[Congressional Record (Bound Edition), Volume 149 (2003), Part 19]
[Senate]
[Pages 25751-25752]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        FUNDS FOR NURSING HOMES

  Mr. GRASSLEY. Mr. President, today I would like to announce a 
significant achievement for this Congress, for the nursing home 
community, and for nursing home residents throughout the United States. 
I announce that the nursing home community committed itself to spending 
about $4 billion over the next decade to direct care and services for 
all patients in skilled nursing facilities.
  This past August, the Centers for Medicare and Medicaid Services 
corrected for errors in rate calculations and adjusted Medicare 
payments to nursing homes by 3.26 percent. I approached the nursing 
home community and asked that they use a substantial portion of those 
funds for direct, hands-on care to residents. They not only agreed, but 
they committed their agreement to writing.
  The American Health Care Association, the Alliance for Quality 
Nursing Home Care, the American Association of Homes and Services for 
the Aging, the American Health Quality Association, and the American 
Hospital Association all have agreed to spend a large

[[Page 25752]]

portion of the increase in funding from that 3.26-percent adjustment 
formula for direct hands-on care to residents, specifically on 
registered nurses, licensed practical nurses, and on certified nursing 
assistants. These are the people who touch the nursing home residents' 
lives most directly, and they are the backbone of the nursing home 
system of quality care if there is going to be quality care.
  Moreover, by committing to use these funds for hands-on direct care, 
these providers are acknowledging that more hands-on direct care will 
help to continue improving the quality of care provided nursing home 
residents.
  I first got involved in the nursing home quality of care issue in 
1997 when I chaired the Special Committee on Aging. There was, at that 
time, concern about thousands of deaths in the State of California due 
to dehydration, malnutrition, bed sores, and a lot of other conditions 
that indicate lack of concern, lack of quality of care. This may have 
been just in the State of California, but it was probably also true of 
other States. These were brought to my attention at that particular 
time.
  At that time I seized the opportunity to expose the sad state of 
affairs in too many nursing homes across the Nation. In 1998, the 
picture wasn't pretty. The General Accounting Office said there were 
serious quality care problems in about 30 percent of California's 
nursing homes. That report inaugurated a new and targeted effort to 
improve the quality of care in nursing facilities, and the quality of 
oversight and enforcement by responsible State and Federal agencies.
  Since 1998, there have been about 17 General Accounting Office 
studies on nursing homes, and even more if you count the work done by 
the Office of Inspector General at the Department of Health and Human 
Services. Improving the quality of care provided in nursing homes is of 
paramount concern to all of us. At the same time, we must recognize 
that not all nursing homes are bad actors. Unfortunately, those who are 
cast the entire community in a bad light.
  Over the years in fighting the battle to improve care in nursing 
homes I have come to learn two very important realities about providing 
quality care to one of our most vulnerable populations. The first 
reality is that there is no quick fix that will cure the problem. There 
is no law, no penalty, no guidance that will eliminate the problem.
  The second reality is that we need the will to direct Federal funds 
right where they are most needed, to those hands-on professionals who 
feed, bathe, and turn the residents of a nursing home. That is what we 
have done here with this agreement among these various professional and 
trade associations. We worked hand in glove with these associations of 
the nursing home community, a community that provided me their written 
commitment to use real money to improve the plight of nursing home 
residents.
  The nursing home community put their money where their mouth is by 
committing to use billions for hands-on direct care to their residents. 
Today I applaud them, I thank them, and I look forward to more such 
agreements, all in the name of making sure that there is quality of 
care at the nursing homes of America.
  I yield the floor.

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