[gdpawel]

Senators Chuck Grassley and Herb Kohl will reintroduce the Nursing Home Transparency and Improvement Act yesterday. The bill, which would require disclosure of nursing home ownership and operations and give consumers better information about nursing home quality, deficiencies, nurse staffing, expenditures and adherence to federal regulations, will contain most of the provisions that were in the legislation when it was first introduced in February 2008.

However, this version of the bill will not require increases in civil monetary penalties, and the focus on independent audits of facilities that are part of chains has shifted to internal quality assurance and compliance and ethics programs (i.e., self-policing) that include procedures to detect criminal, civil and administrative violations. Congress should increase those penalties to as much as $100,000 if a resident is harmed or dies due to negligent care. If simply composing a typical generic Plan of Correction, often repeatedly, is the only remedy required for verified violations, where is the motivation for the facility to change their practices?

The most critical aspect of nursing homes is the lack of adequate staffing. In simple terms, under-staffing results in the loss of the most basic humane care; i.e., adequate nutrition, hydration, personal hygiene, repositioning to prevent pressure sores, timely and/or correct dispensing of medications. Lack of staffing, in turn, creates a constant high turnover among even the most highly-trained, dedicated workers. Mandatory staffing levels were taken out of last year's bill, apparently to improve its chances of being passed. The emphasis should not be put into simply passing a bill, but rather passing a bill that truly addresses the current shortcomings. Mandatory staffing requirements should be reincorporated into this legislation.

House sponsors of the legislation, Representatives Pete Stark and Jan Schakowsky, are expected to reintroduce their version of the bill in April. Now is the time for caregivers of loved ones in a nursing home, and hopefully anyone else, to call/write their federal legislative representatives to pass this bill, with "mandatory staffing levels."

http://aging.senate.gov:80/record.cfm?id=310113