Perspective               

Clinton Proposes $1 Billion Plan to Improve Nursing Homes

Although Medicare does not cover long-term nursing care, many older and disabled persons with Medicare receive skilled care in nursing homes. President Clinton recently announced a proposal to increase staffing in nursing homes and to improve their overall quality by distributing $1 billion in new grants to the neediest facilities over the next five years. Under the Clinton plan, HCFA will also make recommendations for appropriate Medicare reimbursement within two years.

Congress currently spends $39 billion a year on nursing home care. Congress now intends to restore some of the Medicare funds it cut in 1997. The idea of "giving back" to nursing homes was partly brought about by the recent bankruptcy of six of the nation's largest for-profit nursing homes as a result of the financial cuts three years ago.

Since the Medicare cuts of 1997, nursing homes have reported quality problems, low staffing levels, and insufficient funding. A recent study revealed that 54 percent of nursing homes are below the suggested minimum staffing level for nurses aides. As a result of low staffing, patients are cared for less and as a result suffer more bedsores, malnutrition, abnormal weight loss, and depression. As part of the nursing home reform, Clinton seeks to better train health care workers in nursing homes so that each resident would have at least two hours of personalized care every day. Although one study reported that 4.5 hours a day is recommended for each resident, two hours a day is a start.

If you have experienced low quality of care in nursing homes, there is new hope for better care in the near future. For information on how to choose a good nursing home, call 1-800-MEDICARE and request the free booklet titled "Guide to Choosing a Nursing Home."

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