In addition to studying ownership, Maryland officials are crafting regulations - based on a bill sponsored by Del. Patrick L. McDonough, a Republican who represents Baltimore and Harford counties - to require nursing home applicants to disclose to the state "any significant change in the financial condition," including cash flow. Kronmiller said the initiative stemmed from recent financial problems at nursing homes owned by smaller nonprofits, which she said could have been resolved earlier if the state had known about them.
The state also is debating possible ways to get nursing home owners to provide more details on how they are structured. That primarily would benefit consumers, she said.
For example, members of Voices for Quality Care recently researched a St. Mary's County nursing home after learning it had dozens of violations of federal and state regulations on its most recent inspection posted on the Web site of the Centers for Medicare & Medicaid Services. The group identified the firm managing the nursing home, researched other nursing homes across the nation run by the same company and is examining how ownership is structured.
Voices for Quality Care wants to do the same research for all nursing homes in Maryland and has been urging Congress to pass legislation to require more transparency in nursing home ownership.
"We're interested in who owns them, because the owners often hire out-of-state management companies, and if the out-of-state management companies are failing or having problems, we want to go to the owner," said Bronaugh, the group's vice chairman.
Nursing homes whose ownership includes layers of limited-liability companies also threaten to make it harder for nursing home residents to sue over poor care, said Jason Frank, chairman of the elder law section of the Maryland State Bar Association.
The Office of Health Care Quality is "grossly understaffed, grossly underfunded, and so the regulatory model as an alternative to tort just does not work," Frank said.
Kronmiller, the office's director, said she would be a member of the committee that studies nursing home ownership, and the legislature would provide staff. She is chairing the group working on regulations to require nursing home to provide earlier warnings about financial problems and more information about ownership.
"It will require more work on our end, but this is what we are supposed to be doing," she said.
Kronmiller said she hoped the nursing home ownership study would help guide the legislature as it grapples with the controversy over private equity groups.
"Certainly the goal is to provide good care, but aren't they all trying to get money out of it? Why would this be different?" she asked.
james.drew@baltsun.com
