SB 556: Senior care bill tightens state regulations

There are more than 1,200 long-term care facilities in the state, about 500 of which are traditional nursing homes, according to the Missouri governor's office.

In June, Gov. Bob Holden signed SB 556 into law creating the Senior Care and Protection Act, which took effect Aug. 28. This law provides greater protection against neglect and abuse for seniors residing in long-term care facilities and nursing homes through increased penalties upon facilities that are not compliant.

The new law is tougher than the old one. For instance, the criminal penalty for nursing home administrators guilty of concealing abuse and neglect is now a felony rather than a misdemeanor, meaning the possibility of prison time.

The state's neglect statute also was strengthened, making it easier to keep people who abused, neglected or financially exploited seniors out of the long-term care field.

"It is really the first nursing home reform bill in over a decade," said Patrick Lynn, Gov. Holden's senior policy advisor. "It is something many people in the legislature and others have tried to get passed for many years now. It goes a long way to give us tools to make sure our senior citizens are living in safe long-term care facilities."

Local nursing home and long-term care officials are glad the stricter standards have been approved.

"I think it's about time. I've worked in facilities in the past where I think there should have been a stronger criteria for what neglect and abuse is," said Jennifer Clark, community director at Culpepper Place of Springfield. "This act is based on resident rights and is common sense. Neglect needs to be defined more broadly than it has been. I think it's doing that. In my opinion, abuse can encompass dignity issues. I feel very strongly that our residents need to be treated with dignity."

Don Swafford, administrator at St. John's Mercy Villa, said: "I think (the law) has a lot of good intentions. I think it clarified a lot of the current laws we're under, and will offer more protection for the residents of long-term facilities. It's good for long-term care because it's quality based."

Although the law just took effect, Lynn had already seen some positive changes. One part of the act stipulates the need for background checks on potential employees before making job offers, Lynn said. Prior to the new law, background checks were required to be started within the first two days of employment.

The Missouri Department of Health and Senior Services is the enforcement body for this law, except when criminal penalties are involved, Lynn said.

"Basically what this does is give the Department of Health and Senior Services more tools and more power to enforce current law," Lynn said.

Prior to the law, if any Class 1, 2 or 3 violations were found upon inspection and fixed within 30 days, there wouldn't be a fine, Lynn said. Now there is a fine if any violations are found.

This avoids what Lynn called the "roller-coaster effect" where facilities didn't do a long-term fix, just enough to get out of the fine.

A Class 1 violation can cost a facility a fine of up to $10,000 a day, with a maximum of $25,000, Lynn said. A Class 1 is a violation "which would present eminent danger to the health, safety or welfare of any resident or a substantial probability that death or serious physical harm would result," Lynn said.

A Class 1 violation would be no air conditioning, as in the case when four deaths occurred in a St. Louis nursing home in 2001.

The incident helped draw attention to the need for such a protection act, Lynn said. In that particular case, the state couldn't fine the home because the home had technically fixed the problem. Under the new law the home would have had to pay up to $25,000 in fines for each violation and the administrator would be guilty of a Class D felony, Lynn said.

Class 2 violations, which carry a $1,000 a day fine, are those with a direct or immediate relationship to the health, safety or welfare of any resident, Lynn said.

Class 3 violations, with a $250 a day fine, are those violations that have an indirect impact or potential impact on the health, safety or welfare of any resident, Lynn said.

Lynn also pointed out that the new law makes it easier to deny licensing to out-of-state companies that want to set up long-term care facilities.

"Before, we couldn't look at their record in another state to see if they were a good provider or if that state constantly fined them for violations," Lynn said.

One change for local facilities is that they have to notify the coroner after the death of a resident.

"That's new. The Greene County Medical Examiner helped us out by writing an outline of how to report this. He developed a form for us to use to fax to his office," Swafford said.

The coroner provision is just one more way to keep facilities in check, Lynn said. "What we're looking for is another set of eyes out there watching what is going on," Lynn said.