The District's strict nursing home law, sometimes known derisively as the "clocks and calendars" regulation, was thoroughly dissected and threatened with repeal last week at a City Council hearing.
Councilwoman Polly Shackleton's Committee on Human Resources and Aging heard a full day of figurative fist-shaking at the 1974 measure. Designed to protect the elderly from the shoddy and inhumane treatment that was exposed in numerous nursing homes around the country several years ago, the measure is now practical for this city, witnesses said.
If left unchanged, the stringent requirements of the law will drive some homes out of the city, shut down others and exacerbate the city's already severe shortage of nursing home beds, said witnesses opposed to the law.
Clergymen, doctors, lawyers and nursing home operators said the measure's provisions are stricter than federal requirements, calling, for example, for besides telephones in each patient's room.
"Clocks and calendars are required at the bedside, but a lavatory can be 50 feet away," noted William Gaudreau, one of a panel of witnesses from five nonprofit charitable nursing homes run by church and religious groups.
Attorney David Hensler, representing the panel, criticized the law's "inappropriate staff requirements, excessive record-keeping demands" and other standards that are "unnecessarily costly and impossible to meet."
D.C. department of human resources director Albert P. Russo asked the Council to repeal all the major provisions of the law, allowing the less stringent federal requirement to prevail, until the current local standards have been reduced.
Under federal standards, D.C. Village, the city's only public home for the elderly, could more easily regain its certification for the nearly $500,000 in Medcaid funds that it lost last month, Russo said.
Shackleton said the requested amendments to the law could take up to six months to enact. She proposed emergency legislation, putting the local measure's requirements in abeyance until such action can be taken.
"The state has an obligation to write, and enforce, standards that assure the safety and welfare of patients," Shackleton said, but if the requirements "are not really essential" they should not be imposed, she added, indicating support for the appeals to relax the current standards.
Linda Purdue, director of the Gerus Society, a nonprofit group concerned with the care of the elderly, told of a small Northeast nursing home that is threatened with closure for noncompliance with the law by DHR's licensing branch, even as another part of the department is placing patients in the home.
Shackleton has also proposed a bill to amend the nursing home law, which would establish for the first time city standards governing foster care homes for mental patients, halfway houses for released convicts and similar facilties.
Although the 1974 bill was the result of numerous hearings, investigations and discussions over a three-year period, there was little support for retaining it in its present form.
"I would be the first to support amendments," former DHR official Jane Rollins, one of the measure's principal authors, said after the hearings, "but I would hope that they do not throw out the baby with the bath water. A lot of work went into those regulations."