The latest issue of Consumer Reports focuses on the inspection records of nursing homes around the nation.
The article also discusses how for-profit nursing homes influence the regulatory process, using Arkansas as the primary example.
One regulator even says she was discouraged by her supervisors from citing problems:
Nursing homes are not major donors to national political campaigns, but they wield considerable clout in state capitals, where their $500, $1,000, and $3,000 contributions count with gubernatorial, state legislative, and judicial candidates.
In Arkansas, for example, the industry was a top contributor to state candidates in 2004, according to Followthemoney.org, a nonpartisan database of campaign contributions. The Arkansas Health Care Association, which represents for-profit nursing homes, gave almost $100,000 that year to candidates in the state.
The trade association also maintains an office near the Arkansas Capitol in Little Rock, where legislators can stop in and enjoy a free lunch three times a week during legislative sessions.
"They contribute a large amount of money to people's campaigns" and the politicians become beholden, says state Sen. Mary Anne Salmon, a Democrat. She adds, "Nursing homes have stopped some very good legislation that would have made things better for the elderly."
Messages from legislators, subtle and not so subtle, filter down to regulators, who have learned that nursing homes will challenge them if they press too hard. Grachia Freeman, a former nursing home inspector in Arkansas, says that supervisors "would not let me write deficiencies I wanted to write" for a facility she was inspecting. Now a nurse at a VA hospital in North Little Rock, she adds, "They were angry with me for investigating and told me not to complete the survey."
We made several efforts to interview regulators in the long-term care unit of the Arkansas Department of Health and Human Services but were repeatedly rebuffed.