In their defense.

Clinton signs the resident protection act

LONG TERM CARE FACILITIES VOLUNTARILY decertifying from Medicaid cannot transfer or evict Medicaid residents to make room for residents with other payment sources, says a new law signed by President Clinton March 25 known as the Nursing Home Resident Protection Act of 1999. Introduced as HR 540--sponsored by Michael Bilirakis (R-Fla.) and Jim Davis (D-Fla.) and Senator Bob Graham (D-Fla.)--the legislation swept quickly through Congress in reaction to a series of attempted transfers of Medicaid residents reported on by The Wall Street Journal.

Supported by all sides of the long term care industry, from the American Health Care Association to the National Citizens' Coalition for Nursing Home Reform (NCCNHR), the new law applies to all who reside in a facility on the day before it withdraws from Medicaid. Incoming residents must be informed of the law, both verbally and in writing, prior to admission. Furthermore, providers must have each new resident sign a statement indicating that he or she has been informed of the law.

"This law is aimed at preventing future problems rather than addressing a current widespread problem," says AAHSA spokesperson Robert Greenwood. NCCNHR's director Sarah Greene Burger agrees, saying that only a dozen or so nursing homes choose to leave the Medicaid program each year.

Some of the provisions that AAHSA would like to see in this law are contained in the President's fiscal year 2000 budget. In that legislation, Clinton proposes to require nursing homes to conduct criminal background checks of all employees and to build a national registry of workers who have been convicted of abusing residents. He would also like the nursing home regulations amended to allow workers other than certified nursing aides to assist residents in activities such as eating. The budget allots money for this work by increasing the national funding for the prevention of nursing home resident abuse and neglect by 31 percent to more than $309 million.

While Burger is pleased with the passing of the law, she doesn't feel it combats the more subtle yet pervasive forms of Medicaid discrimination. "We would like to see a provision that requires that all facilities participating in Medicaid have all of their beds Medicaid-certified" says Burger. "That way, facilities cannot say that they don't have beds available to prospective Medicaid residents when they actually do but are keeping them open for residents with other payment sources."