On Tuesday, October 10, the Times Union ran an editorial suggesting that lawsuits are the root cause to the problems plaguing our state’s nursing homes. I believe a thorough examination of some relevant facts lead to a different conclusion:

1. What caused the bankruptcies?

• Every one of the corporations (in their own press statements and in their federal filing papers) have themselves attributed the bankruptcies to the reduced reimbursement levels resulting from 1997 Balanced Budget Act.
• In August of this year, the General Accounting Office released its second report in as many years stating that the bankruptcies were the direct result of bad business decisions and reckless expansion by these national chains. Lawsuits were not mentioned as a factor.

2. Do for-profit chains provide worse care?

• On August 1st of this year, the Health Care Financing Administration released the findings of an 8-year study that found, among other things, a majority of homes in America are dangerously understaffed and the for-profit chains were the worst offenders.
• Florida’s own compilation of survey data shows that for-profit homes are 80% more likely to provide substandard care and make it to the “Watch list”.

3. How does Florida’s care compare with the nation?

• The only national survey of the states (compiled by the University of California, San Francisco) puts Florida dead last when it comes to staffing deficiencies. Short staffing by the way is the single largest contributing factor when it comes to substandard care. As a result, Florida is below the national average in 7 of 10 care categories.
• To date, not a single national study has put Florida’s care above the national average.

While I strongly agree with your suggestion that the regulatory apparatus is the preferred mechanism for remedy, unfortunately, until last week, the state has been either unable or unwilling to adequately ensure the safety of residents. And while I applaud Governor Bush’s get tough action on substandard homes, we must all recognize that his administration has inherited a host of problems that will take years to correct.

As a member of the task force on affordability and availability of long-term care, I will work to improve the care for residents without jeopardizing their legal protections. Further, and more importantly, I will fight to change our system of long-term care.

We need to move Florida away from our almost singular dependence on institutional care as a first response and towards community based care systems: small group homes, adult foster care, home help programs and other such proven concepts. If we must have nursing homes, they ought to be smaller and the operators need to be close to the residents. My direct experience (backed by several national and state reports) suggests that faith-based and not-for-profit homes provide better care than the national corporate chains. We need a system that gives families real choices, saves taxpayers money, allows seniors to age with dignity, and make institutionalized nursing care an option of last resort.

Kenneth L. Connor is an attorney who represents victims of nursing home abuse.

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