Nursing home reforms make good headway

Sunday, May 11, 2003

A decision to relocate a loved one to a nursing home can be an emotional one for family members. Imagine the distress that occurs when problems arise that keep a nursing home from providing a humane level of care.

There are plenty of regulations for nursing homes, but making sure they comply cannot be guaranteed. However, legislation adopted this year by the Missouri Legislature and awaiting the signature of Gov. Bob Holden improves the regulatory landscape, both for nursing home residents and for the large majority of nursing home operators who provide excellent care.

For several years, legislators have been attempting to plug some of the holes in current laws that regulate nursing homes. They have been spurred to enact tougher regulations by victims of bad operators, and they have been spurned by operators of high-quality homes that already are overburdened by rules of every stripe.

Finding a middle ground in such a volatile situation hasn't been an easy task, but legislators led by Senate President Pro Tem Peter Kinder of Cape Girardeau and Lt. Gov. Joe Maxwell have found a way to change nursing-home oversight in ways that are beneficial to everyone.

Much of the opposition in previous legislative attempts has come from nursing-home operators who comply with the rules and whose residents -- and their family members -- are happy with the care they receive. Regulations designed to force changes by unscrupulous operators were seen as unwarranted burdens for those who do a good job.

This time around, great care has been taken to listen to those operators who live up to the expectations of families and regulators alike. As a result, the legislation that the governor has indicated he will sign manages to strengthen the law where needed without unduly burdening well-run nursing homes.

Among the provisions of the reform legislation:

Maximum fines, which haven't been changed in nearly 25 years, are increased to $25,000 a day from $10,000 a day for each day a violation exists.

Operators can no longer escape fines for serious violations by fixing the problem or transferring ownership.

It is now a felony to conceal abuse or neglect.

Whistle-blowers are given new protection from retaliation by their employers.

Owners and their employees will be subject to more extensive background checks.

Homes with good records will have fewer inspections.

This compromise effort addresses most of the major concerns that have been raised by victims of poor care at nursing homes.

In addition, the legislation was helped along by a desire of both Republicans and Democrats to improve the lot of nursing home residents. The Senate vote on the legislation was unanimous. All but one House member voted for it.

This is an example of what can be accomplished when political differences are set aside and when legislators incorporate the best ideas of those they are trying to regulate.

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