Nursing Home Bonus Bill

According to an article in the Des Moines Register by Clark Kauffman, Congress is considering legislation that would eliminate taxpayer-funded bonuses to nursing homes.

The amendment to a presently pending budget bill was accepted by unanimous consent of the Senate on Thursday, but the bill itself has yet to be approved.

Last November, the Des Moines Register reported that nursing homes throughout the country were earning hundreds of millions of dollars in taxpayer-funded bonuses despite violations of basic health-and-safety standards. Iowa has had a nursing home bonus program for seven years. Under these programs which exists in 36 states, regulatory violations do not disqualify a nursing home from receiving a bonus that is supposed to be directly related to quality care.

However, the sponsor of the program, the Centers for Medicare and Medicaid Services, which approves and helps fund each of the bonus programs, does not track the payments. Nationally, the total cost of the bonuses is unknown.

In their report last November, the Des Moines Register examined eight programs in the seven states where recent regulatory violations don’t disqualify a nursing home from receiving a bonus and discovered that those eight programs cost taxpayers $312 million per year. It also found that 16 of 23 homes hit with major fines in 2007 qualified for 2008 bonuses. Two homes that earned bonuses were on a federal list of the worst nursing homes in the nation, and a third faced the threat of having its license pulled because of substandard care.

Some of the largest bonuses to poor-performing homes have been in Oklahoma, the home of Republican Sen. Tom Coburn, a medical doctor. Coburn authored Thursday’s amendment, telling his Senate colleagues that taxpayers shouldn’t be billed for bonuses paid to inferior care facilities.

"We paid out in excess of $300 million in bonuses to nursing homes that had significant problems in terms of giving the care and meeting Medicare standards," he said. "Why? Why wouldn’t we fix that?" Coburn’s amendment would prohibit federally funded bonuses to nursing homes and any other government contractors that "fail to meet basic performance requirements."

I find it interesting that we have to legislate matters like this. It would make sense that the government which pays out the bonuses should monitor the care and the use of the money without the need for legislation. But, let’s be grateful for this move to attempt to improve the care of our nursing home residents.