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NURSING HOME REFORM NEWSLETTER

Feb. 3, 2005

THE GOOD….

What could become an historic new law in Kentucky,

House Bill 208 was introduced in the Kentucky General Assembly and with it the beginning of a new organization to promote reforming nursing home care in the state.

Attempts were made in the 1980s to pass quality staffing standards for nursing homes, but the legislation failed. If HB 208 becomes law it would place Kentucky for the first time with 37 other states that have some kind of state staffing regulations for nursing homes.

The new organization pushing the legislation is called Kentuckians for Nursing Home Reform. It already has its own website -- www.KyNursingHomeReform.org -- and will be actively seeking members and supporters of reform statewide.

House Bill 208 phases in staffing standards over a two-year period. In the first year, for example, nursing homes would be required to have a nurse’s aide for every eight residents on the day shift; for every 12 residents on the evening shift; and for every 18 residents on the night shift.

The legislation also provides for staffing by licensed nurses in certain ratios over the three shifts, and it requires nursing homes to increase the number of caregivers if the acuity of the patients demands more care.

It also sets up a 19-member committee to review the staffing standards annually.

Nursing homes can be fined by the state up to $1,000 day if they do not comply with the regulations.

Staffing in nursing homes is a national problem. A federal survey showed that 90 percent of the nursing homes in the United States do not have sufficient staff.

The problem is mostly with front-line caregivers, the nurses’ aides. Not having enough of them is often cause for dehydration, malnutrition, painful bedsores, falls and bruises. Much of the abuse in nursing homes is abuse by neglect, according to study after study nationwide.

Read the whole bill for yourself. Go to website http://www.lrc.ky.gov/record/05rs/HB208.htm for a detailed summary and click on the bill number to get the entire text.

We will keep you informed about the progress of the legislation.

THE BAD….

The bad news is that HB 208 may have opposition from our old friends at the nursing home associations. I am not sure they really represent the nursing home owners because so many of them are good people. The bill is extremely fair to the owners and what it requires is the minimum that any decent nursing home should be doing already. The industry has used the excuse so long about minimum staffing standards not recognizing acuity changes in the care of residents that we wrote mandated acuity action by the nursing homes into the bill. Now they have to put their money where their mouth is. One legislator has already told us that the nursing home people used the old saw on him that the minimum will become the maximum. That is, if the law says you have to have one caregiver for every eight residents on the day shift that that will become the ratio that the nursing home will never go above or below. That excuse, too, is taken care of by the acuity clause in the legislation. You can also expect the nursing home industry to roll out its multi-million p.r. campaign that will show that they already are doing a great job. But we know this is not true, even though we grant that there are some nursing homes, particularly the not-for-profit ones that are providing good service to residents. If the nursing homes would just spend the money they spend on lobbying against improvements and telling Frankfort and Washington how great they are, there would be plenty of funding to provide all kinds of front-line caregivers.

THE UGLY….

We hope there are no legislators who will vote against HB 208 just because the nursing home industry lobbyists tell them to. This is fair legislation and should be non-partisan. It is an attempt to provide a safe environment for nursing home residents, the least we can do for the 30,000 people who find themselves in a nursing home in Kentucky. We know that the nursing home industry gives money to legislators for their election campaigns, all very legal. But we hope that the legislators will think for themselves and do what is right. It would be indeed ugly if this legislation was beaten back because someone needed an extra buck for his election campaign.

THEN THERE’S HOUSE BILL 270

This is another very important bill that was introduced by Rep. Stein and co-sponsored by Rep. Ruth Ann Palumbo (D-Lexington). It would make it a Class D felony and levy a $5,000 fine on anyone caught intentionally tipping off a nursing home in advance that they will be inspected. This bill is strongly supported by the Cabinet for Health and Family Services and especially Inspector General Robert Benvenuti. A bill just like it sailed through the House last year but stalled in the Senate. With administration backing we are hoping that HB 270 will become law. It is much needed. You can see a summary and the entire bill by clicking on http://www.lrc.ky.gov/record/05rs/HB270.htm

WHAT YOU NEED TO DO.

1. Call your state representative and ask him or her to support and be a co-sponsor in the House of HB 208 and HB 270. Do that right away. If you need to, go to the Kentuckians for Nursing Home Reform website to get the number to call and directions on how to leave a message for your representative.
2. Let us know that you want to be a part of Kentuckians for Nursing Home Reform. We will tell you more later about the organization, but you can go to the website now and get a good taste of what it is all about. Remember it is an organization with no dues and no meetings.

HERO BUTTONS TO:

Rep. Kathy Stein (D-Lexington) for sponsoring HB 208 and HB 270, to Rep. Mary Lou Marzian (D-Louisville) and Robert Damron (D-Nicholasville) for signing up to be co-sponsors. And to Rep. Ruth Ann Palumbo for being a co-sponsor of HB 270. There will be more later.

QUOTE OF THE MONTH

"Already legislators and state agencies are grappling with how to manage the shortfall for the programs that depend on Medicaid. I have great confidence that Kentucky’s bishops will be there as advocates and stewards. I just pray that their voice will be as loud as Vonderheide’s." By Ann Marie Marks in her letter-to-the-editor in The Courier-Journal of Louisville.

P.S.

Seventy-year-old George went for his annual physical. All of his tests came back with normal results. Dr. Smith said, "George, everything looks great physically. How are you doing mentally and emotionally? Are you at peace with yourself, and do you have a good relationship with your God?"

George replied, "God and me are tight. He knows I have poor eyesight, so he's fixed it so that when I get up in the middle of the night to go to the bathroom (poof!) the light goes on, and then (poof!) the light goes off when I'm done."

"Wow," commented Dr. Smith, "that's incredible!"

A little later in the day Dr. Smith called George's wife. "Thelma," he
said, "George is just fine. Physically he's great. But I had to call
because I'm in awe of his relationship with God. Is it true that he gets
up during the night and (poof!) the light goes on in the bathroom, and
then (poof!) the light goes off?"

Thelma exclaimed, "That old fool! He's going in
the refrigerator again!"