U.S. Proposes Rules to Upgrade Nursing Home Aides’ Training

Federal health officials Friday proposed long-awaited rules for nursing homes requiring that nurses aides meet competency 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 enacted by Congress in 1987.

“We’ve waited a very long time to get these regulations. They are 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 competency standards for nurses aides and publish lists of those who met the requirements--as well as aides found to have abused or neglected patients or stolen property.

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

Frank said that 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.

“There are far too many people with mental retardation living in nursing homes who are not receiving the care they need,” said Martha Ford of the Assn. for Retarded Citizens.

Concerns have been raised, however, that people turned away because they are mentally ill or retarded will not receive any care and could wind up homeless.