Card-check and transparency and arbitration acts—Oh my!

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If you’ve been staying on top of long-term care news, you’ve probably noticed that lawmakers have been busy lately. Lots of bills have been introduced in recent days—some drawing praise, others scorn from provider associations.

Here’s a rundown of some of the bigger ones to keep an eye on in coming weeks and months, and what they mean to you, the long-term care provider.

Transparency bill

What it is:
Sens. Charles Grassley (R-IA) and Herb Kohl (D-WI) Thursday reintroduced this bill cracking down on oversight and quality. The Nursing Home Transparency and Improvement Act of 2009 would increase public accountability and enforcement of nursing homes. Among other objectives, it would allow state and federal regulators to identify individuals and entities with significant ownership interest or management of the facility. It also would expand the Nursing Home Compare Web site to include information about, and links to, recent health and safety inspection reports.

On the enforcement front, it would allow the placement of civil monetary penalties in escrow accounts following an independent informal dispute resolution process that generates a written record and is completed within 30 days. Facilities that successfully appeal receive the full CMP amount, with interest, back. Also, it would require that nursing homes that close voluntarily provide ample notice to residents and develop a transfer plan for residents.

The verdict:
The jury’s still out. The legislation, when it first was introduced in the last Congress, drew outcries from the American Health Care Association because of its reliance on the survey and certification process. But the new bill, which was released in tandem with a Government Accountability Office report, seeks to bolster the federal government’s survey and certification system. The American Association of Homes and Services for the Aging supported the original legislation.

Background checks


What it is:
The Patient Safety and Abuse Prevention Act of 2009 promotes a nationwide system of background checks to prevent people with criminal histories from working in long-term care settings. It would build on a three-year pilot program to examine ways in which states can implement systems to cost effectively screen applicants for employment in long-term care facilities. Sens. Kohl and Susan Collins (R-ME) reintroduced the bill this week.

The verdict:
Thumbs up. The American Health Care Association President and CEO Bruce Yarwood applauded the senators Thursday for their continuing work on seniors issues. He approves, in part, because providers wouldn’t have to foot the bill.

Card check


What it is:
The Employee Free Choice Act, which generated speculation for months before it was reintroduced, would eliminate the requirement of a secret ballot election for the formation of a union. Instead, a union could earn recognition when a majority of workers sign cards. (That is why it is called the card-check bill.) The legislation essentially makes it easier for unions to form.

The issue pits labor against big business, and Democrats against Republicans. Both sides have been lobbying their sides furiously. The Obama administration has set a pro-union tone, but enough federal lawmakers, and specifically senators, may not necessarily fall in line.

Sen. Tom Harkin (D-IA) and Rep. George Miller (D-CA) reintroduced the bill in Congress days ago. The Republicans countered previously with the Secret Ballot Protection Act, which would preserve the requirement of a secret ballot in union organizing elections.

Service Employees International Union leader Andy Stern said he expects action soon on the card-check legislation.

The verdict: Thumbs way down. Long-term care groups have derided the legislation, arguing that it would deprive workers of their right to a personal ballot, force arbitration and strip employees of their rights to dictate their own working environments.

“This legislation is wrong on policy, wrong on principle, and presents a clear and present danger to every working American who wants to exercise free choice in joining a union,” AHCA’s Yarwood said.

Of course, unions also would cost nursing homes, which already operate on low margins, more money in wages and benefits.

Silver Alert


What it is: The National Silver Alert Act would establish an infrastructure, as well as funding, for alerting both law enforcement and the public when a senior goes missing. The Silver Alert coordinator, a newly created position within the Department of Justice, would oversee the voluntary implementation of the system across the country. The House passed the legislation in February. Sens. Mel Martinez (R-FL) and Herb Kohl (D-WI) introduced the bill earlier this month in the Senate.

The verdict: Thumbs up. Many long-term care and other healthcare and senior advocacy groups have praised the legislation and its chief House sponsor, Rep. Lloyd Doggett (D-TX).

Arbitration Act


What it is: The Fairness in Nursing Home Arbitration Act would stop the mandatory use of a pre-dispute arbitration agreement between a facility and a resident. In the event of a dispute, nursing homes are not prohibited from asking for an arbitration agreement, but residents or plaintiffs would be under no obligation to agree to its use. U.S. Rep. Linda Sanchez (D-CA) introduced the bill earlier this month.

The verdict:
Thumbs down. The long-term care community does not like this bill.

"We believe that the Fairness in Nursing Home Arbitration Act is a misguided attempt to restrict and weaken the Federal Arbitration Act," Dave Kyllo, executive director of National Center for Assisted Living, said.
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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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