Highlights from the Democrat candidates plans for LTC, specifically nursing homes:

From John Edwards:

Living With Dignity

9. OFFER CHOICE IN LONG-TERM CARE:

Our long-term care system is poorly equipped to give independence to older Americans and forces many families to juggle elder care, child care, and their jobs or spend themselves into poverty to pay for nursing homes. Edwards will reform Medicaid and Medicare to let people to choose home-based care in their communities and test innovations such as asset and income protection programs. He will also support states and communities offering much-needed and often less expensive alternatives – like adult day care and senior villages – that allow seniors to live at home with their loved ones.

10. IMPROVE NURSING HOMES AND CRACK DOWN ON ELDER ABUSE:

Independence is the goal, but we also need to strengthen quality and safety protection in nursing homes. Edwards will establish national standards for nursing home care, increase national enforcement against abusive nursing home chains, expand inspections and increase penalties for homes that fail to provide decent care. He will also help improve quality of care with measures like reducing patient-staff ratios and improving care provider training.

From Senator Clinton’s web site- a more detailed explanation and how Hillary intends to finance her plan:

Protecting our Seniors By Improving the Quality of Our Nursing Homes

While the majority of the nation’s nursing homes provide quality care to their residents, when persistent quality violations go unaddressed and when our seniors are subjected to unconscionable neglect, it erodes confidence in the system and makes it more difficult for all operators to function effectively. And sadly, the problem of poor nursing home quality extends far beyond the list of 54 under-performing nursing homes that the Centers for Medicare and Medicaid Services has recently released. In 2006, nearly one in every five nursing homes that received federal funds was cited for serious deficiencies in care. And from 2000-2005, nearly half of the 63 nursing homes that regulators had identified as having an established history of serious medical deficiencies continued to repeatedly fail federal requirements and still receive federal funds.

These severe, and often long-standing, quality violations are more than a regulatory problem. They offend our solemn commitment to ensure that seniors live in dignity and security. Our seniors deserve better. That is why Hillary will take aggressive steps to improve quality in our nation’s long-term care facilities by:

* Tripling Federal Support for Nursing Home Ombudsmen Programs to Protect Consumers of Long-Term Care: Effective ombudsmen programs are crucial to combating fraud and abuse in the long-term care industry. Ombudsmen are on-the-ground and act solely on behalf of nursing home residents to monitor quality: identifying and investigating complaints, providing information, monitoring regulations and participating in resident advocacy organizations. However, ombudsmen programs such as Iowa’s are struggling to meet the many new challenges that nursing home residents face. Currently, the Iowa program ranks last among the 50 states in the number of ombudsmen per nursing home facility beds. Yet while Iowa has been making progress in strengthening its ombudsman program, the office still faces many new challenges. As President, Hillary would triple federal support for state ombudsman programs to $50 million per year. The increased resources will strengthen the capacity of ombudsmen to vigorously investigate complaints and offer new training programs on emerging issues like complex insurance fraud and the purchase of nursing homes by private equity firms.

* Directing the Department of Justice and the Federal Trade Commission to Assist State Consumer Advocates and Prosecutors to Tackle New Challenges to Long-term Care: For the past year, Hillary has been raising concerns about the new regulatory challenges that we face in long-term care. Earlier this year, Hillary called for the Government Accountability Office to investigate the unconscionable mistreatment of seniors who have purchased long-term care insurance by their insurance providers—many of whom were systematically denying benefits while forcing steep premium increases. And in October, Hillary called for an investigation into whether nursing homes with new hybrid ownership structures—created in many instances by private investment groups—were evading regulators for quality violations and sub-par standards. As President, Hillary will direct the Department of Justice and the Federal Trade Commission to lend their consumer protection prosecution expertise to state regulators who are struggling to tackle these new and complex challenges. State regulators need sufficient information and sophisticated tools to effectively police nursing homes and insurance carriers, and as President, Hillary will ensure they have the support they need.

* Reversing CMS’ Inexcusable Policy and Giving Seniors Full Access to Usable Data on Nursing Homes, including Data on Nursing Home Ownership Structures: Choosing a nursing home is one of the most important life decisions a senior and their family makes. When seniors and their families are empowered with information, they become not only effective consumers but effective regulators in the nursing home marketplace. But the federal government needs to do far more to ensure that seniors and their families have the information they need to make informed choices. As President, Hillary will direct CMS to release all information on the designations it makes about the quality of nursing home facilities. CMS’s unwillingness to freely and openly share its full list of 128 under performing nursing homes is inexcusable, and must be reversed. Hillary will direct CMS to provide on the Nursing Home Compare website accurate, up-to-date data on nursing home staffing levels; the full—not just abridged—reports from inspections and complaint investigations; and any and all information about repeat offenses that CMS compiles. Finally, CMS should compile and post clear information about the ownership structures of long-term care facilities–so seniors can know who is in charge of the facilities they live in.

* Strengthening our nursing and direct care workforce with a national system of background checks for long-term care workers and a $125 million in Workforce Improvement Grants: While thousands of long-term care professionals provide admirable care to our elderly every day, abuse and neglect of our seniors in long-term care is on the rise. As President, Hillary will combat this abuse with a nationwide system of state criminal background checks for long-term care workers. In addition to ensuring our long-term care workers are qualified, Hillary will also ensure that we have a strong well-trained long-term care workforce. She will invest an additional $125 million per year to improve recruitment and retention of health and direct-service professionals and provide greater consumer choice. The new investment will: 1) provide grants to states to adopt and expand successful organizational models for workforce tracking and coordination, including the development of worker registries through a new directed spending program; 2) make federal funding available to states, in partnership with local organizations, to develop a credentialing programs for direct support professionals (where as a condition of receipt of grants, states must collaborate with state universities and community colleges to allow credentialing program to count as college credit); 3) provide grants to states to encourage the expansion of successful agency models of care that give seniors and individuals more direct control over the services they receive and the people that provide them.