Bill Nelson

Well, aren't some things blurring now between nursing homes and ALFs?

Should CMS have the authority to shut down ALFs when chronic problems are occurring and state regulators have failed to act?

As I mentioned, Senator Kohl's home state of Wisconsin is a shining example of a very good regulatory framework.

So the laws weren't being enforced.

Well, on the basis of what we've seen in this newspaper report, the regulatory agency in this case--AHCA in the state of Florida, the Agency for Health Care Administration--wasn't doing its job.

So what should we at the federal level do, in your judgment, in order to see that the ombudsmen can do their jobs more effectively so that these horror stories that we've heard about won't happen, and so that the vast majority of ALFs that…

That's exactly the message that I've gotten here. I mean, I can't say it any better than you just said it.

If you can have somebody taken care of in their home instead of having to go into a nursing home, it's cheaper, the quality of life is better, everybody's happier. It's a win-win-win.

Well, maybe we should have had that person here answering the questions. Why didn't they blow the whistle? Or why didn't they know? Is that the role of an ombudsman?

It's a state responsibility.

Isn't this the purpose of an ombudsman? We require an ombudsman.

A bully pulpit that was filled by the Miami Herald, I might say.

Well, you do have the bully pulpit.

We have--we require from states corrective action plans if there is a shortfall that is identified.

When you were making a decision to go in that particular home, you said that you went and visited, and it looked fairly good.

So there were no assets to go after. There was only a $35,000 insurance policy?

What is so revealing in the Miami Herald article is example after example of egregious conduct on the part of the facilities, and some of them didn't even get a slap on the wrist.

The states ought to have the regulatory authority to enact whatever action under state law that they deem appropriate to correct a particular activity.

Thank you very much for your very heartfelt testimony.

But we can't afford to have the whole thing undermined by 5 or 10 percent of the providers who are not performing and are not being regulated effectively.

The development of a federal framework to help standardize the requirements for the Resident's Bill of Rights and a Disclosure Statement.

Thank you for giving me the privilege of chairing this hearing today on an extremely timely topic, Ensuring Quality and Oversight in Assisted Living.

We work with the states.

In any of your experiences, have you ever seen this taken to a prosecution?

Of course. Mr. McCAIN. Isn't one of the fundamental problems in the housing crisis, in the Senator's State and my State and particularly California, Nevada, and others that were the crest of the wave, that we should have made--and still…