Part 1: Three Major Nursing Home Reforms Signed Into Law
Posted by PKSD Law Firm on April 1, 2010 in Nursing Homes and Elder Rights
Part 1 of 3
With the signing of the health care reform bill, three paramount nursing home reforms became law. The Nursing Home Transparency and Improvement, the Elder Justice Act, and a national program of criminal background checks on long-term care workers all became laws with President Obamas signature last March.
While most of these programs were years in the making, most of the provisions are expected to be in place only after one or two years of regulations development a critical part of the implementation process because regulations will spell out the details of how the law will be enforced.
Here are the significant reforms.
Nursing Home Transparency and Improvement
This law will provide consumers a substantial amount of new information about individual facilities. Key provisions include:
- Public disclosure of nursing home owners, operators, and other entities and individuals that provide management, financing, and services to nursing homes.
- Establishment of internal procedures by nursing homes to reduce civil and criminal violations and improve quality assurance.
- Collection of staffing data electronically from payroll records and other verifiable sources and public reporting of hours per resident day of care and turnover and retention rates.
- Improved public information on Nursing Home Compare, including staffing data for each facility that includes hours of care per resident day, turnover, and retention rates.
- Links to facilities survey reports and plans of correction on state websites; summaries of complaints against facilities, including number, type, severity and outcome; a standardized complaint form; and adjudicated criminal violations by facilities and their employees inside the facility, including civil monetary penalties levied against the facility, its employees, contractors, and other agents.
- Establishment of a consumer rights information page on Nursing Home Compare, including services available from the long-term care ombudsman.
- A review of Nursing Home Compares accuracy, clarity, timeliness, and comprehensiveness and modifications of the site based on the review.
- A Government Accountability Office study of the Five Star Quality Rating System.
- Improved timeliness of survey information made available to the public.
- A requirement for nursing homes to make surveys and complaint investigations for three years available on request and to post a notice where they are available.
- A requirement that states maintain a website with information on all nursing homes in the state, including survey reports, complaint investigation reports, plans of correction, and other information that the state or CMS considers useful.
- A statutory requirement for a special focus facility program
- Establishment of methodology for categorization and public reporting of facilities expenditures, regardless of source of payment, for direct care (including nursing, therapy, and medical services); indirect care (including housekeeping and dietary services); capital assets; and administrative services.
- Improved complaint handling, including a voluntary standardized form for filing complaints with the survey agency and ombudsman; and protection of residents legal representatives and other responsible parties from retaliation when they complain about quality of care.
- Escrowing of civil monetary penalties after an independent informal dispute resolution process and pending resolution of further appeals.
- Sixty-day advance notification of facility closure and authorization to continue Medicaid payments pending relocation of all residents.
- Dementia care and abuse prevention in nurse aide training programs.
- Demonstration projects to identify best practices in culture change and information technology.
- Demonstration program to develop, test, and implement federal oversight of interstate and large intrastate chains.
The other programs will be covered in posts over the next few days.