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Be prepared.

States plan for possible nursing home closures

STATES ARE STARTING To SPEAK our ABOUT Washington's recent calls to get ready for possible nursing home chain closures.

On May 7, HCFA sent a letter to state agencies asking them to implement contingency plans to ensure that 'resident health and safety are protected despite the financial decline" of nursing homes. The plans should outline how states would handle the closure of multiple nursing homes, including how they would ensure a smooth transition to new management.

In addition, Senator Charles Grassley (R-Iowa), chairman of the Senate Special Committee on Aging, introduced a bill (S.840) in early May to protect residents in case of facility closures. The bill addresses the costs associated with closures, plans to transfer patients, and other protective measures.

States' reactions to the federal directives range from chagrin and alarm to a can do" attitude. For example, Rick Harris, director of the Bureau of Health Provider Standards in the Alabama Department of Public Health, says it was inappropriate for HCFA to put the ball in the states' court. "We tend to get nervous when HCFA starts talking about states ensuring patient safety. Even in the best of times, when we have lots of money and staff, the best we can do is to assess facilities for the quality of care and take enforcement actions accordingly," he says.

Harris voiced his concerns in a recent letter to Senator Grassley.

Hams says his department has looked at whether it could use public health nurses to staff nursing homes in the event that defunct facilities could not pay their bills. "We decided that would run into some serious issues, such as available manpower, malpractice coverage, and the appropriateness of using our nurses for such care," he says. "Even if we had licensed nurses to spare, we don't have the nurse aides, dietary, and housekeeping, which comprise the bulk of facilities' staff."

By contrast, Maryland views HCFA's request as a helpful exercise. "If we had to relocate residents, we would do that in a way that would protect those residents," says Carol Brenner, director of the licensure and certification admin istration for the Maryland Department of Health and Mental Hygiene. "In the past ten years, we have closed ten homes for quality of care problems, resulting in a thousand resident transfers," she adds. "We've also relocated another thousand residents from assisted living and board and care homes on short or no notice. In all cases, we found that the health care community will pull together to find places for the people."

Of course, there may not be any large-scale closures, especially if Congress or HCFA acts to restore adequate funding to PPS this fall. Research analyst Rob Mains with Advest in Saratoga Springs, New York, believes there could be a for-profit chain bankruptcy or two on the horizon. But he predicts these will be Chapter 11, allowing the providers to remain in operation.
 First-quarter performance drops
 such as these have Washington worried:

 1998 (PROFIT) 1999 (LOSS)
Sun $18.4 million $11.3 million
Vencor $26.5 million $12.4 million

Source: Sun, Vencor
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Article Details
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Publication:Contemporary Long Term Care
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 1999
Previous Article:At risk.
Next Article:Cancellation policy.

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