On Dec. 1, the U.S. Department of Health and Human Services will post on its Web site a list of 62 facilities that consistently offer poor care to nursing home residents and continually fail to comply with national standards.

Kerry Weems, acting administrator of the Centers for Medicare and Medicaid Services, made the announcement at a hearing of the Senate Aging Committee conducted by Sen. Herb Kohl on Thursday.

"I believe Americans should have as much information as possible about nursing home operation in order to make the best judgment about the care they provide," said Kohl, the committee chairman.

He held the hearing to call for increased transparency of all aspects of nursing home operation including ownership, staffing and results of government inspections. He also seeks stronger enforcement of facilities that are not in compliance with government standards.

"I honestly believe that more nursing homes will come back into compliance for good if they have the court of public opinion and the power of market forces as encouragement," Kohl said.

About 1.5 million Americans live in 16,400 nursing homes, said Weems, and more than 3 million receive some nursing home service during the year.
Bonnie Zabel, administrator of Marquardt Memorial Manor, a Medicare and Medicaid skilled nursing facility in Watertown, Wis., founded in 1969, was a witness at the hearing.

"People are in crisis when a decision is made to move kin to a nursing home," she said, and hospital discharge planners "too often take the path of least resistance" trying to get the patient out the door as soon as possible.
She advocated providing public information that is accurate, reliable and written in plain English.

She also recommended that consumers look for "person-directed" care, which is a philosophy about treating people as individuals in a nursing home situation.
"Their lives once made a difference and they deserve respect" even when elderly and frail, she said.

Another witness, David Zimmerman, a professor of health systems engineering at the University of Wisconsin-Madison, has been conducting research on the quality of care for 25 years.

Transparency is essential, he said, so the public knows who is providing the care and who is accountable for it; who is the operating entity of the nursing home; and who is the landlord.

Sen. Ron Wyden (D-Ore.), a member of the Aging Committee, concurred with the need for public disclosure. "There's something out of whack in this nation when it's easier to find information about a washing machine than about health care services."

Sen. Chuck Grassley (R-Iowa) said he is focused on three goals: eliminating abuse and substandard care, providing high-quality care and identifying bad actors in the nursing home work force.