The Case for Nursing-Home Reform

St Louis Post-Dispatch (MO), January 1, 1994 | Go to article overview

The Case for Nursing-Home Reform


A Post-Dispatch series on the sorry state of nursing-home care in Missouri prompted Gov. Mel Carnahan to set up a task force to look at ways to overhaul the state's nursing-home system. The task force has completed its review and has recommended reforms. It is now up to the Legislature to turn these forward-looking recommendations into law.

Written by reporters Robert Steyer and Theresa Tighe, the Post-Dispatch series laid bare a nursing-home industry suffering from weak state regulations, equally weak enforcement and widespread staff shortages. All these shortcomings translated into poor care, particularly for seriously ill patients.

Among other things, the task force recommends that the Legislature change nursing-home reimbursement policies. All homes now get the same reimbursement rate, whether their patients require comprehensive care or light care. The task force says the reimbursement policy should reflect the level of care rendered. Changing the policy would make it easier for the sickest patients to find nursing-home beds and receive better care.

Some nursing homes are certain to oppose this recommendation, just as they are likely to frown on the task force's support for a tax on nursing homes and a higher license fee to finance improved patient care. Such a tax isn't without precedent. Hospitals now pay a tax to help Missouri deliver health care to the needy; it would be reasonable to tax nursing homes to improve patient care. …

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