[Congressional Record (Bound Edition), Volume 154 (2008), Part 11] [Senate] [Page 15804] [From the U.S. Government Publishing Office, www.gpo.gov]LONG-TERM CARE Mr. WYDEN. Since my days of working with the Gray Panthers in Oregon, I have been aware of the special obligation that we have to both our younger and older citizens who are in need of long-term care services. The Omnibus Budget Reconciliation Act of 1987 was a watershed in efforts to make life safer and more dignified for individuals living in long-term care institutions. Since 1987, the long-term care industry has continued to evolve in ways that require another look at the state of long-term care. In a constantly changing for-profit and nonprofit industry, Federal and State governments need better information about the organizations and staff who provide care to residents of long-term care. Individuals, families, and service providers also need good information about long- term care to make informed decisions about their options. Chairman Kohl, I laud you and your colleagues who have thoughtfully identified current or emerging problems in long-term care. The Nursing Home Transparency and Improvement Act of 2008, S. 2641, makes important strides in helping us to get more substantive information about nursing home ownership and staffing. It strengthens the Nursing Home Compare Web site and provides additional information for the general public. I am therefore pleased to become a cosponsor of this legislation. Mr. KOHL. Thank you, Senator Wyden. Given your long commitment to aging and health issues, your support is especially important and meaningful. Mr. WYDEN. While I am pleased to support the legislation, I do have some concerns about the bill as it is written and hope that we can work together to make some changes to the bill. It has been helpful for me to talk about the bill with the many fine people who operate nursing homes in Oregon and others. And these folks have identified what I think are legitimate concerns with the bill. Mr. KOHL. I would appreciate hearing of those concerns, Senator. Mr. WYDEN. There are two issues of particular concern where I hope we may be able to get agreement on modifications. First, the bill calls for increased civil monetary penalties and requires that they be placed in escrow in advance of adjudication of an alleged violation. This provision could be especially burdensome to smaller nursing homes that already operate close to the margin. I think it would be useful to review the size of the proposed fines but especially the escrow provision. Tying up thousands of dollars in escrow would be particularly difficult for small nursing homes and especially unfair for homes whose alleged violations were later found to be without merit. I also believe it raises due process concerns in terms of imposing penalties before a matter has been finally settled. Mr. KOHL. We will certainly review those provisions in light of your concerns. Mr. WYDEN. The other issue of concern in the legislation concerns the requirement that every nursing home that is part of a group of nursing homes with common ownership and annual revenues of $50 million or more be subject to annual audits. Many of the nursing homes in Oregon are family-run businesses. A few of our Oregon owners operate groups of nursing homes that would meet the criterion for annual audits of each of their nursing homes. I am concerned that the cost of annual audits would be financially burdensome for them and for small nursing home chain owners in other parts of the country. Mr. KOHL. I appreciate the care with which you have reviewed the Nursing Home Transparency Act. I will take under serious consideration the issues that you have raised. Again, your cosponsorship of this legislation is important in view of the many efforts you have made and continue to make to improve the lives of America's older citizens. ____________________