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Commentary: What to do about health care? Help people in long-term care

This article first appeared in the St. Louis Beacon, Nov. 16, 2009 - One down, one to go! The House health-care bill, America's Affordable Health Choices Act (HR 3200) passed. So, why should you join our effort to keep Nursing Home Transparency in Health Care Reform? To get the Senate Finance Committee Health care reform bill (S 1796 ), America's Healthy Future Act, passed through the Senate next.

The Nursing Home Transparency and Improvement Act -- part of the larger Senate bill -- is one of the most important efforts in more than two decades to improve the care of current and future nursing home residents. Here are some key reasons to support this bill:

  • It's a no-cost bill
  • It would increase public information and require disclosure about nursing home owners and operators, chains and global private investment companies that control more than two-thirds of the industry
  • 1.4 million elders and people with disabilities live in nursing homes, and many are at risk because the owners can't be held accountable for their care and safety
  • We need to help stop profit-seeking investors from competing against residents for resources

FACT: The American population is aging. For a healthy future for America's elders, we need a long-term care system that is transparent and helps individuals make informed choices about services and that provides quality care. Families need to know the names of people who own nursing homes and how to call them to account for the performance of their businesses. People also need access to strong public systems to investigate and correct abuse and neglect.
According to investigators from the Office of Inspector General at the U.S. Department of Labor, complex operating structures really contribute to substandard care in our area nursing homes. The OIG has found as many as 17 companies involved in the operation of a single nursing home. Operating entities usually contract with a management company to perform day to day operations. These complex structures and associated lack of transparency in ownership and management create continual challenges for ensuring accountability and greatly complicate law enforcement investigators.

Serious problems persist and nursing home fines have not increased in over 20 years. Our state, like others, cites nursing homes every year for harming residents or putting them at risk of serious injury or death.

Yet civil monetary penalties - even for negligence or abuse that results in death -- have not been increased since the 1987 Nursing Home Reform Act. Nursing Homes may avoid paying these fines by filing frivolous appeals. The transparency act would escrow these penalties during such appeals and the House bill includes long-overdue increases in the penalties.

Nursing home residents and their families deserve accurate information and better care. The bill would improve access to critical information about how well nursing home providers staff their facilities, make other quality related information available and make it easier for residents and families to file complaints about poor care and treatment. It will also protect them from retaliation.

Some information and statistical data obtained from NCCNHR (formerly the National Citizens' Coalition for Nursing Home Reform).

About the author

Maureen Hill is executive director of the Long Term Care Ombudsman Program.

The St. Louis Long Term Care Ombudsman Program was established in 1979 as an independent, nonprofit public service provider of advocacy services and resource information and advice on nursing homes, regulations and resident rights. It advocates for nursing home residents mediating complaints for quality of care issues.

In the 21 Missouri counties served, there are close to 20,000 residents in more than 300 long-term care facilities. For more information, call the Long Term Care Ombudsman Program at 314-918-8222 or visit www.ltcop-stl.org