The blockbuster piece of nursing home legislation introduced last week put the for-profit community on edge – and in a delicate position in terms of public relations.

That was evident in a bit of a verbal tussle McKnight’s recently was engaged in with one of the associations.

As a refresher, the Nursing Home Transparency and Improvement Act of 2008, introduced by Sen. Charles Grassley (R-IA) and Sen. Herb Kohl (D-WI), is intended to increase transparency and possible penalties.

Transparency measures include adding more nursing home ownership information on the Nursing Home Compare Web site, such as the identity of those participants in the Special Focus Facility Program. On the disciplinary front, the bill would ramp up punitive measures against those facilities with deficiencies. It would increase civil monetary penalties to $100,000 from $10,000 for a deficiency that results in death.

Clearly, the for-profit community was in a tenuous public relations position with its members and the larger provider community. After all, how do you react to legislation that may impose harsh penalties on your membership and possibly increase the regulatory burdens on facilities – but still stands for quality improvement?

Clearly, the American Health Care Association and the Alliance for Quality Nursing Home Care did not want to appear against reform – but didn’t want to wholeheartedly embrace the legislation either.

McKnight’s ran into a bit of a roadblock when it came to deciphering the Alliance’s position.

The Alliance, which represents some of the largest nursing home chains in the country, said that it “commends” the senators for “their longstanding and continuing commitment to nursing home quality improvement, a commitment reflected in today’s introduction of the Nursing Home Transparency and Improvement Act.”

It said later in its statement that it hopes “to work closely and cooperatively with Senators Kohl and Grassley to strengthen some provisions in their legislation.”

Hmm … So does that mean the Alliance supports or does not support the legislation? It’s hard to say.

We got confused. Our first Web site headline of the news story, “Alliance, SEIU rally around punitive reform bill” elicited a swift reaction from the Alliance, which thought the headline was too strong.

We agreed and replaced it with another, “Alliance, SEIU approve of punitive reform bill.”

Again, the Alliance wasn’t pleased, telling us so in an e-mail. So once again (third time’s the charm), we changed it. The final product? “Alliance, SEIU react to reform bill.” Not exactly a readership-boosting headline, but one that sums up its sentiment.

To be honest, the Alliance was right. We did not accurately state its position.

Still, a fair question remains: What does this organization think of this new bill? Its preoccupation with parsing language reflects its possible ambivalence.

If I may be so bold I would like to offer a recommendation: Take a stand. If you don’t like the bill, say so, like the American Health Care Association, which called it “well-intentioned, but off-target.”

And certainly don’t be afraid to recognize the legislation for its merits: a bill, which may need tinkering but whose ultimate goal is to approve the care in our nation’s facilities for the elderly.

It is a shame we had to state the Alliance’s position three times. But we might have been less mixed up if we weren’t trying to decipher a mixed message.