Kinder leads drive for reforming nursing homes

JEFFERSON CITY, Mo. -- A bipartisan group of lawmakers and state officials on Monday unveiled nursing home reform legislation aimed at cracking down on elderly abuse and neglect while improving standards for quality care.

Similar efforts have failed several times in recent years as competing interests sought provisions that were unacceptable to some lawmakers.

Senate President Pro Tem Peter Kinder, R-Cape Girardeau, said the bill he is sponsoring was drafted following input from all interested parties, who agreed to leave points of contention that derailed past efforts out of the debate.

"Both sides have given up things we would rather not have given up to get to this point where we think we have a shot at enacting real comprehensive reform legislation and elder abuse legislation," Kinder said.

The bill's many provisions include making it a felony for nursing home operators to knowingly cover up acts of abuse or neglect and no longer allowing homes to avoid paying fines for serious violations by agreeing to fix problems.

Because of the lax requirements in existing law, Lt. Gov. Joe Maxwell said not a single operator paid a fine last year.

"We're going to make sure the owners and the homes themselves can't avoid the fines by simply correcting the violations," said Maxwell, a Democrat.

Operators would still have the opportunity to fix lesser problems in order for fines to be waived.

The estimated cost of the bill to the state has not yet been calculated.

House Speaker Catherine Hanaway, R-Warson Woods, said Kinder's bill and a similar measure to be filed in the lower chamber this week would provide incentives for good operators by ensuring consistency and fairness in the inspection process, in addition to punishing poor-quality care providers.

"We want to reward the good homes, and we want to kick the stuff out of the bad ones," Hanaway said. "It's pretty simple."

State Sen. Pat Dougherty, D-St. Louis, said families who put loved ones in nursing homes often assume that because facilities are licensed by the state they provide a high standard of care. Sadly, he said, that is not always the case.

"Today the stonewalling that has occurred in the past has come to an end," Dougherty said. "I think the barriers we have seen have come down, and with the passage of this legislation the protections for our elderly will be going up."

The measure requires homes to be inspected at least annually, though more frequently if a home is cited for continuing problems. It gives the Department of Health and Senior Services the power to revoke the licenses of operators who refuse to cooperate with inspectors.

It also requires more extensive background checks of out-of-state operators seeking a license to do business in Missouri, as well as home employees coming from another state, to ensure they don't have a record of problems elsewhere.

"We've got to prevent these bad actors from ever operating in our state to begin with," Maxwell said.

Martha Hicks of the Silver Haired Legislature, an elderly advocacy group, said the bill is an important step toward stemming abuse.

"I don't believe in all these years I've been an advocate that I have seen a better example of consensus and of compromise," Hicks said.

One issue the bill doesn't address is increasing the rate at which the state reimburses nursing homes for caring for residents eligible for public assistance. Attempts to increase nursing home funding have contributed to the failure of similar measures.

Kinder said it is estimated the state underpays homes by as much as $20 per resident per day. Although the state is trying to hold down expenses, Kinder said the issue is one that requires attention at some point.

The bill is SB 556.

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