Nursing Home Law Changes Proposed : Aging: Consumer groups protest federal agency’s revisions.

Federal health officials disclosed their proposed revisions to a controversial federal nursing home law Friday, provoking a wave of outrage from consumer groups.

The revisions would give inspectors greater latitude in enforcing sections of the law that govern, for example, a nursing home’s administration of drugs and the practice of transferring patients out of the facility. Deciding what constitutes an accident hazard and proper room furnishings also would be left up to inspectors.

The National Citizens Coalition for Nursing Home Reform called upon Inspector General Richard Kusserow to investigate the U.S. Health Care Finance Administration for its “hasty and spurious” revisions, which they said would eliminate important patient protections and undercut the law’s enforcement.

Rep. Pete Stark (D-Oakland) fired off a letter Friday to the health care agency’s administrator, Gail Wilensky, urging her to withdraw a number of proposed revisions that he said “would inevitably jeopardize the health, safety and quality of care provided to nursing home residents.”

However, state health officials reacted positively to the changes--many of which they had suggested. “We think they made a lot of progress,” said Scott Lewis, spokesman for the state department of health services. “There are certain areas we still need to . . . talk about.”

Federal officials began revising the law late last month, largely in response to California’s refusal to implement it. In an unusual move, Gov. Pete Wilson personally complained in a letter to President Bush that the guidelines were in many cases costly, unnecessary and illegally promulgated.

The coalition of nursing home reform advocates said Friday that the revisions were made in response to political pressure and intervention from the White House.

Federal officials could not be reached for comment on the coalition’s charges.

The revisions were sent to state health officials for their comment. When they are approved in final form, they will be distributed to all states.

The coalition said that other states may be thrown into confusion by the revisions, losing their “direction, movement and motivation to implement the law.”

All states but California implemented the law Oct. 1. Many state health officials have reported success in enforcing those rules and said they are confused about how the revisions will affect them.

The revisions include rewording of language regarding use of physical restraints.

The law originally required that patients or their legal representative specifically agree to the restraints. The revision says restraints may be applied as long as the patient “does not refuse.”

Also, the law originally required inspectors to ask whether the resident agreed to the use of a restraint. Under the revision, the inspector would instead determine whether the patient received an explanation of the use of the restraint.