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State of the nursing home industry

The Nursing Home Reform Act (or OBRA ’87) was passed 20 years ago and a hearing was held earlier this month to discuss the state of the industry now, in 2007. Senate Special Committee on Aging Chairman Herb Kohl (D-WI) spoke to the inadequacies of a system that has allowed dangerous and poorly performing nursing homes to escape penalties, and announced his intention to introduce legislation that would enact a better system of background checks for nursing home employees.

The Government Accountability Office’s testimony was similar, noting that because these poorly performing nursing homes are not held accountable through sanctions or penalties, they do not have an incentive to improve care. The GAO also alleged that nursing homes that have made an effort slip back into poor performance, while many have made no progress at all.

Friends and Relatives of Institutionalized Aged (FRIA) also presented testimony. FRIA is a consumer resource for free information and assistance on long term care that has worked hard to reform the industry. FRIA added that the population of people over 65 years of age is projected to double by 2030, making the need to address long-term care issues all the more urgent. However, instances of nursing home abuse and neglect are also on the rise.

Staffing, for instance, is only required to be “sufficient” by federal laws. The Centers for Medicare and Medicaid Services recommended a bare miniumum standard, which was found to be met by less that 10% of homes nationwide. According to the GAO, more than 300,000 elderly and disabled residents live in chronically deficient nursing homes where they are “at risk of harm due to woefully deficient care.” These agencies complained that the government is not taking enforcement seriously, which should be non negotionable and swiftly pursued.

Additionally, financial transparency is not required of or practiced by the nursing home industry. The federal government pays near $50 billion dollars a year to the long-term care industry, yet there is not accountability or transparency regarding how these dollars are spent. This aid is being cut down, instead of redirected and restructured. New York, for instance, will lose over 1,200 nursing home beds by 2008 even though its senior population is increasing. Chicago is another example of a city cutting health care funds and putting those in need of long-term care at a serious disadvantage.

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