Clinton Wants Nursing Home Scrutiny
The Associated Press - By Sonya Ross WASHINGTON, 21 July, 1998 (AP)
President Clinton today announced a series of steps to crack down on nursing homes that fail to give high-quality care to their patients - and to prod states to do a better job in regulating them.
Clinton said he would ask Congress to pass legislation that would require nursing homes to conduct a criminal background check on workers and would set up a national registry of nursing home employees convicted of abusing residents.
The legislation also would allow more employees to receive training in preventing malnutrition and dehydration and reauthorize the nursing home ombudsman program under the Administration on Aging. The ombudsman provides consumers with information such as records of abuse and neglect at poorly run nursing homes.
But the Clinton administration said it would reject Congress' suggestion that state inspectors can be replaced by inspectors from private, accredited agencies. After experimenting with that idea, administration officials have found it would not work.
"They miss too much," said Donna Shalala, the secretary of health and human services. "They actually put nursing home residents in jeopardy. We are concluding, based on that experience, that we should continue with well-trained state inspectors."
The Clinton administration also was taking several steps on its own, such as directing state enforcement agencies to impose immediate penalties on nursing homes that repeat serious violations. Currently, enforcers allow numerous opportunities for such nursing homes to come into compliance.
The Health Care Financing Administration put new nursing home regulations in place three years ago. Since that time, quality of care has improved.
The Department of Health and Human Services was submitting a 900-page report to Congress outlining its findings during that three-year period and making recommendations on how nursing home care can be further improved.
HCFA announced a number of actions it would take to bolster state inspections, including requiring that they be done annually in a less predictable manner - at night or on weekends, for example.
"They inspect every year, but they tend not to vary the time and the date,"
Shalala said. "We've said ... `you've got to have a more random system so
that people are surprised."
Other steps taken by the administration include:
- Targeting nursing home chains with a poor record of meeting state standards, so that they will be inspected more frequently.
- Referring the most serious violations to the Justice Department for criminal or civil prosecution.
- Cutting off inspection funds to states that continually have a poor record of citing nursing homes for substandard care.
- Increasing federal oversight of state inspections, and provide extra training and assistance to state officials.
- Publishing the results of annual nursing home surveys on the Internet.
- Collecting information on patient care in a national automated data system, so that federal and state officials can identify problem facilities earlier.
AP-NY-07-21-98 1456EDT
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