Besides the weather, politics and who's running for governor, the favorite topic in the state Capitol is usually money — especially now during another legislative session. Advocates for nursing home reform know all about the money issue. It's one of the nursing home industry's favorite excuses for not improving care.
Also, the fear often is that, if some money is found, it will be used by nursing homes for the wrong reasons or it will go into the pockets of nursing home owners and not to help the residents.
Against this backdrop comes proposed legislation about the Civil Monetary Penalty Fund, which collects the state's share of federal penalties on nursing homes found not in compliance with regulatory standards. Right now, there is almost $13 million in the fund.
That's a lot of money in these days and times — or anytime for that matter — and it bears watching and good management. The law says that CMP funds must be used for projects or activities that benefit residents or that protect a resident if a facility is closing. In short, it is a unique and potent resource to fund innovative activities that can make a difference in the lives of nursing home residents.
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The fund is now managed by the secretary of the Cabinet for Health and Family Services, and decisions on use of fund money are approved by the federal Centers for Medicare and Medicaid Services. The fund at best is unstable, so it is difficult to depend on it for recurring support of projects. Penalties assessed on nursing homes and put in the CMP fund vary widely each year — from about $600,000 in 2004 to more than $5 million in 2009.
It's hard to get records on the fund from the state or federal governments; but the latest report, obtained through the Freedom of Information Act, for the first half of 2010, showed $95,875 in penalties being paid into the fund by long-term care facilities.
To ensure the most effective use possible of the fund, Kentuckians for Nursing Home Reform, a non-profit advocacy group, wants to set up an advisory committee. Rep. Mary Lou Marzian of Louisville has agreed to sponsor creation of such a committee. Sen. Ray S. Jones of Pikeville may also introduce it in the Senate.
The committee would be advisory only, but it could also serve as a watchdog to ensure that every expenditure would help residents of nursing homes. The committee would be made up of appropriate state officials, representatives of the nursing home industry, advocates for nursing home reform and family members of nursing home residents.
In recent years, the money has been used to support the statewide nursing home ombudsman program ($764,000 last year) — a valuable program that helps nursing home residents.
On the other hand, $17,000 was taken out of the fund last year to pay for training nursing home operators and their staffs. The training covered both state and federal licensing and certification requirements. It was training that many observers think the nursing homes should be doing routinely themselves.
With about $13 million sitting there, other ideas are popping up for using CMP funds. One of these is to expand ombudsman services to assisted living facilities. The ombudsman program also suffers from a shortage of staff. Also, CMP funds could be used to create an ombudsman program on financial exploitation of elders.
There is a lot to be done on behalf of our elders in nursing homes. The CMP Fund can be one answer to the financial plight that now inhibits any innovative programs. An advisory committee needs to be formed right away, and put to work.
For more information, go to http://www.KyNursingHomeReform.org.Ky. Voices: Nursing home fund needs advisory panel