[Congressional Record Volume 154, Number 121 (Wednesday, July 23, 2008)]
[Senate]
[Page S7145]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                             LONG-TERM CARE

  Mr. WYDEN. Since my days of working with the Gray Panthers in Oregon, 
I have been aware of the special obligation that we have to both our 
younger and older citizens who are in need of long-term care services. 
The Omnibus Budget Reconciliation Act of 1987 was a watershed in 
efforts to make life safer and more dignified for individuals living in 
long-term care institutions.
  Since 1987, the long-term care industry has continued to evolve in 
ways that require another look at the state of long-term care. In a 
constantly changing for-profit and nonprofit industry, Federal and 
State governments need better information about the organizations and 
staff who provide care to residents of long-term care. Individuals, 
families, and service providers also need good information about long-
term care to make informed decisions about their options.
  Chairman Kohl, I laud you and your colleagues who have thoughtfully 
identified current or emerging problems in long-term care. The Nursing 
Home Transparency and Improvement Act of 2008, S. 2641, makes important 
strides in helping us to get more substantive information about nursing 
home ownership and staffing. It strengthens the Nursing Home Compare 
Web site and provides additional information for the general public. I 
am therefore pleased to become a cosponsor of this legislation.
  Mr. KOHL. Thank you, Senator Wyden. Given your long commitment to 
aging and health issues, your support is especially important and 
meaningful.
  Mr. WYDEN. While I am pleased to support the legislation, I do have 
some concerns about the bill as it is written and hope that we can work 
together to make some changes to the bill. It has been helpful for me 
to talk about the bill with the many fine people who operate nursing 
homes in Oregon and others. And these folks have identified what I 
think are legitimate concerns with the bill.
  Mr. KOHL. I would appreciate hearing of those concerns, Senator.
  Mr. WYDEN. There are two issues of particular concern where I hope we 
may be able to get agreement on modifications. First, the bill calls 
for increased civil monetary penalties and requires that they be placed 
in escrow in advance of adjudication of an alleged violation. This 
provision could be especially burdensome to smaller nursing homes that 
already operate close to the margin. I think it would be useful to 
review the size of the proposed fines but especially the escrow 
provision. Tying up thousands of dollars in escrow would be 
particularly difficult for small nursing homes and especially unfair 
for homes whose alleged violations were later found to be without 
merit. I also believe it raises due process concerns in terms of 
imposing penalties before a matter has been finally settled.
  Mr. KOHL. We will certainly review those provisions in light of your 
concerns.
  Mr. WYDEN. The other issue of concern in the legislation concerns the 
requirement that every nursing home that is part of a group of nursing 
homes with common ownership and annual revenues of $50 million or more 
be subject to annual audits. Many of the nursing homes in Oregon are 
family-run businesses. A few of our Oregon owners operate groups of 
nursing homes that would meet the criterion for annual audits of each 
of their nursing homes. I am concerned that the cost of annual audits 
would be financially burdensome for them and for small nursing home 
chain owners in other parts of the country.
  Mr. KOHL. I appreciate the care with which you have reviewed the 
Nursing Home Transparency Act. I will take under serious consideration 
the issues that you have raised. Again, your cosponsorship of this 
legislation is important in view of the many efforts you have made and 
continue to make to improve the lives of America's older citizens.

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