We previously posted on the importance of government agencies as well as advocacy and watchdog groups in keeping nursing homes and long-term facilities transparent, honest and law-abiding. Surveys, investigations either open or undercover, and the vetting and consideration of complaints of elder abuse from residents or loved ones are all important to this effort.
This reporting and investigatory structure is vital to keeping nursing homes honest and pushing them to improve quality of care to patients so that they may meet and exceed the standards set out by the law and regulations. In a report card released by a Florida-based advocacy watchdog group that reports on nursing homes around the country, the state of Texas was found to be the worst-ranked state in the entire United States, including all 50 states and the District of Columbia. The state of Illinois did not fare all that well in this comprehensive assessment, either. As far as Texas is concerned, however, the worst state in the union for nursing homes and long-term care facilities has at least one member of its state legislature demanding not just for better oversight or moderate crackdowns, but for threats of outright closure of homes that do not meet the proper standards.
The Proposed Law
Texas State Senator Charles Schwertner has proposed measures that would mean an automatic revocation of a nursing home’s license to operate if it reaches a certain threshold of legal or regulatory violations. In general, federal and state governments often order the closing of nursing homes for a failure to meet standards, for excessive violations, and for a failure to make improvements when sanctioned or put on a probationary type of list.
The federal government, through the United States Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS), have jurisdiction to regulate nursing homes and ensure their compliance with those rules if those facilities accept federal dollars through insurance programs like Medicare and Medicaid. In Texas, for example, a nursing home lost that funding after numerous violations and nearly had its license revoked. Homes like that one can only survive if they make the right improvements in terms of cleanliness, food quality, and making and following care plans tailored for each resident. It also includes hiring and retaining responsible staffers who are not negligent and do not abuse the residents. This requires tremendous planning, an organized system, and a commitment to maintaining that system and following the plan. The same home, under a new administrator, eventually had its license renewed.
Senator Schwertner’s plan for nursing homes like the one just mentioned would be a “three strikes” rule. If a nursing home is found by the state’s Department of Aging and Disability Services to have at least three confirmed high-level deficiencies, all occurring on separate days in the same two year span, would have its license to operate revoked by the state. Schwertner believes stricter rules and enforcement will keep nursing homes honest, and shut down the ones that simply are not fit to serve its patients. While it remains to be seen if new rules like this are successfully passed in 2015, perhaps over time Texas can make the slow climb out of the cellar of low ranking states for nursing home care.
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