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Nursing Home Reform OK'd

April 22, 1999
By: David Grebe
State Capital Bureau
Links: HB 826

JEFFERSON CITY - More options in nursing home care - and specialized care for Alzheimer's patients - may be on the way. A bill sponsored by Rep. Tim Harlan, D-Columbia, changing the way Missouri regulates nursing homes has gotten initial approval in House.

The Alzheimer's Association says it's important to allow Alzheimer's patients to have unique facilities - because nursing home care is sometimes too restrictive for these patients.

But tension surrounds a provision that would allow limited expansion in homes that are near capacity. Presently, new nursing home beds cannot be added if another home nearby has excess capacity.

"It's important to consumers," Harlan said. "It allows for expansion in places where consumers want to live." Harlan's bill extends the moratorium - but he said some expansion will be allowed.

According to Shawn Bloom, executive director of the Missouri Association of Homes for the Aging, the moratorium serves to protect uncompetitive providers. Bloom's organization represents primarily nonprofit nursing homes.

But the Missouri Health Care Association - which primarily represents for-profit nursing homes - disagrees.

"We believe there has to be planning in health care - it's not like the delivery of other products," said Earle Carlson, MHCA Executive Director. "There are a lot of reasons - besides incompetence - that a facility wouldn't be 90 percent full," he added.

Harlan says he's tried to arrive at consensus - but that dissension within the industry made that difficult.

"The nursing home lobby is very powerful," Harlan said. "Most lawmakers have three or four nursing homes in their districts - and you hear from them - but you don't hear from consumers on this type of issue," he said.

Bloom said many older Missourians want continuous care and want to stay in the same place when they need more critical care. "We're trying to do everything we can to ensure adequate options for individuals," Bloom said. Bloom said some facilities needed to expand to make continuous care available.

The bill also modifies what's known as the "pathway to safety" requirement - proponents say this requirement currently forces people into skilled care when they really don't need it. They say "pathways to safety" - designed to prevent fire death - are unnecessary in homes with sprinkler systems.