Nursing Home Care Jeopardized by GOP Plan, Advocates Charge

WASHINGTON —  A landmark 1987 law imposing federal quality standards for nursing homes caring for low-income Medicaid patients will be gutted by congressional Republican legislation overhauling the program, Democratic senators and nursing home reform advocates charged Friday at a hearing. They said that would threaten a return to the days when elderly patients were tied to wheelchairs and otherwise abused.

“Congress’ rash, regressive move reflects cruel disregard for America’s growing number of citizens who are elderly and have disabilities,” said Elma Holder, executive director of the National Citizens’ Coalition for Nursing Home Reform. About 1.6 million elderly are receiving long-term care paid for by Medicaid, at a cost of about $30 billion a year.

Sen. Edward M. Kennedy (D-Mass.), who presided at the Democrat-sponsored hearing on GOP plans to cut $182 billion from Medicaid growth over seven years, also said that the House version of the GOP plan wipes out an existing “spousal protection” law ensuring that the at-home spouses of nursing home patients need not give up their income and assets before Medicaid starts paying the bills for the spouse in the nursing home.

Medicaid law once led to the “pauperization of the families of those who need nursing home care,” since Medicaid payment for nursing home care did not kick in until the family had spent almost all it had on providing care for the patient, Kennedy said.

But a 1988 law required states “to allow a spouse in the community to retain a minimum income of $1,200 a month” from combined family income without the nursing home partner losing Medicaid nursing home eligibility. That would be repealed in the House bill, Kennedy said, as would a 1965 provision forbidding states from forcing the adult children of the elderly to pay their parents’ nursing home bills.

However, Mike Collins--a Republican spokesman for the House Commerce Committee, which handled the bill--said Democratic claims that Medicaid long-term care patients and their families will go unprotected are totally wrong. He said the GOP bill directs the states to draft their own laws on nursing home quality standards and spousal protection, and lays out a detailed list of conditions and situations they must address.