‘New Yardstick’ To Measure Nursing Homes State Worries 40 Percent Of Homes Could Be Declared Substandard Under New Rules

Forty percent of Idaho’s nursing homes could be declared substandard and are at risk of losing their patients under federal regulations due to take effect July 1.

Idaho has joined Washington, Oregon and Alaska in pleading with federal officials to delay the change. Gov. Phil Batt and all four members of the Idaho congressional delegation have written letters.

Scott Spears, head of a group of 74 Idaho nursing homes, estimates the new rules will require each home to add an average of one full-time employee just to handle paperwork.

“They’re going to be very burdensome,” Spears said. “It’s going to put facilities in jeopardy.”

Federal officials dispute Spears’ claim, saying they don’t think the rules will add to paperwork.

“It’s the applying of penalties that has folks upset,” said Barbara Gagel, director of the Health Standards Quality Bureau of the federal Health Care Financing Administration.

State officials also are frustrated at still not having the final version of the new rules - although they’ve been in the works since 1987.

“We’re looking for another draft on the 15th,” said John Hathaway, chief of the Bureau of Facility Standards in the state Department of Health & Welfare. “We don’t feel like it’s very well-prepared.”

Idaho, which inspects nursing homes under federal rules, has worked to help homes come up to standard. But the new rules use fines and other sanctions if homes don’t comply within set time limits.

“We estimate that 40 percent of the nursing homes in Idaho would fall into the substandard category,” said Health & Welfare spokeswoman Ann Kirkwood. “They’re not providing substandard care. It’s just a new yardstick.”

Kirkwood said one reason the state has focused on cooperation is that elderly nursing home residents view the facilities as their homes. Some studies show that residents who are moved have shorter life expectancies.

Gagel said federal officials share those concerns and have developed the new rules at the urging of consumer groups. “I think this is a very positive move,” she said. “What we’re doing with this rule, we think, is motivating facilities to remain in compliance with the standards. It clearly represents a change from the past.”

Members of the nursing home industry helped write the new rules, Gagel said. They didn’t get upset until they “found out that when you apply this, a lot of nursing homes in the country aren’t going to meet that standard.”

Scott Burpee, chief executive at Valley Vista Care Center in St. Maries, said the new rules are overkill.

The 1987 law that led to the new regulations did some great things, Burpee said, like reducing nursing homes’ reliance on physical restraints and drugs. But he’s worried that the new regulations focus on rules, rather than patient care.

Hathaway said Idaho nursing homes will need “more staff, more training and more vigilance” to comply with the new rules.

“The expectation is going to be that people know what they’re doing all the time, and that they do it all the time.”

That will mean higher costs, he said.

Today, just 5 to 7 percent of Idaho nursing homes are in the substandard category, according to the state. That’s about the national average.

Gov. Batt, in a letter to U.S. Sen. Larry Craig, said, “If these regulations go into effect July 1, you can expect higher costs, more federal control, more paperwork, more questions - and no special benefit.”

, DataTimes