Nursing Home Lobbyists Had Access during Clinton Years!!!

Clinton vs McCain...Same old same old!!

Who is getting tough on what Lobbysists ?


Nursing Home Lobbyists Had Access

Monday, March 3, 2008
The New York Times


Published: April 23, 1997
Nursing home executives were lobbying the Clinton Administration to relax enforcement of rules affecting their industry even as they contributed hundreds of thousands of dollars to the Democratic Party last year.

The executives attended coffees at the White House with President Clinton and Vice President Al Gore. One slept in the Lincoln Bedroom at the White House and has since become finance chairman of the Democratic National Committee.

Several big contributors in the industry pressed their case in meetings with Donna E. Shalala, the Secretary of Health and Human Services, and Bruce C. Vladeck, who supervises Medicaid and Medicare as administrator of the Federal Health Care Financing Administration.

The executives were also fighting cuts in the two Federal health programs, for poor people and the elderly. They did not get everything they wanted, they say, but interviews with Federal officials and nursing home executives suggest that their contributions helped them gain more access than they would otherwise have had.

Nursing homes, which are extensively regulated by the Federal Government, derive more than half of their revenue from Medicaid and Medicare. Even small changes in rules or reimbursement can have enormous implications for them.

Alan D. Solomont was chief executive of the ADS Group, the largest nursing home company in Massachusetts, when he wrote to Mr. Vladeck complaining about ''serious problems and flaws'' in the enforcement of nursing home regulations last May. In his letter, he urged the Administration to limit the use of ''civil monetary penalties,'' or fines, imposed on nursing homes found to have violated Federal standards.

Fines for violating the regulations, covering almost every aspect of nursing home care, can range up to $10,000 a day.

When he wrote the letter, Mr. Solomont was chairman of the Democratic Business Council, which raised almost $20 million for the Democratic Party last year. On Jan. 22 of this year, he became finance chairman of the Democratic National Committee.

''I believe I was recommended for this job by the President and the Vice President,'' he said in an interview last week. Administration officials confirmed his statement.

The Democratic National Committee has been at the center of a furor over fund-raising, as investigators try to determine what, if anything, donors got for their contributions.

Mr. Solomont, a former president of the Massachusetts Federation of Nursing Homes, said he met with Federal officials last year not because he was a big donor, but because he was ''a credible, progressive voice'' for the industry. At the time, he said, he and Mr. Clinton were resisting Republican efforts to dismantle the Medicaid program and to roll back Federal standards for nursing homes.

''I wanted to get nursing home people solidly behind the President's plan to preserve Medicaid and to preserve Federal standards,'' Mr. Solomont said in the interview.

''I thought that the Administration would find more support for its stand if it listened to the legitimate concerns of health care providers. The average nursing home provider hates Government and feels burdened by Federal regulation. I wanted the providers and the Government to sit down and see how they could collaborate to elevate the quality of care.''

Mr. Clinton had already unveiled his own plan to reduce the growth of Medicaid, but it would not have saved as much or turned the program over to the states.

The Multicare Companies of Hackensack, N.J., bought Mr. Solomont's company for $60 million in December. He recently relinquished his position as vice chairman of Multicare, but remains a consultant.

In 1995 and 1996, Mr. Solomont, his company, his wife, his mother and his three brothers gave more than $187,000 to the Democratic National Committee and the Clinton-Gore campaign. Since becoming finance chairman of the Democratic Party in January, Mr. Solomont said, ''I have not engaged in any advocacy on matters related to nursing homes.''

Mr. Clinton has repeatedly asserted that big campaign contributors received no special favors from his Administration, and nursing home executives echo that view. Some of their requests were granted; some were denied. But the executives had exceptional access to top Administration officials.

Though money often buys access to power in Washington, the efforts of the nursing home industry are particularly well documented. Federal election laws limit donations to candidates to $1,000 from an individual and $5,000 from a political action committee. But there is no ceiling on contributions to political parties for party-building activities.

Paul R. Willging, executive vice president of the American Health Care Association, which represents more than 10,000 nursing homes, said he wanted the Government to take ''a more reasonable approach'' to enforcement of nursing home rules.

''I have never seen money tied to favors,'' said Mr. Willging, who was deputy administrator of the health care financing agency under President Ronald Reagan. ''But access is critical. There is no question that a willingness to participate in the electoral process, including financial participation, does help insure access.''

Bruce Yarwood, chief lobbyist for the American Health Care Association, attended coffees with Mr. Gore in May 1995 and March 1996, according to White House records. Records of the Federal Election Commission show that Mr. Yarwood donated $90,000 to the Democratic National Committee in those years. Mr. Willging said most of the money came from the trade association.

Mr. Vladeck came to Washington as a critic of the nursing home industry. In a 1980 book, ''Unloving Care,'' he documented mistreatment of nursing home residents. He served on a panel of the National Academy of Sciences that recommended tougher regulation of the industry in 1986. Most of the recommendations were incorporated in a 1987 law.

Howard J. Bedlin, vice president of the National Council on the Aging, a research and advocacy group, said: ''Bruce is probably the best H.C.F.A. administrator we've had. But in the last 18 months, there has been a clear pattern of the agency caving in to industry pressure to weaken the nursing home quality law, to the detriment of nursing home residents.''

Chris Jennings, a White House aide who coordinates health policy for the President, said he met with Mr. Solomont several times and knew he was a big contributor, but was not influenced by him any more than by the consumer advocates he met with. In any event, Mr. Jennings said, nursing home executives dislike many of the President's policies, because they believe the policies will reduce their revenues.

Another big contributor, Dr. Robert N. Elkins, chairman of Integrated Health Services of Owings Mills, Md., and his company gave $560,000 to the Democratic National Committee from December 1995 to November 1996. Two of the contributions, totaling $125,000, were made on Dec. 20, 1995, one day before Dr. Elkins attended a coffee with Mr. Clinton. White House records show that Dr. Elkins attended one coffee with Mr. Gore and three with Mr. Clinton in a six-week period in 1995-96.

Dr. Elkins's company operates nursing homes, home health care agencies, hospices and other medical services regulated and reimbursed by the Federal Government. Marc B. Levin, executive vice president of the company, said that neither he nor Dr. Elkins would discuss the campaign contributions.

Nursing home executives and Federal health officials were particularly active in July 1996, as the Presidential campaign heated up, though people on both sides now insist that the timing was just a coincidence.

Government records show that Dr. Elkins's company gave $100,000 to the Democratic National Committee on July 5 and $120,000 on July 24.

In a letter to the nursing home association on July 26, Dr. Vladeck said he had given the industry a draft policy statement describing the proper use of civil monetary penalties, and he added, ''My staff is available to discuss the language of this instruction before it is final.''

In the past, the Government had authorized the use of fines to correct minor violations. In the new policy issued in January, the Government said such penalties should be ''reserved for situations of serious noncompliance.''

Toby S. Edelman, a lawyer at the National Senior Citizens Law Center, a consumer group, said: ''Advocates for nursing home residents had far less access to senior Federal officials and much less opportunity to review the changes in policy on civil monetary penalties. Indeed, we saw no reason to change the policy.''

In October, the Administration came up with a proposal that would have scaled back inspections of many nursing homes. But in December, after the plan became public, the White House shelved it under a barrage of criticism from consumer groups and members of Congress.