Nursing home reform sent to governor

JEFFERSON CITY, Mo. -- While stories of elder abuse at the hands of negligent nursing home operators generates massive public outcry, the care provided by good facilities never generates headlines. The result is a tarnished public image of the industry as a whole that is frustrating to those dedicated to running quality operations.

Di Di Terbrak, assistant administrator of Chateau Girardeau in Cape Girardeau, said reform legislation awaiting Gov. Bob Holden's signature will reinforce the protective steps good homes already take while forcing the bad homes to improve.

"The number of homes that provide substandard care are in the minority," Terbrak said. "If the focus is on those facilities, hopefully it will improve everyone's image in long-term care."

On a 32-0 vote Wednesday, the Senate took the final action needed to send the bipartisan reform measure to the governor's desk, ending an effort four years in the making.

Senate President Pro Tem Peter Kinder, R-Cape Girardeau, said the bill, which he sponsored, meets the goal of targeting poor-quality homes while not overregulating those with proven track records.

"It will force bad homes to shut down and that is all to the good," Kinder said.

Holden said in a statement that he intends to sign the bill into law, assuming no fatal flaws are discovered during a customary review.

"This legislation will provide the state with more authority to protect citizens in long-term care," Holden said.

The bill will increase maximum fines, which haven't been adjusted since 1979, from $10,000 to $25,000 for each day a violation exists. It will also prevent nursing home operators from escaping fines for serious violations by fixing the problem, even if death or serious injury has resulted, or by transferring ownership.

Other provisions of the bill would make it a felony to conceal abuse or neglect, provide whistleblower protections to employees who report problems, require more extensive background checks for home owners and employees and allow less frequent inspection of homes with good records.

Kinder's final bill is the result of countless hours of compromise between reform advocates and the nursing home industry, which helped derail past efforts.

Changes made last by a House committee threatened to upset that compromise, but the full chamber backed off of most of those alterations in sending the measure back to the Senate Tuesday on a near-unanimous 144-1 vote.

One potential bill-killer considered by the House but ultimately dropped would have increased the rate at which the state reimburses nursing home owners under Medicaid. While many lawmakers recognize a need for raising the rate, the multimillion-dollar price of doing so was considered cost prohibitive this year.

The bill is SB 556.

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