Legislators have rolled up their sleeves to make changes in the nursing home business, but facility administrators and the state health department are tight-lipped — for now.
Thomas E. Johnson (R-Benton) has initiated House Bill 61 to allow the building of private-pay nursing homes without the hassle of the certificate of need (CON) process.
“If you’ve got $5 to $10 million in your pocket and want to build a private-pay nursing home in Mississippi, you would think you would be allowed to do that and enter the nursing home business, but you can’t,” said Johnson. “Under the current law, you have to go through the CON process and prove there’s a need. Then you have to get legislative action in order to get it approved. Each one has a bill.”
A slew of bills addressing nursing homes and CONs are listed on the legislative committee agendas for the House and the Senate. The CON process is already a hotly debated issue for hospitals and Gov. Kirk Fordice has vowed to do away with the procedure.
“As long as someone wants to build a private-pay nursing home that is not taking taxpayer dollars, then you should be able to do that as long as you meet the licensure and health standards,” Johnson said. “You should not have to go through any legislative process.”
House Bill 61 is currently in committee, and Johnson will be surprised if it is well received, he said.
“You can understand that people who are already in the nursing home business probably won’t like this,” Johnson said. “It’s typical those people who are in a business want to keep others out although I’m not saying that’s what they’re going to do. Several months ago, a particular lobbyist who works with nursing home owners told me that the bill would probably be supported. But last week, I was told it would be opposed. That’s what I would expect.”
About a dozen nursing homes in the Jackson area were called and administrators were asked — from a business perspective, what would you like to see? Almost all administrators were unavailable or declined comment.
Steve Crawford of Crawford Nursing Home Inc. of Jackson, family-owned since 1954 and licensed for 79 beds, said he has no objection to House Bill 61 or Senate Bill 2679 but he doesn’t believe either will be passed.
“It will be real interesting to follow, especially if it passes,” Crawford said. “I’ll be curious to see what Governor Fordice does with it.”
Streamlining the process
Jim Bean (R-Hattiesburg), chairman of the Senate Public Health and Welfare Committee, has three bills in the works, including Senate Bill 2679 requiring pre-admission screening for nursing facilities and authorizing additional beds. It is considered by many a compromise to House Bill 1191, which would have provided 2,000 more nursing home beds. Fordice vetoed it.
“There are always a number of bills filed requesting CONs for nursing homes,” Bean said. “This bill would alleviate that.”
Under the present system, screening assessment is completed after a patient is admitted to a nursing home, he said.
“Information furnished to us indicates that of some 15,000 people who reside in nursing homes, about 3,028 of them probably have the ability to continue to live independently if adequate and appropriate home- and community-based services were provided,” Bean said.
Pre-admission screening would determine if nursing home admission is appropriate care, he said.
“Mississippi spends 99.8% of all long-term care Medicaid funds for institutional care and only 0.2% for community-based services,” Bean said. “The national average for home and community based services is 12%. This is an indication that we are institutionalizing people as their only choice when there may be other choices.”
Nancy Kay Sullivan Wessman, director of communications for the state department of health, said it is premature to speculate.
“When we see the bills that play through committee, we will be in a position to discuss them,” Wessman said.