NURSING HOMES

JUST one week ago, meaningful nursing home reforms seemed destined for defeat in the Missouri Legislature. On Wednesday, a good bill was approved and sent to Gov. Bob Holden. That's important news for vulnerable nursing home residents and their families. Mr. Holden should sign the bill.

The bill could have been stronger, but it is far superior to the toothless laws on the books, which allow nursing homes to escape sanctions for even the most egregious offenses.

Efforts to change those laws failed during each of the last three legislative sessions. This session, after the Post-Dispatch published an eight-part investigation into abuse and neglect in the nation's nursing homes, things were different.

Lt. Gov. Joe Maxwell deserves much of the credit for the reforms. Mr. Maxwell was criticized on this page last year for not doing enough. But he has invested great effort in changing the law. It was Mr. Maxwell who crafted much of the original reform bill. In February, he reached a compromise with Senate President Pro Tem Peter Kinder, R-Cape Girardeau, that protected important reforms. Among them were stiffer fines for serious offenses and a requirement that all nursing home deaths be reported to county coroners.

Mr. Holden also deserves credit. He backed the reforms, and promised to veto a watered-down version of the bill.

Also deserving praise and thanks are the Legislature's GOP leaders, Mr. Kinder and House Speaker Catherine L. Hanaway, R-Warson Woods. Mr. Kinder killed nursing home reform last year. This year he sponsored the compromise package, although he was absent from the Senate floor debate. . Ms. Hanaway's staff spent last week disavowing the actions of two GOP members who tried to gut the reforms. But either Mr. Kinder or Ms. Hanaway could have killed the reforms. Instead, both kept open minds and, most importantly, kept working to push the package through the Legislature in the face of heavy pressure from the nursing home lobby.

Much remains to be done. At the top of the list is improving the accountability of nursing home executives. Too often, they make decisions based on profits rather than the best interests of their patients. If patients suffer, blame belongs not just to the nurse's aide making minimum wage, but also with the executive earning a six-figure salary. It's too bad that the compromise didn't include a provision of Mr. Maxwell's bill that would have required nursing home executives to certify the conditions in their home - the way corporate executives now have to certify the accuracy of their books.

Next year, the Legislature should also enact a provision, approved by the Senate, that would allow abuse or neglect victims to videotape their testimony. The tape could be used if the victim later died or was found incompetent to testify. Critics charged that the provision was unconstitutional, but it is used in Illinois and other states - and it is contained in legislation before Congress.

For now, Missouri lawmakers can take pride in the protections they have provided to some of our most vulnerable citizens.