providing the bulk of direct patient care services. This weakness can and should be corrected.” In the legislative hopper In late June, as the special legislative session approached, Texas politicians began pressing for action. Sen. Walter Health, sanitation and safety violations in Texas nursing homes number two to five times the national average. But the governor had to be pressured to act; the bureacracy has been hopelessly inadequate; and home operators have opposed reforms which raise costs. whose bill requiring at least two open hearings a year at all nursing homes passed the Senate only to be idled away in the House during the regular session, asked Gov. Dolph Briscoe to include nursing home reform in his legislative agenda for the special session. And Sen. making abuse of nursing home patients a felony. At first, Briscoe was cool to the addition of the nursing home issue to the special session calendar; he preferred limiting it strictly to school finance. But he finally gave in and threw nursing homes, Seadock, and a few other items into the legislative hopper. Legislators said privately that the governor’s eventual support of tougher laws for nursing homes was prompted more by his 1978 reelection hopesand Atty. Gen. John Hill’s announcement that he would send a special investigating panel around the state to hold hearings on nursing home conditionsthan to any sudden surge of compassion for the elderly.* With the governor’s acquiescence, the Legislature began hearings on nursing * That Briscoe’s commitment to nursing home reform is less than ardent seems borne out by Nadeane Walker’s July 22 story in the The Dallas Times Herald. According to Walker’s report, the nursing home patients in Texas are entitled to the services of an ombudsman empowered to field and act on nursing home complaints and organize community advocate groups for improved patient care. The money for the ombudsman$30,000 yearly from HEWgoes to Douglas Richnow of the Governor’s Committee on Aging. Richnow says, however, that his job is to study the legal needs of the elderly, and that’s where the $30,000 goes. “I’m not interested in setting up local groups of goody-two-shoes people to walk around nursing homes,” he told the Times Herald reporter. home conditions in July. The testimony before the Senate human resources committee was devastating and supported everything federal investigator Holton had said in his report. Mrs. Freddie Mader of Houston showed slides of her grandmother’s pustulated 3-inch-wide bedsore. Vance Ferguson, of Austin, told the panel that all of his mother-in-law’s belongings had been stolen several times and that once he’d found her tied up and displaying “what is commonly known as a fat lip.” And a San Antonio man told of being intimidated by nursing home administrators when he complained to them of the treatment his wife was receiving. Nonetheless, there were forces opposed to serious reform. Committee leased to the Observer a letter from a banker in Wichita Falls who had written to urge that the state’s nursing homes not be treated too harshly. “One unfortunate incident [the Pine Haven beating] apparently has caused legislation to be considered which would be very hard on the nursing home industry,” wrote George Adams, president of the Parker Square Savings and Loan Association. Adams, whose savings and loan finances more nursing homes than any other S&L or bank in the state, warned against requirements “that are not needed and will raise the cost of operation.” Meanwhile, Hilmar G. Moore, chairman of the State Board of Welfare, denounced the “sudden crusade” spawned by the Lufkin News and David Holton and declared, “I believe the quality of care [in the homes] to be excellent.” Moore downplayed the need for reform. “Panic or hasty action is not warranted,” he said in a letter to Senate and House committee chairmen, adding “I will not be silent while the Department of Public Welfare is used as a whipping boy.” `Official permissiveness’ The legislative hearings revealed a bureaucratic labyrinth hampering the regulation of nursing homes. Holton apparently was not far off when he said that a climate of “official permissiveness” contributed to lax operating standards. And Dr. Fratis Duff, director of the state Health Department, told the House health and welfare committee he could remember only one instance when a Texas nursing home had its license revoked. The law passed last month mandated the reorganization of the appropriate regulatory agencies and established tougher sanctions against unsafe nursing homes that violate health standards. However, the new statute is shot full of holes and many who had hoped for true reform are pessimistic. The core of the nursing home bill, which passed the House and Senate by huge margins, is a provision that places the various state regulatory activities under the direction of the licensing agency, i.e. the Health Dept. Holton had recommended the consolidation of certification and enforcement functions, but not everyone liked the department chosen to do the job. Some say the Health Department’s broader authority is just a cosmetic alteration, no guarantee that conditions in nursing homes will improve. And, in late July,, Health Dept. officials admitted to Austin AmericanStatesman reporter Jim Baker that the department had not processed some nine-month-old complaints. the committee’s vice chairman, and others unhappy with -the Health Department’s past performance opposed this provision in committee. Madla, who wanted the Welfare Dept. to be given the job of regulating nursing homeshis amendment failed 6 to did not vote for the bill in committee and almost succeeded in holding it up. The bill also sets civil and criminal penalties for operators who run facilities where patients are abused, and where DPW standards are not met. The Health Dept. now has the authority to levy fines of $25 to $1,000 against nursing homes; the penalty for assaulting a nursing home patient has been made a felony punishable by two to ten years in prison and a $5,000 fine. In addition, it is now a Class A misdemeanor to fail to report to law enforcement officials any instance of patient abuse. NURSING HOME CHAINS NAME AND CORPORATE HOMES HEADQUARTERS IN TEXAS ARA Services BEDS IN TEXAS National Living Centers 88 8,884 Houston Geriatrics, Inc. 22 2,646 Cireeiey, uoio. Leisure Lodges 52 5,378 Fort Smith, Ark. Challenge Homes 25 2,850 Dallas National Health Enter prises, Santa Monica 15 1,947 ANTA Corp. 11 1,864 Oklahoma City Autumn Hills and 13 1,405 Convalescent, Inc. Truco Properties 8 1,003 Monterey Life Systems 11 940 Columbus, Ohio Hillhaven 8 886 Tacoma, Wash. Carex Intl 10 784 Los Angeles v , A”, 1, ID,
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