Laws target nursing home regulation

New task force, new transparency among measures

He also signed a measure that would expand the transparency of nursing home licensure. Advocates have cried out against corporations buying nursing homes.

‘‘These are organizations, companies that are far more concerned about profit margins and bottom lines than they are with quality of care for patients,” said Ebs Burnough, political director for 1199SEIU, which represents health care workers. Burnough called the bills on licensure and establishing the workgroup ‘‘definitely a great step in the right direction.”

Annapolis legislators turned their attention to long-term care during the last legislative session, using as a case study a Bethesda nursing home with 200 licensed beds that nearly lost federal funding last year after sub-par care resulted in two patient deaths. Bethesda Health and Rehabilitation has since passed re-inspections and results of a report summarizing the nursing home’s role in patient deaths have been posted on a federal nursing home comparison Web site. The reports have yet to be posted on the state’s Web site for nursing home consumers.

One measure used by Centers for Medicaid and Medicare Services to compare nursing home quality is the prevalence of pressure sores, or bedsores. Most downcounty nursing homes were at or over the state’s average, according to 2006 data. Facility reports are posted at mhcc.maryland.gov⁄consumerinfo⁄nhguide.

Concerns also rose last year about quality of care and oversight at nursing home facilities, when the private equity firm Carlyle Group bought the ManorCare nursing homes.

One of those facilities, ManorCare Rossville in Baltimore, was among 131 facilities nationwide to be placed on a federal watch list May 20. Waldorf Center in Waldorf was also branded with ‘‘special focus facility” designation. Both facilities will be inspected every six months by the Office of Health Care Quality; nursing homes typically undergo annual inspections.

Legislation sponsored by Del. Patrick L. McDonough requires companies seeking state nursing home licensure to prove they can deliver quality care by meeting medical and financial standards — and to clearly spell out who owns and manages the nursing home.

‘‘In a very sensitive service like taking care of the frail and elderly, and all of the inherent problems associated with that service including possible litigation to protect those people, you need to know who the responsible parties are,” said McDonough (R-Dist. 7) of Middlesex. The law ‘‘also provides us with new authority to investigate financial conditions in nursing homes before things go belly-up or become to the point of no return.”

Such financial investigations will resemble the current system for check-ups in nursing home care, McDonough said.

Advocates told McDonough about red flags in nursing home services, he said.

‘‘Staff not receiving pay for a couple of weeks, paper plates suddenly replacing regular plates. ... But we didn’t have the enforcement authority to check those things out,” McDonough said.

Del. Richard B. Weldon Jr. (R-Dist. 3B) of Brunswick sponsored legislation that should cut in half the amount of time it takes for a Medicare recipient to wait for Medicare long-term care eligibility. Patients were waiting up to 18 or 24 months to have their eligibility determined, Weldon said.

‘‘I thought it was a crime that families are having to wait that long,” he said.

Eligibility will now be consolidated into the Department of Health and Mental Hygiene, instead of split among three agencies as it was previously.

Another product of the session, a bill sponsored by Del. Mary-Dulany James (D-Dist. 34A) of Havre de Grace, establishes a task force to study how nursing home ownership relates to quality of care, and whether the state needs to further expand regulations on ownership.

The Office of Health Care Quality will participate in the new task force and will convene a workgroup this summer to ‘‘come up with language that gives more information on who owns nursing homes,” said Wendy Kronmiller, its director.

Weldon said he sees the new laws as a front-end regulation on nursing home care.

‘‘We want to make sure that DHMH can affirm to residents and families that nursing homes are being held to that appropriate level of standards,” he said.