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Senate panel rejects administration plan to change nursing home rules

There should be no dilution of federal nursing home inspection rules. That was this week's firm decision by the Senate's special committee on aging.

Without dissent, Democrats and Republicans joined in requesting that the Reagan administration withdraw rule alterations that could weaken protection of elderly patients.

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The economic motives of Reagan red-tape cutters were not disputed. But the proposed methods were opposed by witnesses from all sectors of the nursing home industry, said the committee's letter to Richard Schweiker, secretary of health and human services (HHS).

And congressional concern over the impact of regulatory reform on the vulnerable elderly won't stop with the committee action. House legislators with authority over health regulations have introduced a bill that would delay changes in nursing home rules while a special study is commissioned.

The proposed rules, part of Reagan's regulatory relief program aimed at cutting paper work and costly compliance requirements, included these controversial changes:

* Nursing home accreditation and inspections would be conducted on a two-year cycle rather than annually.

* Facilities with deficiencies would no longer be subject to mandatory, on-sight resurveys within 90 days. Resurveys could be done by phone.

* Official responsibility for the nursing home accreditation would be given to a single, private organization - the Joint Commission on Accreditation of Hospitals (JCAH) - contracted on a fee basis and not accountable to the public.

A spokesman for Secretary Schweiker would not comment on the House and Senate actions, adding that the public comment period on the proposed rules ended in July and the administration will be considering the public comments before deciding whether to continue with the proposed rules.

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Administration efforts to revise the rules were aimed at streamlining the regulatory process by ''eliminating cumbersome and unnecessary requirements and to concentrate our scarce resources on providers with deficiencies,'' the committee was told last month by Carolyne Davis, administrator of the Health Care Financing Administration.

But it's hard to tell where regulatory excess ends and true protection begins - especially given the sensitive concerns of the 1.3 million Americans over 65 who are cared for in nursing homes.

HHS administrators stress that the rule changes were aimed at eliminating unnecessary burdens on the $22 billion nursing home industry, which relies on federal funding from programs like medicaid and medicare for 57 percent of its business.

For example, said one administrator, it would be less costly to eliminate the annual survey requirements at the facilities with consistently good records. Instead, he said, limited funds could be better used to go after homes with consistent deficiencies. In explaining the elimination of the 90-day mandatory in-person resurvey, he said that in-person follow-ups don't need to be made on many deficiencies - like the correction of board meeting minutes - that can be rectified quickly and confirmed by phone or mail.

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