White House Rejects Plan to Ease Inspection of Nursing Homes
White House spokesperson Ari Fleischer said Friday that an internal HHS proposal to ease the regulation of nursing homes had been "rejected out of hand" more than two weeks ago and that President Bush intends to "strengthen accountability" of the industry, the New York Times reports. Fleischer's remarks came the same day that the Times reported that the Bush administration planned to unveil an initiative calling for less frequent inspections of nursing homes with "good records of compliance with federal health and safety standards" and increased regulation for homes with a history of violations (Pear, New York Times, 9/8). Instead, Fleischer said that the administration plans to announce an initiative this fall calling for increased regulations of the industry. "We're going to beef up and strengthen nursing home protections," he said (Meckler, AP/Philadelphia Inquirer, 9/8).
The Washington Post reports that the Times story was based, in part, on an internal document prepared about two months ago by analysts at the Centers for Medicare and Medicaid Services. The document also supported CMS Administrator Thomas Scully's recent public statements (Goldstein, Washington Post, 9/8). In an Aug. 28 conference call with long term care experts, Scully suggested that the current law requiring that all nursing homes that receive Medicare or Medicaid funding be inspected an average of once a year, with "no more than 15 months between inspections," would be amended to broaden the maximum interval to two years (New York Times, 9/8). The document also called for a reconsideration of other regulations that the nursing home industry has described as burdensome, including a law that "requires the government to stop payments to nursing homes" that do not correct safety violations within six months (AP/Philadelphia Inquirer, 9/8). But Fleischer said, "The administration has no plans to reduce the frequency or the intensity of nursing home oversight [and] no plans to reduce the penalties" for violations, adding that the president "believes very strongly that it's a federal responsibility to protect seniors in nursing homes."
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Scully said in a statement Friday that the administration is "pursuing initiatives to strengthen accountability and improve monitoring of nursing homes on behalf of all Medicare and Medicaid beneficiaries." However, the Times reports that Scully "spoke freely about the idea" of easing nursing home regulations in a June 4 speech as well as during the conference call with long term care experts and in talks with congressional aides last week. During the conference call, Scully said, "We ought to take the pot of money that we have, come up with reasonable quality measures in coordination with the industries wherever we can, and reward good providers with less scrutiny and less harassment, and go after bad providers with more scrutiny and more harassment." Last Thursday, CMS spokesperson Joyce Winslow said that Scully was committed to "reviewing good nursing homes less often and bad ones more often" (New York Times, 9/8).