New Nursing Home Rules Set Higher Standards

Some nursing homes will have to strengthen their health care services and meet other higher standards of care to qualify for Medicare and Medicaid reimbursement under new regulations issued Monday.

They will also have to give nursing home residents more rights, including the right to refuse treatment and to manage their own money.

The final rules were drafted in response to a law enacted by Congress in 1987 and reflect responses by more than 5,500 groups and individuals to proposed regulations published in October, 1987.

The final regulations will apply to nearly 15,000 long-term care facilities. The rules are open to a 90-day comment period and most will go into effect 90 days after that. The rest will go into effect Oct. 1, 1990.

Dr. William L. Roper, administrator of the Health Care Financing Administration, said the new regulations “take an important step in improving the quality of care provided in America’s nursing homes.

“These regulations change our focus in regulating nursing homes, away from looking to see merely if a facility has the capacity to deliver care, to looking at the quality of care that is actually being delivered,” he said.

The regulations would, among other things:

--Give patients the right to refuse treatment, manage their own money, receive visitors, manage their own privacy, express grievances, be free of restraints and not be transferred or discharged against their will.

--Offer patients services needed to treat specific conditions and guard against such things as inappropriate weight gain or loss and bedsores.

--Require nursing homes to have 24-hour nursing capability, including a registered nurse for eight hours of every day.

--Require facilities to train nurses aides, provide dental, vision and hearing care, and offer an activities program by a qualified professional.

The American Health Care Assn., which represents licensed nursing homes and long-term health care facilities, generally endorsed the regulations but expressed concern about the length of time it is taking to put them in place. Deadlines for some parts of the regulations have already passed, said Linda Keegan, a spokeswoman for the association.