New legislation being introduced in Congress is aimed at improving care in nursing homes, in part by increasing transparency about who owns and operates the facilities and increasing financial penalties for serious quality deficiencies.
Sens Herb Kohl (D-Wis) and Charles Grassley (R-Iowa) have introduced the Nursing Home Transparency and Improvement Act of 2008. They said the legislation seeks to improve quality of care by providing more and better information for consumers.
The legislation represents increased pressure from the federal government on nursing homes to improve quality. Last week, the Centers for Medicare & Medicaid Services released plans for improving care in nursing homes and other facilities for its beneficiaries through CMS's contracts with its Quality Improvement Organizations.
Also, on February 12, CMS officials identified more underperforming nursing homes, a follow-up to their announcement last November of "special focus facilities" that had failed to improve significantly in quality performance.
Nursing home data is published by the federal government on the Nursing Home Compare Web site.
"The federal government now spends $75 billion annually on nursing homes through Medicare and Medicaid, and spending is projected to rise as costs associated with the boomer generation increase," Kohl said. "Congress has a responsibility to demand high-quality services for residents and accountability from the nursing home industry in return for this huge investment of public resources."
The proposed legislation would:
• increase transparency about nursing home ownership and operation by enabling the public to know who owns the facilities;
• provide more transparency of a nursing home's expenditures by requiring more detail in cost reporting;
• enable the government to levy penalties of as much as $100,000 for deficiencies resulting in death, as much as $25,000 for deficiencies causing "actual harm or immediate jeopardy" and not more than $3,000 for other deficiencies;
• sets deadlines and requirements for paying penalties;
• improves staff training and requires study on increased training requirements; and
• requires a study on the role that financial issues play in poor-performing nursing homes.
The country now has more than 17,000 long-term care facilities caring for approximately 1.7 million elderly and disabled individuals.