Sides square off over nursing home bill

State Sen. Jim Tracy says a bill he is co-sponsoring would help improve patient care by lowering liability insurance costs for nursing homes. Critics, however, say the bill would make it harder to hold nursing homes accountable for error and is backed by nursing home operators who made campaign contributions to its sponsors.

Tracy is a Republican from Shelbyville.

The bill, introduced by Tracy in the Senate and by State Rep. Randy Rinks (D-Savannah) in the House, places nursing homes under the same guidelines as other medical malpractice cases, which means that attorneys' fees for such cases would be limited. It allows nursing homes to require that new incoming patients agree to arbitration of any patient care disputes. Existing patients would not be affected, only those admitted after the bill becomes law.

It limits non-economic damages (such as damages for pain or emotional distress) in nursing home malpractice cases, setting a limit similar to that currently in place for worker's compensation cases. Economic damages -- damages which can be measured and quantified -- would not be limited.

Tracy said Tennessee has the second-highest per-bed liability in the nation, adding $4,500 per year to the cost of a nursing home bed. Tracy said that if that money didn't have to be spent on insurance, it could be spent on patient care.

"That is the whole reason for the bill," he said. "To me, it's all about patient care -- trying to improve the quality of care in nursing homes."

A report released Wednesday by AARP Tennessee, which opposes the bill, says that damage limits don't appear to reduce litigation costs. AARP commissioned the report, which was prepared by The Lewin Group, a Virginia-based health care policy and consulting firm.

"Nursing home representatives say such lawsuits take funds that otherwise would be spent on care, but the report found no evidence to support that suggestion," states an AARP news release.

The lobbying group Tennessee Citizen Action, and a reporter/blogger for the alternative weekly newspaper Nashville Scene, have been sharply critical of the bill, going so far as to publicize one legislator's dubbing it the "kill old people cheap act."

"This bill is one of the most outrageous and extreme examples of corporate greed and political over-reaching that we have ever seen," said Tom Peters, of Tennessee Citizen Action, in a news release.

Jim Woods, of the Nashville Scene, pointed out in a blog entry that the various sponsors of the bill received campaign contributions from National Health Corp., a nursing home operator which favors the bill.

According to the state election finance web site, NHC's political action committee gave $5,000 to Tracy's campaigns in 2007, $4,000 in 2008 and $5,000 this year.

Tracy told the Times-Gazette that NHC's contributions to his campaigns were not surprising and denied they had anything to do with his sponsorship of the bill.

"They're a big employer in my district," Tracy told the Times-Gazette. He said that out-of-state trial lawyers are opposing the nursing home legislation.

"The problem is that our laws right now allow the filing of limitless lawsuits claiming tens of millions of dollars in damages," said Steve Flatt, of NHC, in a news release. "The result is that the big-money personal injury lawyers from Texas and Florida have been arriving regularly to pelt our courts with lawsuits."

However, Tennessee Citizen Action said residents' ability to sue for damages is needed in Tennessee, saying the state is "almost dead last" in providing quality of care for senior citizens in nursing homes. It has also had what TCA calls a record number of homes cited for repeated violations by state regulators.

AARP says that increased staffing, better oversight and licensing of smaller facilities are keys to improving nursing home care in Tennessee.