Washington, D.C. – Today, the D.C. Council voted unanimously to approve the Health Care Facilities Improvement Act of 2010. This legislation provides much-needed updates to District law regarding the regulation of nursing homes and nursing home administrators licensed in the District in order to promote the health and safety of the District’s elderly population.
“Revamping healthcare services for some our most vulnerable residents is long overdue,” said Councilmember David Catania (At-Large), Chairman of the Committee on Health. “This bill will put in place new requirements that will completely revolutionize the way healthcare is provided to our nursing home population.”
The Health Care Facilities Improvement Act is the culmination of a nearly year-long endeavor of the Committee on Health to examine and improve the state of the District’s nursing homes. While there are some high-performing facilities in the District, many District nursing homes are providing low quality and inconsistent care to residents. In fact, the Centers for Medicare and Medicaid Services rank some of the District’s nursing homes among the worst in the nation. In 2008, District nursing homes averaged 19 deficiencies for Medicare certification, compared to a national average of 8 deficiencies per nursing home.
This poor performance record is explained by weak District regulations that merely codify the minimum standards set forth in federal regulations and do little to raise the bar. In addition, while each nursing home has policies and procedures in place that govern delivery of care, they are not universally implemented. This results in nursing homes depending on emergency rooms and acute care facilities to provide basic medical care and ultimately leads to poor overall quality of care and poor quality of life for residents.
“Some of our nursing homes are using 911 and hospital emergency rooms as their primary means of providing healthcare,” Catania explained. “This is simply not acceptable. Emergency rooms are not the appropriate place to provide primary care to our elderly. This practice strains already crowded emergency rooms and is far more costly. Instead, the time has come to require that appropriate services be offered on-site at each of our nursing facilities.”
The Health Care Facilities Improvement Act bolsters the licensing requirements for nursing home administrators and the Mayor’s ability to sanction their licenses when residents’ health and safety is at risk. The bill also imposes new requirements for nursing facilities by creating a first-ever minimum physician hours requirement, raising minimum nursing staffing hours, mandating employee training, establishing minimum on-site medical services, and better regulating transfers to hospitals or acute care facilities. Furthermore, the bill requires additional components for admission assessments, enhances resident discharge planning, and ensures resident rights. Finally, the bill strengthens the Mayor’s ability to sanction nursing facility licenses and authorizes the Mayor to assign a temporary manager or monitor to failing facilities.
The legislation was endorsed by the American Association of Retired Persons (AARP) and the D.C. Long-Term Care Ombudsman. The final vote on the bill was 13-0.
The Council also voted to approve the Healthy D.C. Equal Access Fund and Hospital Stabilization Emergency Act of 2010. The bill provides up to $2.9 million in FY 2010 for the Healthy D.C. Equal Access Fund, which will be used to reimburse United Medical Center (UMC) in Ward 8 for service provided to uninsured District residents. The legislation also appropriates $3 million to assist UMC in managing its current financial challenges.
UMC is the only District hospital located east of the Anacostia River. It serves as the District’s defacto safety-net hospital. Over the last two years, with the assistance of the District Government, the hospital has witnessed substantial clinical improvements. It has also experienced significant capital investment including a new MRI machine, new CT-Scanners, a new hyperbaric wound program, among others.
Despite its successes, UMC has recently experienced financial challenges resulting from a poor economy and a lack of privately insured patients. Today’s legislation represents one of several steps underway to “true up” the District’s reimbursement system to more accurately compensate the hospital for the care it provides.
###
