[Congressional Record (Bound Edition), Volume 147 (2001), Part 11]
[Extensions of Remarks]
[Page 15045]
[From the U.S. Government Publishing Office, www.gpo.gov]




        INTRODUCTION OF THE NURSING HOME QUALITY PROTECTION ACT

                                 ______
                                 

                          HON. HENRY A. WAXMAN

                             of california

                    in the house of representatives

                         Monday, July 30, 2001

  Mr. WAXMAN. Mr. Speaker, today I am introducing the Nursing Home 
Quality Protection Act. It is imperative that we do everything in our 
power to protect our most vulnerable citizens--the elderly and disabled 
who live in nursing homes. That is why I and my colleagues are 
introducing this legislation today-- to take a crucial first step 
towards ensuring that seniors in nursing homes are provided the care 
they deserve.
  This legislation is a product of a series of investigations reports 
conducted by my staff into nursing home conditions. These reports have 
consistently found numerous violations of federal health and safety 
standards in nursing homes throughout the country. Many of the 
violations harmed residents. Common problems included untreated 
bedsores; inadequate medical care; malnutrition; dehydration; 
preventable accidents; and inadequate sanitation and hygiene.
  Moreover, during the course of these investigations, we began to 
notice an unexpected and extremely disturbing trend. Many of the 
nursing homes we examined were being cited for physical, sexual, or 
verbal abuse of residents. I asked my staff to investigate whether 
these abuse cases were isolated occurrences--or whether they signaled a 
broader, nationwide problem. The report I released today presented the 
results of this investigation.
  What we found was shocking. Within the last two years, nearly one-
third of the nursing homes in the United States have been cited by 
state inspectors for an abuse violation. In over 1,600 nursing homes--
approximately one out of every ten--these abuse violations were serious 
enough to cause actual harm to residents or to place them in immediate 
jeopardy of death or serious injury.
  As documented in the report, we found examples of residents being 
punched, choked, or kicked by staff members or other residents. These 
attacks frequently caused serious injuries such as fractured bones and 
lacerations. And we found other examples of residents being groped or 
sexually molested.
  We also found that the percentage of nursing homes cited for abuse 
violations has doubled since 1996. I hope that this is the result of 
better detection and enforcement. To its credit, the Clinton 
Administration launched an initiative in 1998 to reduce abuse in 
nursing homes, and this initiative may be responsible for some of the 
increase in reported cases of abuse.
  But I am concerned that some of the increase in abuse cases may 
reflect an actual increase in abuse of residents. In 1997, Congress 
unwisely decided to repeal the Boren Amendment, which guaranteed that 
nursing homes receive adequate funding. Since then, federal funding has 
not kept pace with the costs of providing nursing care. As a result, it 
is harder and harder for nursing home operators to provide seniors the 
kind of care they need and deserve.
  I know many operators of nursing homes who are dedicated to providing 
the best care possible. They would never knowingly tolerate abuse or 
other dangerous practices in their facilities. But unless we are 
willing to pay nursing homes enough to do their job, intolerable 
incidents of abuse and other types of mistreatment will continue to 
persist in too many nursing homes.
  I do not want to suggest that most residents of nursing homes are 
being abused. The vast majority of nursing staff are dedicated and 
professional people who provide good care. In many instances, the only 
reason that abuse is even reported is because of the actions of 
conscientious staff members.
  On a personal note, my mother-in-law is in a nursing home in 
Maryland. I've met with many of the people that care for her. They are 
good people, but they have difficult jobs. They work long hours in 
understaffed conditions, and they don't make a lot of money. Under such 
trying circumstances, it's not surprising that staff turnover is high 
and that facilities are forced to hire people who shouldn't be working 
in nursing homes.
  But the bottom line is clear: Something clearly needs to be done to 
improve nursing home conditions. The senior citizens who live in 
nursing homes are frail and vulnerable. Frequently, they are 
defenseless and cannot even report problems to others. They deserve to 
be treated with respect and dignity--not to live in fear of abuse and 
mistreatment.
  It would have been intolerable if we had found a hundred cases of 
abuse; it is unconscionable that we have found thousands upon 
thousands.
  That's why I and many other members are introducing the Nursing Home 
Quality Protection Act later today. Our bill is a comprehensive 
approach to improving conditions in our nation's nursing homes. The 
bill would:
  Increase resources to nursing homes so they can hire more staff;
  Institute minimum nurse staffing requirements;
  Impose tougher sanctions on poorly performing nursing homes;
  Require criminal background checks on employees; and
  Increase Internet disclosure of nursing home conditions.
  This is a good piece of legislation that has been endorsed by 
organizations representing nursing home residents and workers. It will 
do much to improve the quality of care received by the one and a half 
million people who live in our country's nursing homes.
  I want to assure all Americans who have a family member in a nursing 
home that we will do all we can to protect their aging loved ones. They 
helped our generation when we needed their help. And now it's our 
turn--and our obligation--to make sure they can live safely and without 
fear.

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