Congress. Proponents like the bill's chances, in part because it's authored by the respected Grassley, who is the senior Republican on the Senate Finance Committee. But Yarwood and others are working on a counterproposal. Even the AAHSA wants some provisions removed, such as the bill's call for an increase in civil penalties of up to $100,000 for a deficiency resulting in death. Delays likely to come from those and other proposed changes mean, for those waiting for nursing home reform, it could be 21 years and counting.
Judy R. Roy
Independent Living Resources of Greater Birmingham
206  13th Street S.
Birmingham, AL  35233-1317
Phone  205.251.2223  ext 102
Email  bhamilc1 at bellsouth.net
There are only four kinds of people in the world: those who have been caregivers; those who are currently caregivers; those who will be caregivers; those who will need caregivers. - Rosalynn Carter