Nursing Home Standards

By 1983, two years into the Reagan government, nursing home reform groups discovered depression. After years of modest progress in nursing home standards, Reagan was proposing the inconceivable — scrapping many health and safety regulatory responsibilities by the federal government and reducing the number of nursing home inspectors and Inspectors.
He went too far. Outraged members of Congress, citing fires, food poisoning, gross neglect and abuse in notorious nursing home scandals in their district, reared back and told the Reaganites “no way the federal taxpayers were paying $6 billion a year to support 1.3 million elderly Americans in these homes. That level of commitment required policies and obligations on state enforcement agencies and the industry that spelled proficiency and security.

Why the prompt response from a Congress that had been falling on its collective knees for months before similarly ignorant or cruel White House moves? Because there was a citizen constituency beck home that put the heat on Congress and the White House. The National Coalition for Nursing Home Reform and its affiliates, The Gray Panther chapters, the National Council on Senior Citizens, the American Association of Retired Persons and the nursing home monitoring organizations established under the Older Americans Act mobilized.

With the expert help of the National Senior Citizens Law Center, meetings and negotiations began with officials of the Department of Health and Human Services. Recommendations ranged from upgrading inspector corps and skills to diversifying penalties to include fines, public notification requirements and receiverships, not just the draconian and therefore little used shut down authority! Also, they pushed for filing nursing home inspection reports in local libraries to advance intelligent choices by families between these nursing homes.

Well, the wheels of bureaucracy and ideology move slowly toward the light. But soon to be disclosed are some major strengthenings of federal standards to nursing homes receiving Medicare and Medicaid. More comprehensive rules for round-the-clock care by on site licensed nurses and a patient’s bill of rights in specific situations — food, complaints, privacy, etc. — are in the offing.

These proposals, which will be subject to a 90 day comment period, rely heavily on recommendations made lest year by the Institute of Medicine of the National Academy of Sciences.

For the elderly citizens living forlorn and sometimes frightened lives in many of these 16,000 nursing home facilities, these forthcoming decisions may alleviate some of their burdens. These decisions came down from on high but they were driven by grassroots below and will succeed only to the extent that these roots stay firm and deep.

For more information on whet you can do, and how you can choose between facilities, send a self-addressed envelope to The Gray Panthers, 311 S. Juniper Street, Philadelphia, PA 19107 or call 215-545-6555.

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