Neglect and Abuse Targeted

S 2933 – Elder Justice Act Targets Nursing Home Neglect and Abuse

Senators John Breaux (D-LA) and Orrin Hatch (R-UT) introduced the Elder Justice Act of 2002 on September 12. The bill is the culmination of several hearings and a General Accounting Office report on neglect, abuse and exploitation of the elderly, including nursing home residents. Senator Breaux, chairman of the Aging Committee, has said the goal of the bill is to "give elder abuse the same attention and resources as those devoted to child abuse and violence against women."

The wide-ranging, 138-page bill addresses elder abuse in home and community settings as well as institutions. However, a number of provisions specifically address prevention, reporting and prosecution of abuse and neglect in nursing homes and other long term care facilities. The bill would:

• Establish criminal penalties for neglect and abuse in nursing homes, including prison terms for individuals and fines up to $3 million for facilities.

• Require long term care facilities that received at least $10,000 a year in federal funds to report "any reasonable suspicion of a crime" against residents to law enforcement authorities. Owners, operators, employees, or contractors that failed to comply would be fined up to $200,000 or designated as "excluded individuals" who could not be employed for up to three years in a Medicare or Medicaid facility. If a resident were harmed because of their failure to report, exclusion would be mandatory for up to three years.

• Allow the Attorney General to petition the federal courts for appropriate relief to eliminate patterns of conduct that result in abuse and neglect against residents.

• Require criminal background checks of workers with access to residents.

• Require nursing homes to give 60 days’ notice to HHS and the state regulatory agency when they planned to close, including a plan for adequate relocation of residents. Owners that failed to comply would be fined up to $1 million and excluded from participation in Medicare and Medicaid, in addition to any other penalties that applied.

In other provisions, the bill would:

• Authorize a government study of the roles of public agencies charged with responding to elder abuse and neglect, including long term care ombudsmen, and recommend ways to eliminate gaps and duplication.

• Authorize evaluations and pilot studies relating to ombudsman programs.

The bill would also authorize:

• "Incentive grants" to improve retention of direct care workers, including funds for career ladders; training; and bonuses or other increased compensation.

• Programs to support management practices that promote staff retention; workplace culture change; and continuing education for nurse aides.

• Training grants for "targeted disciplines" -- including state surveyors, long term care facility staff, state ombudsmen, and advocates.