The D.C. Council is in the process of fast-tracking Bill 18-481–The Health Care Facilities Improvement Act of 2010. This is a mistake. Rather than improving care facilities, this bill will decimate the District’s long-term care community with unfunded mandates and untenable staffing requirements. The Council should delay the second reading of this bill until March at the earliest rather than moving ahead with it on Feb. 2. Nursing homes were provided no advance notice that this bill would be coming before the Council and on a fast track; they should at least be given the opportunity to make their views known.
Care providers are already facing enormous challenges to deliver quality service. This bill mandates additional hours of patient care without providing the funding for the increased staff. How will facilities even find additional staffing with the national shortage of registered nurses? Puzzlingly, the bill excludes the work of facility medical directors in the mandated hours, which will discourage physicians from serving in such a role. Medical directors and nursing supervisors make a tremendous impact on the quality of care because they provide the leadership that produces accountability and discipline on the front lines. The proposed bill ignores this important phenomenon. Moreover, arbitrarily eliminating nursing supervisors and managers from the direct patient care calculations while at the same time raising the required number of hours indirectly requires our long term care facilities to absorb hundreds of thousands of dollars in new staffing costs. This cannot possibly be supported under our already overtaxed budgets.
Clearly, there are major problems with this bill. It presents another unfunded mandate on our already beleaguered nursing homes that could easily drive many of our facilities into bankruptcy. Is it the goal of the D.C. Council to close our facilities and force our residents to seek care in other states?
Before it goes any further, we should heed the Hippocratic oath: First, do no harm. This bill would harm the District’s long-term care community and ultimately undermine the level of patient care provided.
Ron Wolff is the interim CEO of The Washington Home and Community Hospices. Burton Gray is a member of the Board of Directors of The Washington Home and Community Hospices, elected in January 2010 after serving on the Investment Committee since 2007.