THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Wednesday, August 28, 1996 TAG: 9608280013
SECTION: FRONT PAGE: A12 EDITION: FINAL
TYPE: Editorial
LENGTH: 61 lines
An agreement intended to clean up a Richmond nursing home while protecting 143 Medicaid patients from eviction promises to be a victory for all Virginians. However, it also is a forewarning of a public-policy dilemma that could prove catastrophic if unattended.
The handling of the Forest Hill Convalescent Center sets a standard that may impact other troubled facilities, including Manning Convalescent Home in Portsmouth and the Accomack County Nursing Home in Parksley.
Two months after the Richmond center was stripped of Medicare/Medicaid funding because of deficient care, a settlement this week between state officials and the owner includes these components:
A licensed administrator from outside the home will be brought in temporarily and given two months to bring Forest Hill into compliance.
The owner of the home will pay an estimated $300,000-to-$500,000 to cover the federal government's part of Medicaid payments and the salary of the temporary manager.
Residents, who would have been moved to area hospitals and then to other nursing-care centers, will be allowed to stay in a facility that, however imperfect, is home.
If this works, residents will have a better facility and they will avoid dislocation during a precarious time of life.
Difficult as the choice to move them would be, however, it would be preferable to ignoring poor sanitation and indifferent or inadequate care. For too long and in too many cases, substandard care of elderly patients who cannot fend for themselves has been tolerated.
Last summer, the federal government started cracking down on violators. The action came not a moment too soon. One result is that in states such as Virginia, where enforcement was lax, a growing number of homes may find themselves in Forest Hill's predicament.
Nursing-home-industry spokesmen say that the new approach allows ``zero tolerance'' for mistakes and is unrealistically harsh. They are wrong. Inspections remain infrequent and the public can be sure that for every mistake found during a visit, there are dozens of others that go undetected during the rest of the year.
The public is paying a pretty penny for care of the elderly. Government has a right and a duty to see that the money is well-spent.
What the Forest Hill situation also makes clear, however, is that carrying through on the threat of moving patients from substandard facilities will not be easy. Not only are families rightly resistant to a health-threatening change, but there simply may not be any place else for patients to go.
State Medicaid Director Joseph Teefey, who worked with the attorney general's office and others in a marathon session to arrive at the Forest Hill settlement, acknowledges the problem. Earlier this summer, while trying to relocate the home's residents, state workers could find only 19 available nursing-home beds in the Richmond area.
It's a win-win situation if violations are remedied and patients can stay where they are. But groups such as the General Assembly's Joint Commission on Health Care need to be planning now for future situations in which we are not so lucky.
The wrong approach would be to let the difficulty of change dictate leniency in enforcement when circumstances already are stacked to the industry's advantage. by CNB