Frommer nursing bill becomes law

October 01, 2004

Josh Kleinbaum

The theory is simple. Nursing homes give money to the state, and for

every dollar they give, they will get twice as much back.

Gov. Arnold Schwarzenegger turned that theory into law this week

by signing the Nursing Home Quality Care Act. But some nursing home

advocates believe the bill fails to hold nursing homes accountable

and opens the door for fraud.


"This is the first major reform in nursing home financing in

California in about 25 years," said Assembly Majority Leader Dario

Frommer (D-Glendale), who sponsored the bill. "What it's going to

mean for our patients is better care, better funding for the homes

themselves, and better training and better wages for the workers."

The bill creates a 6% tax on revenue generated by all nursing

homes. The state will pool that money together to trigger federal

matching funds, doubling the total, and then redistribute it to the

nursing homes.

Frommer said the legislation restricts how the nursing homes spend

the money by putting funding caps on categories such as

administration and patient care, ensuring that the appropriate amount

of money goes to patient care. The legislation also includes an

incentive system to reward nursing homes that increase patient care,

Frommer said.

But some nursing home advocates and the AARP argue that the bill

is ineffective because it does not include penalties for those that

violate the funding caps.

"If you don't use this money the way you should, or if you don't

meet the current staff-to-patient ratio, they're not going to take

those funds away," said Pat McGinnis, executive director of

California Advocates for Nursing Home Reform. "This doesn't have any

of those checks-and-balances.

"For some facilities which provide pretty good care anyway, this

is great. But for ones that game the system, and have been gaming the

system for years, this is a bonanza. They struck the jackpot."

Frommer said lawmakers addressed the criticism by requiring an

independent audit after the program's first year and having the bill

expire after three years, forcing lawmakers to go through a thorough

analysis before making the system permanent.

"It's a radical approach," Frommer said. "When you do something

that's very different, you'll always have people who are

uncomfortable with it. But it's got bipartisan support, and a large

segment of seniors are on board with it."

But Lupe De La Cruz, manager of advocacy for AARP, said the audit

and the analysis will burden the state's auditing department, which

is already understaffed and overworked. He did not think these

safeguards are enough to hold nursing homes accountable.

"We've not been able to count on the good faith of the industry to

provide better care," De La Cruz said. "We need to do it in statute.

This bill doesn't do that."

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