If only Congress could pass a law that would guarantee the well-being of each and every resident living in a U.S. nursing home. Nearly 1.7 million nursing home residents and their loved ones could rest easier if it were only that simple.
About 10 years ago, I started a crusade to raise public awareness about shortfalls in the inspections and enforcement system overseeing the nation's 17,000 nursing home facilities. As then-chairman of the Special Committee on Aging, I conducted congressional oversight hearings that exposed acute negligence and cases of substandard care in an industry that serves the most vulnerable members of society.
When families make the decision to seek around-the-clock care for a loved one in a nursing home facility, the financial toll can be burdensome. Families shouldn’t also have to carry a burden of guilt wondering if their mother who suffers from Alzheimer’s disease is receiving adequate supervision and nutrition or if an immobile spouse is being properly cared for to avoid bedsores.
The congressional hearings I led a decade ago revealed that a few bad apples in the barrel could spoil the reputation of an entire industry. Horror stories of malnutrition, bedsores, abuse and dehydration led to policy changes that were designed to strengthen protections for nursing home residents and make the inspections process more accessible and transparent for consumers. Working with my fellow lawmakers, long-term care advocates, industry representatives and government regulators, I advocated for reforms that would tighten enforcement and stiffen accountability for wrongdoers; address staffing ratios and employee retention; and, deliver consistent, high quality care for nursing home residents.
As the top ranking Republican on the Senate Finance Committee, I have continued my scrutiny of the nursing home industry to ensure residents are receiving the quality care they deserve and to protect the taxpaying public. The federal government now spends $75 billion dollars annually through Medicare and Medicaid on nursing home care. That figure will grow exponentially in the years ahead as more aging baby boomers climb the longevity ladder. We know the retiring baby boom generation presents significant challenges to public entitlement programs, such as Social Security, Medicare and Medicaid. Policymakers also must prepare for the swelling population of Americans who likely will need to turn to our long-term care delivery system to maintain a good quality of life.
Building on my longstanding legislative efforts to improve the standard of care in our nation's nursing homes, I introduced bipartisan legislation in February that would require better information for consumers that’s provided by the federal government on the Nursing Home Compare website; accurate reporting of the staff who are providing direct services in nursing homes; stiffer penalties for serious quality deficiencies; and, greater accountability and transparency about who owns and operates nursing homes.
My ongoing oversight work includes an examination of an ownership trend by large investment companies buying up nursing home chains. A disturbing analysis last fall by The New York Times reported a correlation between profits going up and the quality of care going down when investment groups took ownership. I’ve called upon the federal agency responsible for overseeing nursing home inspections to account for the alleged health and safety violations in nursing homes owned and operated by private equity investors.
It seems as though some of the investor groups have woven a complex management web to evade litigation and regulation. I don’t have a problem with investors buying up nursing homes struggling financially to keep their doors open for business. But I do have a problem if they put their own financial bottom line before the real bottom line, which is the well-being of vulnerable nursing home residents. And that bottom line ought to be simple to understand.
Cost-cutting decisions that put the safety, health and well-being of nursing home residents at risk are not acceptable And they never will be. Investor-owners need to understand boardroom decisions have life or death consequences upon the most vulnerable citizens among us.
They say what comes around goes around. If only the owners of our nation’s nursing homes would put themselves in the shoes of their residents, Congress would not find itself legislating on how to provide compassionate care, consistently.