April 17,2002

Grassley Seeks Public Access to Nursing Home Study

WASHINGTON – Sen. Chuck Grassley, ranking member of the Committee on Finance, andRep. Henry Waxman, ranking member of the Committee on Government Reform, today asked theCenters for Medicare and Medicaid Services to increase public access to a key nursing home staffing study. Their request letter follows.

April 17, 2002

Mr. Thomas A. Scully
Centers for Medicare and Medicaid Services
200 Independence Ave. SW
Room 314-G
Washington, D.C. 20201

Dear Administrator Scully:

As you know, the second phase of a congressionally mandated study, “Appropriateness ofMinimum Nurse Staffing Ratios in Nursing Homes,” was recently released by the Department ofHealth and Human Services (HHS). The findings of the report, which had an original due date ofJanuary 1,1992, have been eagerly awaited by members of Congress, researchers, nursing homeowners, nursing home workers, nursing home residents, and their family members.

The report analyzed empirical data linking nursing home staffing levels with quality of careand concluded that 90 percent of nursing homes in the United States have staffing levels that are toolow to provide adequate care. The report should play a critical role in any executive or legislativebranch effort to improve nursing home staffing levels.

Given the landmark nature of this report, we were disappointed to hear from your staff thatthe Centers for Medicare and Medicaid Services (CMS) is not posting the report on the agency’s website. We hope this is not a final decision. The nursing home staffing study was mandated byCongress and paid for with federal tax dollars. The study provides critical information on nursinghome conditions and suggests possible ways to improve quality of care. As such, the study shouldbe easily accessible to members of the public. And since Phase 1 of the report is available on theCMS web site (although arguably difficult to find), it would be logical to include the second and finalphase as well.

By declining to post the study on its web site, HHS and CMS impede public access to thereport and its important conclusions. We are concerned that this decision might leave the impressionthat HHS and CMS are unconcerned about the staffing problem.

As a temporary measure, we have posted a copy of the report on the web site of the minorityoffice of the House Committee on Government Reform, www.house.gov/reform/min. But this is nota permanent solution. The report should be available on the CMS web site, where it can be accessedby members of the public when they are searching for nursing home information. Please let us knowwhether the decision against posting the report is final or whether it remains open for consideration.

Please respond by Monday, April 29, 2002. If your staff members have any questions, please directthem to Jill Gerber (Grassley) at 202/224-6522 or Brian Cohen (Waxman) at 202/225-5051.


Sen. Chuck Grassley 
Ranking Member 

Rep. Henry A. Waxman
Ranking Member
Committee on Finance Committee on Government Reform