[Congressional Record Volume 145, Number 40 (Monday, March 15, 1999)]
[Senate]
[Pages S2692-S2693]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          NURSING HOME RESIDENT PROTECTION AMENDMENTS OF 1999

  Mr. COCHRAN. Mr. President, I ask unanimous consent that the Senate 
now proceed to the consideration of Calendar No. 38, H.R. 540.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report.
  The legislative clerk read as follows:

       A bill (H.R. 540) to amend title XIX of the Social Security 
     Act to prohibit transfers or discharges of residents of 
     nursing facilities as a result of a voluntary withdrawal from 
     participation in the Medicaid Program.

  The Senate proceeded to consider the bill.
  Mr. BAYH. Mr. President, today I rise as an original co-sponsor of S. 
494, the Nursing Home Resident Protection Amendments of 1999, a 
bipartisan bill that would protect Medicaid patients from being dumped 
out of nursing homes in favor of patients who pay only through private 
funds.
  When a senior citizen enters a nursing home facility he or she does 
so with the intention of making it their new home. It may not have the 
memories or immediate comfort level of the home they are used to, but 
for each elderly person that must enter a nursing home, they are 
exchanging the feelings of familiarity connected with their old home 
for the security and peace of mind that only comes with constant 
medical attention. In the recent past, some nursing home companies took 
actions that jettisoned these residents from the beds of their new 
homes based solely on their method of payment. Those who had the 
economic capability to pay with private funds were allowed to remain in 
the facility while those that needed governmental assistance in 
payment, paying with Medicaid dollars, were told to leave.
  The eviction is not just a matter of the inconvenience of finding a 
new home, it is a matter of life and death. Studies show that death 
rates among nursing home patients who are transferred or evicted is two 
to three times higher than normal.
  In some circumstances people were left without any real ``home'' to 
go to. Someone's method of payment should not determine whether or not 
they can continue to live in their new community or receive necessary 
medical attention. Once a facility has decided to accept a resident 
they should not be able to remove them based on whether they pay with 
private dollars or Medicaid. That is discrimination. Therefore, I 
decided to co-sponsor this bill and join the efforts of Senator Bob 
Graham and others to prevent this discriminatory and traumatizing event 
from happening to even one more person.
  I fully agree that the nursing home industry is a vital element in 
the continuum of care available to the elderly, and that a balance must 
be struck between encouraging private operators to

[[Page S2693]]

make the investment necessary to operate these vital facilities and 
protecting patients and their families from unfair treatment. The 
reality is that nursing homes are a business and it must be 
economically feasible for them to operate. However, once a nursing home 
accepts a patient they should fulfill their promise and allow the 
patient to remain a part of the nursing home community regardless of 
payment status.
  This issue is of particular concern to me since Indiana seniors 
experienced this unfair treatment. Approximately sixty elderly patients 
from one nursing home facility in Indiana, Wildwood, were told to leave 
because of their method of payment. In some cases, after they had 
worked hard to save for their future and were forced to spend every 
dollar to support themselves in the nursing home. Even spending every 
dollar they saved did not ensure them security since, once that money 
was depleted and they received government assistance, they were told 
their money was not good enough to keep them in the facility.
  Robyn Grant was the Indiana State Long-Term care Ombudsman for eight 
years. She recently testified on behalf of the National Citizens' 
Coalition for Nursing Home Reform before the House Subcommittee on 
Health and Environment in regard to this issue. Ms. Grant relayed the 
letter of a daughter of a resident who was evicted because they were 
paying with Medicaid. That woman wrote that ``You have destroyed lives 
and emotions and torn apart families. Yes, many of these people though 
not blood related, considered their companions and friends as family. 
Your facility was their home. Physical and emotional health was gravely 
endangered by the insensitive actions of the nursing home company.''
  Current law must be changed so there is no propensity for seniors to 
be torn apart from their newly found families in the future.
  Nursing homes should have the ability to chose what payment programs 
in which they will participate. However, if a facility decides to 
accept Medicaid patients, they must uphold the promise they made to 
those seniors. This bill would prevent a nursing home that decides to 
withdraw from the Medicaid program from evicting residents who were 
accepted prior to the facility's withdrawal. In addition, if a facility 
is a private-pay only, it would be required to notify the resident upon 
her entrance to the facility that she could be evicted after her 
private funds were exhausted. The Nursing Home Resident Protection 
Amendments of 1999 would protect the 68% of nursing home residents who 
rely on Medicaid at some point during their stay. This bill will not 
cost anything, but will have a significant positive impact on the lives 
of seniors faced with the need to enter a nursing home.
  We owe it to all our citizens to keep them informed and protected 
from discriminatory practices. This bill does that and I urge my 
colleagues to join us in turning this legislation into law.
  Mr. COCHRAN. Mr. President, I ask unanimous consent that the bill be 
considered read a third time and passed; that the motion to reconsider 
be laid upon the table; and that any statements relating to the bill 
appear at the appropriate place in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill (H.R. 540) was considered read the third time and passed.

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