Hearing of the Senate Finance Committee - Senator Lankford Works to Protect Seniors from Abuse

Hearing

Senator James Lankford (R-OK) today participated in a Senate Finance Committee hearing entitled, "Promoting Elder Justice: A Call for Reform," at which he questioned Ms. Megan H. Tinker, Senior Advisor for Legal Review at the Office of Counsel to the Inspector General for the US Department of Health and Human Services (HHS), and Mr. John E. Dicken, the Director of Health Care at the US Government Accountability Office (GAO).

Lankford's Q&A focused on issues of fully vetting--at the state and national level--nursing home and senior adult living facility staff. Currently, 13 states lack consistency in their background check process, often only checking within the state and not checking national criminal databases before hiring staff. Lankford also asked about issues in the Centers for Medicare and Medicaid Services (CMS) five-star rating system for senior care facilities. CMS currently rates facilities on a variety of factors, but the process for collecting accurate data families need is flawed. Lankford also sought GAO recommendations on how to ensure abuse or low-quality issues in nursing facilities are timely and accurately reported to CMS to ensure they are immediately addressed.

Excerpts

On proper background checks for facility staff (00:00 -- 00:52)

Lankford: I want to come back to this background-check issue. There are 13 states currently that are not doing background checks for employees that are there or ownership obviously, as you mentioned the loopholes on before. Does that include states that only do a state background check but not a national background check? Are there some states that are only doing a state criminal check but not doing a national?

Tinker: Yes, part of the 13 states is 13 states that might have current state background checks in place but have not, for high-risk providers, fully gone through the process of implementing national criminal background checks.

Lankford: So the other 37 states all do a full national criminal background check? Not just a state only.

Tinker: Absolutely, however there are these loopholes that do allow for some opportunity to not perform those background checks.

On ways to best assess quality senior care facilities (01:55 -- 03:54)

Lankford: We have a tremendous number of really high-quality facilities in Oklahoma with staff that love the folks they serve with and love getting a chance to serve seniors and all of that care. Have you been able to note in any of your previous work what denotes to a family when they are looking or common characteristics of really high-quality care facilities? For instance, local ownership, transparency in data, relationships with local hospitals, allowing cameras to be in facilities owned by the patients' families. Have you noticed certain things that if those things are present this seems to be a higher-quality, less-abuse facility?

Dicken: We did talk to nursing homes as well as to inspectors as to some of the challenges and issues that would be in homes that were more or less likely to have abuse. Many of those related to staffing, whether we heard from staff that we spoke with directly that in some homes they had resources that if there were a difficult situation, if they were stretched they could turn to other staff that could relieve them. Other homes they said they really did not have that flexibility to turn to other staff and may feel underworked and over-stretched. We also heard that there were more challenges often in homes that might have a diverse population including both elderly and younger residents, those with cognitive issues as well as other issues. That can pose more challenges, certainly consumers need to look not only at the five-star rating but other information that's available and talk to the nursing home ombuds and others to find out the better performing home.

Lankford: So how would individuals get that information?

Dicken: Well, the starting point can be information on nursing home compare but going beyond that to talking to ombuds, to discharge planners from hospitals, that may know more local situations, certainly it's important to visit the homes and to talk to the staff and administration.

Lankford recently cosponsored a resolution (S. Res. 242) introduced by Finance Committee Chairman Grassley to designate June 15 as "World Elder Abuse Awareness Day" in order to raise awareness about and help fight elder abuse in our nation.

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