Governor Donald L. Carcieri signed into law Tuesday five bills designed to improve the regulation and oversight of nursing homes throughout Rhode Island, a press release from the governor’s office said. The five pieces of legislation, The Long Term Care Reform Act of 2005, were the result of efforts by the Carcieri administration and the General Assembly to address issues that came to light after the closure of Hillside Health Center.
“The bills will create a comprehensive system of oversight and accountability for nursing homes in Rhode Island,” Carcieri said. “For the first time in the history of our state, we have the ability to assure that these facilities are financially solvent and that they have the resources to provide quality care for residents.”
Rhode Island has the sixth-highest concentration of people age 65 and over, and approximately 22,000 people 85 and older. Senior citizens represent the fastest-growing segment of Rhode Island’s population. Currently, approximately 9,500 Rhode Island seniors reside in nursing homes, the release said.
The five bills make up a comprehensive package aimed at addressing resident care issues at Rhode Island’s nursing homes and providing more thorough oversight of their administration and financial condition.
The first bill addresses quality assurance for residents and early state intervention. It improves communication between state departments in cases of complaints about nursing homes and creates a triage system so complaints are handled swiftly, and adds extra inspections for facilities with patterns of deficiencies, a General Assembly press release said. It also sets standards for releasing information about problems to the public, state agencies and residents’ families.
The bill also requires financial reports from nursing homes and triggers state intervention when financial problems are found.
The second bill is called the Germaine Morsilli Act, after an 87-year-old resident who inspectors repeatedly found lying in her own waste with no dressing on her worsening bedsore at the Hillside Health Center. She died of heart disease six weeks after the state finally ordered her moved to another home. This bill is aimed at improving the quality of care for nursing home residents. It defines administrators’ roles in oversight of care, and requires reporting of nursing home staffing levels. It requires the state to create a plan to notify residents and their families in cases of substandard care of a resident and find a way to determine and predict which homes need intervention because of quality problems. It would also allow family councils and require facility quality improvement programs at each home.
The third bill tightens controls on licenses issued to nursing homes. It will also establish a “probationary status” as an intermediate step before the health department limits admissions to a nursing home or removes its license, and define the “controlling person” of a nursing facility as the person who is ultimately responsible for inadequate care or insufficient response to quality problems. It will also require license holders to prove they have adequate cash on hand and disclose information on partnerships and previous nursing home involvement.
The fourth bill addresses receivership of failing nursing homes and is based on legislation previously submitted by Attorney General Patrick Lynch. It will establish a process by which the health department director can seek receivership for homes whose mismanagement or insolvency is jeopardizing resident care, seeking minimal disruption to residents.
The final bill is a resolution requiring DHS to study the need for home care, adult day services, respite care, assisted living and nursing home care, and make recommendations for financing community-based long term care to ensure access for people in need.
