NCCNHR (formerly the National Citizens’ Coalition for Nursing Home Reform) is a 501(c)(3) nonprofit membership organization founded in 1975 by Elma L. Holder to protect the rights, safety and dignity of America’s long-term care consumers.   NCCNHR issued the following Bulletin:

The health care reform bill passed by the House of Representativesbefore includes not only sweeping health insurance reforms but also nursing home transparency, criminal background checks on long-term care workers, and a voluntary payroll deduction system that would provide benefits for long-term care services. The bill, H.R. 3962, the Affordable Health Care for America Act, can be downloaded at


As expected, the bill includes-without amendment-nursing home transparency provisions requiring:

1)  Public disclosure of individuals and entities that own, govern, operate, finance, provide services to, and/or control the nation’s nursing homes.

2)  Compliance and ethics programs and internal quality assurance programs in nursing homes, and pilot projects to test ways to improve oversight of chains.

3)  Collection and reporting of staffing information based on payroll data, including hours of care per resident day, turnover and retention rates, and facility expenditures for wages and benefits.

4)  A review of Nursing Home Compare and addition of information about sanctions against facilities and the number of adjudicated crimes occurring in them.

5)  A categorical breakdown of expenditures on cost reports to show how much facilities spend on direct care versus other expenses.

6)  An improved state complaint process to help protect complainants against retaliation.

7)  An increase in federal civil monetary penalties and a process to hold CMPs in escrow during appeals (although only after an independent informal dispute resolution process was completed).
8)  Adequate notification when facilities decided to close, including the option for the government to continue reimbursement until relocation was achieved.

9)  Training of nursing assistants in dementia care and abuse prevention.

10)  The bill would authorize a program of national criminal background checks on all long-term care workers who have access to residents or patients–from those who provide in-home long-term care services to nursing home employees.

H.R. 3962 also incorporates the Community Living Assistance Services and Supports (CLASS) Act to create a national voluntary social insurance system through which enrollees who became disabled (after paying into the system for at least five years) could purchase community-based long-term care, services or supports. Nursing home residents who were Medicaid beneficiaries could retain 5 percent of their benefit, in addition to their personal needs allowance, for their personal use while the remainder was applied to the cost of their care. (See page 1562 of the bill.)


Last-minute efforts to add the Elder Justice Act to H.R. 3962 were not successful. The EJA is in the health care reform bill passed by the Senate Finance Committee.




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