Welcome to Citizens for Better Care - COALITION FOR NURSING HOME REFORM

The office of the Assistant Secretary for Planning and Evaluation in HHS has released a case study of eight states’ experiences with state nurse staffing ratio laws. (The states studied were Arkansas, California, Delaware, Minnesota, Missouri, Ohio, Vermont, and Wisconsin.) Although advocates may question why the Urban Institute, which conducted the research, included states like Wisconsin and Minnesota whose ratios have had negligible impact because they fall substantially below recommended standards, and why it omitted two "– Maine and Florida "– that are among the best, the report may be helpful to consumers who are seeking staffing legislation in their states. It includes chapters on the attempts of Arkansas and Delaware advocates to implement the NCCNHR staffing standards. The study also provides a chart showing staffing standards required in the 50 states and DC. To download a copy of the 70-page study, “State Experiences with Minimum Nurse Staffing Ratios for Nursing Facilities: Findings from Case Studies in Eight States,” go to the ASPE Web site at http://aspe.hhs.gov/daltcp/reports/8state.htm#finding.

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NCCNHR Files Amicus Brief Supporting Families in Alabama Arbitration Case

NCCNHR, in conjunction with AARP and the Alabama Silver-Haired Legislature, filed an amicus curiae brief in Briarcliff Nursing Home, Inc. v. Turcotte and Briarcliff Nursing Home, Inc. v. Woodman, asking the Supreme Court of Alabama to rehear the two cases in which it upheld mandatory arbitration clauses in admissions contracts. In the cases, which involve wrongful death actions brought on behalf of residents in the nursing home, Briarcliff moved to force arbitration according to a clause in the residents’ admissions contracts. The trial court had denied the provider’s motion to force arbitration, and the nursing home appealed.

The state Supreme Court reversed the decision of the trial court. It determined that the families were seeking to impose duties that arose from the admissions contracts and “stood in the shoes” of their deceased family members; therefore, they were bound by the arbitration clause in the contracts. In its decision favoring Briarcliff, the court held that the nursing home did not have overwhelming bargaining power, the arbitration clause was not unconscionable, and the terms of the clause were not grossly favorable to either party. The court also found that the families had not shown that they were unable to find a nursing home that did not require arbitration without considerable expenditure of time and resources, nor that they did not have access to a facility outside the county in which they lived or to in-home care.

NCCNHR’s amicus argues in support of the families that due to the circumstances that typically surround the nursing home admissions process – which include vulnerable individuals and families in crisis without reasonable choices – such admission contracts are unconscionable and one-sided. “In such an environment it is unlikely that residents or their family members would know that the contract contained an arbitration clause or comprehend its meaning and consequences,” the brief says.

For more information, contact Lori Smetanka at NCCNHR, lsmetanka@nccnhr.org.

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CMS: HIPAA Doesn’t Forbid Posting of Survey Results

Since the HIPAA privacy rule came out last year, some nursing homes have found HIPAA to be a convenient excuse to withhold information from residents and families. CMS recently made one thing clear, however: HIPAA has not changed the Nursing Home Reform Act requirement for nursing homes to post their survey results in a readily accessible place. It also does not affect the state and federal government’s responsibility to make survey results available to the general public. In a letter to state survey directors February 12, CMS said it regretted that “in rare circumstances the statements of deficiencies may inadvertently release information that can be traced to a particular resident,” but it said that it had to balance its concerns about residents’ privacy with its statutory duty to regulate the nursing home industry through surveys and public access to the results. You can download a copy of the letter from the CMS Web site at http://www.cms.hhs.gov/medicaid/survey-cert/letters.asp. The item is #18.

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NCCNHR, ORC Work with Industry to Interpret HIPAA Requirements

NCCNHR and the Ombudsman Resource Center have been meeting with the American Health Care Association, American Association of Homes and Services for the Aging, AARP, and Families USA to develop consensus guidelines for consumers and providers on what the privacy law requires—and what it permits. We will make the information available to members and on the NCCNHR Web site when the guidelines are completed.

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Norovirus Hits Virginia Long-Term Care Facilities

Residents of three Northern Virginia long-term care facilities were recently stricken with the Norovirus, the stomach flu that has attracted attention for infecting passengers of cruise ships. The illness usually causes nausea, vomiting, diarrhea, and stomach cramping and, in some people, low-grade fevers, chills, headaches, muscle aches, and tiredness. It lasts one or two days, but sufferers are still contagious for up to 72 hours.

For nursing home residents, the biggest concern is dehydration. Norovirus is very contagious and can spread easily from person to person through eating contaminated foods or touching contaminated surfaces or infected persons. In the Virginia outbreak, the Fairfax Department of Health quarantined the facilities. Other precautions include sanitizing surfaces with chlorine bleach-based cleaners; frequent hand washing; and keeping infected staff and others away from residents.

For more information, contact Jean Badalamenti at NCCNHR, jbadalamenti@nccnhr.org.

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Industry Calls Defeat of Malpractice Bill “Wasted Opportunity”

The American Health Care Association says the Senate’s rejection of S. 2061, a medical malpractice bill that would have restricted mothers and babies’ lawsuits against gynecologists and obstetricians, was a "wasted opportunity" to reinvigorate the debate on medical liability reform.Â” Tort reform opponents, including NCCNHR, had suspected all along that the sponsors’ strategy was to pass a bill in the Senate that applied narrowly to one medical specialty but that could be broadened to other providers when the bill was conferenced with a comprehensive medical malpractice bill passed last year by the House. Indeed, the publication Congress Daily reported last week that Senate leaders had privately promised other physicians that they would benefit from the “Healthy Babies, Healthy Mothers Act.” A lobbyist for the American College of Physicians said his group’s understanding with the Senate leadership had been that the goal of the bill “was always comprehensive liability reform.” Senate Majority Leader Bill Frist (R-TN) has said he intends to bring up two other malpractice bills, one aimed at helping rural and inner city providers and another affecting emergency room care. Both are likely to share the same fate as the mothers and babies bill but could become fodder in the election debate this year.

NCCNHR’s statement opposing S. 2061 is on our Web site at http://www.nccnhr.org/govpolicy/246_1278_8006.cfm.

Janet Wells

Director of Public Policy

National Citizens' Coalition for Nursing Home Reform

1424 16th Street, NW, Suite 202

Washington, DC 20036

202/332-2275

FAX 202/332-2949

http://www.nursinghomeaction.org

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Long Term Care:Facilities|Services|Complaints

Site last updated 03/15/04