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Nursing Home Task Force Says, 'The System Is Broken and Can't Be Fixed'

NASHVILLE, Tenn., Aug. 25 /PRNewswire/ -- A national task force from the American Association of Homes and Services for the Aging (AAHSA) recently reported that the current survey and certification processes used to evaluate long-term care facilities nationwide is broken and beyond repair.

After a thorough investigation into survey and certification protocol across the country, the task force concluded in its final report, "Broken and Beyond Repair: Recommendations to Reform the Survey and Certification System," that an independent, broad-based national panel of experts should be convened to re-examine the oversight process for nursing homes.

The report's 31 recommendations address short-term and long-term solutions, including improved communication to surveyors and providers about new requirements and changes to the survey process, standardized job descriptions for surveyors, more efficient use of survey resources, and flexibility to adapt to culture change. The task force's overarching recommendation is that an independent commission, such as the Institute of Medicine, re-examine the survey and certification process to "create a common vision for how our nation should care for its frailest citizens and to recommend a new oversight model for ensuring that this vision becomes reality in every nursing home today."

This report hits home in Tennessee, where the trend of increased admission suspensions continues for the second consecutive year, with 16 facilities forced to remit significant fines and suspend new patient admissions so far in 2008, following 29 in 2007. This comes as a result of violations reported under the current survey system.

Co-chair of the 20-member task force and CEO of Hebrew Health Care in West Hartford, Conn. Bonnie Gauthier acknowledged that, "Our short-term suggestions alone won't bring the system back to the intent of OBRA 87-achieving optimal, quality-based, resident-centered care-but they will tide the system over until broad systemic change can occur." Immediate changes needed, according to the report, include better public reporting of survey results, joint education of providers and surveyors, and greater overall consistency in the process.

TNAHSA, Tennessee's AAHSA affiliate, works closely with the Department of Health in an ongoing effort to provide updated and accurate information to licensed providers of long-term care services, according to TNAHSA Executive Director Carrie Ermshar.

"Because the Centers for Medicare and Medicaid Services play a significant role in the certification process, the solution must address procedures at the state and federal levels," said Ermshar. "We have encouraged enhanced training for Tennessee Department of Health licensure surveyors and we are seeing tremendous efforts to improve communications between surveyors and facilities. We have a great team of providers, lawmakers and surveyors in Tennessee and we all share the common goal of providing excellent patient care."

To inform its conclusions, the report includes a digest of interviews with survey agency representatives from seven states and a catalog of surveyor job descriptions from numerous states.

Timothy L. Veno, president and CEO of the Kentucky Association of Homes and Services for the Aging (KAHSA) and a co-chair of the task force, said that, "The frustration of good providers has reached a boiling point." Veno added, "We have to help shape a better system of consumer protection for residents."

Larry Minnix, AAHSA's president and CEO, said the task force captured the demoralization of providers who feel caught in a vicious circle. "We have to break the cycle of fear that paralyzes us all: consumers fear nursing homes, nursing homes fear the state, states fear the federal government, the federal government fears Congress and Congress fears voters," Minnix said. "This system is broken and can't be fixed. A system based on consistency, fairness and accuracy will help us move toward the day when there are two types of nursing homes: the excellent and the non-existent."

Copies of the report are available on AAHSA's Web site at .


TNAHSA represents skilled nursing facilities, assisted living facilities, senior housing services and various agencies serving senior adults throughout Tennessee. An affiliate of the American Association of Homes and Services for the Aging (AAHSA), TNAHSA provides leadership, advocacy, education and communication services. For more information about TNAHSA, please visit or call 615-256-1800.

SOURCE Tennessee Association of Homes and Services for the Aging
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