Funds for Nursing Homes

FUNDS FOR NURSING HOMES

Mr. GRASSLEY. Mr. President, today I would like to announce a significant achievement for this Congress, for the nursing home community, and for nursing home residents throughout the United States. I announce that the nursing home community committed itself to spending about $4 billion over the next decade to direct care and services for all patients in skilled nursing facilities.

This past August, the Centers for Medicare and Medicaid Services corrected for errors in rate calculations and adjusted Medicare payments to nursing homes by 3.26 percent. I approached the nursing home community and asked that they use a substantial portion of those funds for direct, hands-on care to residents. They not only agreed, but they committed their agreement to writing.

The American Health Care Association, the Alliance for Quality Nursing Home Care, the American Association of Homes and Services for the Aging, the American Health Quality Association, and the American Hospital Association all have agreed to spend a large portion of the increase in funding from that 3.26-percent adjustment formula for direct hands-on care to residents, specifically on registered nurses, licensed practical nurses, and on certified nursing assistants. These are the people who touch the nursing home residents' lives most directly, and they are the backbone of the nursing home system of quality care if there is going to be quality care.

Moreover, by committing to use these funds for hands-on direct care, these providers are acknowledging that more hands-on direct care will help to continue improving the quality of care provided nursing home residents.

I first got involved in the nursing home quality of care issue in 1997 when I chaired the Special Committee on Aging. There was, at that time, concern about thousands of deaths in the State of California due to dehydration, malnutrition, bed sores, and a lot of other conditions that indicate lack of concern, lack of quality of care. This may have been just in the State of California, but it was probably also true of other States. These were brought to my attention at that particular time.

At that time I seized the opportunity to expose the sad state of affairs in too many nursing homes across the Nation. In 1998, the picture wasn't pretty. The General Accounting Office said there were serious quality care problems in about 30 percent of California's nursing homes. That report inaugurated a new and targeted effort to improve the quality of care in nursing facilities, and the quality of oversight and enforcement by responsible State and Federal agencies.

Since 1998, there have been about 17 General Accounting Office studies on nursing homes, and even more if you count the work done by the Office of Inspector General at the Department of Health and Human Services. Improving the quality of care provided in nursing homes is of paramount concern to all of us. At the same time, we must recognize that not all nursing homes are bad actors. Unfortunately, those who are cast the entire community in a bad light.

Over the years in fighting the battle to improve care in nursing homes I have come to learn two very important realities about providing quality care to one of our most vulnerable populations. The first reality is that there is no quick fix that will cure the problem. There is no law, no penalty, no guidance that will eliminate the problem.

The second reality is that we need the will to direct Federal funds right where they are most needed, to those hands-on professionals who feed, bathe, and turn the residents of a nursing home. That is what we have done here with this agreement among these various professional and trade associations. We worked hand in glove with these associations of the nursing home community, a community that provided me their written commitment to use real money to improve the plight of nursing home residents.

The nursing home community put their money where their mouth is by committing to use billions for hands-on direct care to their residents. Today I applaud them, I thank them, and I look forward to more such agreements, all in the name of making sure that there is quality of care at the nursing homes of America.

I yield the floor.