Feds announce crackdown on nursing home flaws
Bed sores, abuse, inspections targeted
Federal officials announced in July a major push to improve conditions in nursing homes, an initiative that will have an impact on wound care providers. In an announcement at the White House, President Clinton called the effort part of "honoring the great social compact between the generations."
Key elements of Clinton's proposal include:
· Preventing Bed Sores, Dehydration, and Malnutrition. The Health Care Financing Administration (HCFA) will step up its review of nursing homes' ability to prevent bed sores, dehydration, and malnutrition. Nursing homes with patterns of serious violations will be sanctioned. HCFA also will work with the Administration on Aging, the American Dietetic Association, clinicians, consumers, and nursing homes to develop a repository of best practice guidelines for residents at risk of weight loss and dehydration.
· National Abuse Registry. This registry would list nursing home employees convicted of abusing residents.
· Stronger enforcement. HCFA will take several steps to boost enforcement of nursing home regulations. This will include:
- Nursing homes found guilty of a second offense for violations harming residents will have sanctions imposed and will not receive a "grace period" that allows them to correct problems and avoid penalties.
- HCFA will permit states to impose civil monetary penalties for each instance of serious or chronic violation. Until now, penalties have been linked only to the number of days a facility was out of compliance with regulations.
- Nursing home inspections will be conducted more frequently for repeat offenders with serious violations, without decreasing inspection frequency for other facilities.
- Nursing home inspection times will be staggered, with a set amount to be done on weekends and evenings.
- Federal and state officials will focus enforcement efforts on nursing homes within chains that have a record of noncompliance with federal rules.
· State initiatives. To target states with weak inspection systems, HCFA will:
- Provide additional training and other assistance to inspectors in states that are not adequately protecting residents.
- Enhance federal review of the surveys conducted by the states. Standard evaluation protocols will be implemented in every state this fall.
- Ensure that state surveyors enforce HCFA's policy to sanction nursing homes with serious violations and that sanctions cannot be lifted until after an on-site visit has verified compliance.
- Terminate federal nursing home survey funding to states that fail to adequately survey or improve inadequate survey systems. HCFA then will contract with other entities to conduct nursing home survey and certification activities in those states.
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