U.S. Proposes New Rules to Improve Nursing Homes

Federal health officials proposed long-awaited rules for nursing homes today requiring that nurses aides meet competence standards and that residents be screened for mental illness and retardation.

The rules proposed by Health and Human Services Secretary Louis W. Sullivan carry out some of the major nursing home reforms passed by Congress in 1987.

“We’ve waited a very long time to get these regulations. They are both incredibly important,” said Barbara Frank, associate director of the National Citizens Coalition for Nursing Home Reform, a consumer group.

Under the proposals, states would develop training and competence standards for nurses aides and publish lists of those who met the requirements--as well as of aides found to have abused or neglected patients or stolen property.

As of Oct. 1, nursing homes participating in the Medicare and Medicaid programs could employ only aides who met the standards. Training would have to be given free to workers, and there are some exceptions for aides already hired.

Frank said the law was needed because “a lot of nursing homes hire people directly off the street without giving them proper supervision or training.”

People entering nursing homes would be tested for mental retardation and illness and residents would be screened annually to make sure they are not being “warehoused” in such facilities, Sullivan said.

When a person who has been a resident of a nursing home for less than 30 months is found to be mentally ill or retarded, the state must arrange or provide treatment at a more appropriate facility. Longer-term residents could receive treatment without moving from the facility.

Advocates for the mentally ill and retarded have favored such measures, saying thousands of nursing home residents should be in other facilities.