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 SNF Advocates Prep for Senate Finance Hearing, Mark Parkinson to Testify

On July 23 the Senate Finance Committee, under the direction of Chair Charles Grassley (R-Iowa), is scheduled to hold a hearing on what is titled, “Promoting Elder Justice: A Call for Reform,” marking the second time since March that the committee has focused its attention on skilled nursing facilities and safety issues.

Advocates for long term and post-acute care providers say they are working closely with committee staff about the substance of the hearing and have secured a witness slot for Mark Parkinson, president and chief executive officer of the American Health Care Association (AHCA), in order to offer the profession’s point of view.

Clifton Porter II, senior vice president, government affairs, AHCA, says that the focus for the association and its members remains on offering solutions to any concerns raised at the hearing.

“We continue to be all about creating policy that ensures our patients receive the utmost protection, and we are open to working with the committee to accomplish that goal,” Porter says.

He says the focus of the hearing may be a new Government Accountability Office (GAO) report or possibly an Office of Inspector General (OIG) report released in June that dealt with an analysis of emergency room admissions and the percentage of potential abuse victims from that pool.

Among the many issues that may arise, he says it is important for lawmakers to understand that when it comes to abuse and neglect, there are a variety of requirements and definitions in use by regulators that differ from care setting to care setting. “One thing we want, as part of the solutions we offer, is a standardized definition of abuse across all settings so that they are aligned,” Porter says.

Other potential solutions rest in developing legislation to have nursing facilities participate in and have access to the national practitioner data bank to prevent unqualified or dangerous people from obtaining employment, he says. Currently, there can be gaps in background checks on potential staff if state databases are not linked.

AHCA has also been working with members of the Finance Committee on improvements for the recruitment and retention of certified nurse assistants via loan forgiveness and training programs. Porter notes that loan forgiveness has already been introduced as part of legislation to improve the staffing situation at skilled facilities.

The association is also working with the Centers for Medicare & Medicaid Services (CMS) on adding customer satisfaction to the Five Star Quality Rating System. “When it comes to the overall picture of a center, customer satisfaction could be a helpful tool for consumers, so we hope the committee takes time to discuss this next week with CMS,” Porter says.

During the first hearing in Grassley’s committee on skilled nursing care on March 6, the committee discussed the issue of CMS oversight of abuse and neglect claims at nursing facilities, as well as staffing adequacy and staff screening procedures.

At that time, senators reviewed the details of a recently released OIG report on skilled nursing resident safety. At the March hearing, David Gifford, MD, senior vice president of quality and regulatory affairs and chief medical offer for AHCA, said staffing isn’t the only serious concern for nursing facilities.

In addition, he said centers’ ability to monitor compliance with state and federal rules and regulations is a significant problem, which is made more complicated by uneven inspection citation practices from state to state.

For the July 23 hearing, the following is the latest list of those scheduled to testify: 

Panel I  

--Megan Tinker, senior advisor for legal review, Office of Counsel to the Inspector General, U.S. Department of Health and Human Services, Washington, D.C.

--John Dicken, director, health care, U.S. Government Accountability Office, Washington, D.C. 

Panel II

--Robert Blancato, national coordinator, Elder Justice Coalition, Washington, D.C.

--Mark Parkinson, president and chief executive officer, American Health Care Association, Washington, D.C.

--Lori Smetanka, executive director, The National Consumer Voice for Quality Long-Term Care, Washington, D.C.

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