It’s understandable why most Massachusetts legislators weren’t talking publicly last week about one particular amendment they cut from the state budget before sending it to Governor Charlie Baker. Opposing a measure titled “Preventing patient abuse in nursing homes” probably wouldn’t sit well with constituents, especially older ones, who tend to vote in droves. The proposal, which called for drastically increasing the limit on fines that can be levied against nursing homes for health and safety violations, seemed to have broad support on Beacon Hill. Until it didn’t.
Every year, plenty of worthy proposals don’t make it to the final version of the budget, but this one was intended to benefit people who are no longer able to care for themselves — and it wouldn’t have cost the state anything. Despite the Senate’s approval of the measure in late May — and an indication from Baker that he would sign off on it — the amendment vanished after it went to a House-Senate budget conference committee. State Senator Mark C. Montigny, the New Bedford Democrat who sponsored the amendment, was rightfully livid after it failed.
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Increased oversight of nursing homes is urgently needed, especially as for-profit companies drive an industry-wide consolidation. A series of stories by Boston Globe reporter Kay Lazar has shown that for-profit nursing homes — which now account for about three-quarters of Massachusetts’ 400 facilities — are generally cited for health and safety issues more often than nonprofits. Earlier this year, for instance, the US Centers for Medicare and Medicaid Services fined Woodbriar Health Center in Wilmington nearly $290,000 for problems related to the deaths of two patients. Woodbriar is owned by Synergy Health Centers, a for-profit chain that has acquired an appetite for Massachusetts nursing homes. The size of the penalty was unusually large, however, and state inspectors have much less clout than federal regulators — the current maximum state fine is a paltry $50 a day. Montigny’s amendment raised it to $10,000, which is the federal limit. That surely would have inspired nursing home operators to adhere more closely to the rules. The largest fines would be assessed for the most egregious violations, such as gross neglect or lapses in care that cause serious injury or death. The money collected would have gone into a newly-established trust fund set up to finance more rigorous inspections and, if needed, the transfer of residents from subpar nursing homes.
So what happened? Politics as usual, probably, is to blame for the amendment’s demise. Lazar reported that the Massachusetts Senior Care Association, which represents nursing homes, has doled out $635,000 to lobbyists since 2011. A firm started by former Senate president Robert E. Travaglini received the bulk of the money. “Some of the most disgusting for-profit chains spend a lot,” says Montigny, “but not on the right things.”
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The nursing home trade group would better serve its members — as well as nursing home residents and their families — by doing everything it can to ensure the highest standards at every facility statewide. Most are staffed with dedicated nurses, aides, and other employees who provide skilled and essential care. Bringing the few outlier homes into line by imposing tougher fines, or by shutting them down altogether, would benefit everyone. When the next legislative session convenes, Montigny should bring back his proposal for reconsideration. Let’s hope there aren’t any more Woodbriars in the interim.