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Long-term care providers are held to some of the strictest regulations in the nation, the American Health Care Association complained to the Bush Administration last week.

More than 130,000 pages of Medicare and Medicaid rules and instructions for skilled nursing  facilities exist, said Sandra Fitzler, RN, AHCA’s senior director of clinical services during a public meeting sponsored by the U.S. Department of Health and Human Services and the U.S. Office of Management and Budget. That’s three times the page total of the IRS tax code and its federal tax regulations combined, she noted.
 
To emphasize the administrative burden over regulation puts on nursing homes, Fitzler said the Medicare cost report requires many staff hours and trained accountants to accurately complete. The Minimum Data Set is so complicated that nursing homes often run into problems with interpretation of its 500-page manual.

She also said the nursing home survey and enforcement system is highly subjective, process-oriented, punishment-driven and has strayed far from its intended intend to improve and reward quality care.
 
Fitzler said the implementation of the new Medicare Part D Prescription Drug Program will only add to the administrative burdens.
(Published 11-7-05)