Statement of the Honorable John D. Dingell on the GAO Report on Nursing Home Enforcement and Quality of Care

27 Jul 2007

RELEASED

March 18, 1999

WASHINGTON, D.C. - Senators Chuck Grassley and John Breaux, and my fellow Representatives Pete Stark and Nick Smith, I thank you for joining in a cooperative, bipartisan effort to monitor the quality of care for some of our nation's most vulnerable citizens. One and a half million Americans live in nursing facilities, including one quarter of all seniors over the age of 85.

Two years ago, we asked the General Accounting Office to investigate the implementation of the Nursing Home Reform Act. The GAO report studied nursing homes in four states: California, Texas, Pennsylvania, and my home state of Michigan.

The findings of this report are troubling. The GAO states that 25% of all nursing facilities had health and safety deficiencies that resulted in actual harm to residents. Nearly 40% of nursing homes with these severe deficiencies were repeat offenders. The result is a "yo-yo" pattern of compliance: a nursing facility is found deficient, the facility corrects the problem temporarily, and the facility once again slips into noncompliance.

This report concludes that we do not have an effective system for investigating and sanctioning nursing homes that violate health and safety standards. Currently, when the Health Care Financing Association sanctions a deficient nursing home, the home has an opportunity to correct to problem before a civil monetary penalty is assessed. Another problem is that some state investigations of complaints against nursing homes do not occur quickly enough. State investigators are required to act within two days in response to a complaint alleging immediate jeopardy to nursing home residents, but investigations for less urgent complaints often lag.

On Tuesday, the Health Care Financing Administration announced a new initiative to toughen enforcement rules for nursing homes. HCFA will close the loophole that allows a nursing home the opportunity to correct a violation and avoid paying a fine. HCFA will also require states to investigate all complaints against nursing homes within 10 working days.

These are important steps, but we will need to take additional measures to correct the flaws in the enforcement infrastructure that now exist. I am disappointed that the nursing home regulations mandated by the Omnibus Reconciliation Act of 1987 have not yet been implemented as we in Congress intended. However, I am confident that with the cooperation of the Health Care Financing Administration and the states, we will be able to apply and enforce protections for nursing home residents that are the safest and most effective in history.