association and its subsequent participation in drafting of regulations, selfimprovement programs, etc. Since the association represents virtually all private establishments, this is a further indication of the better results obtained when private industry functions with rather than under Government. The proprietary operators of Kansas, through their association, have, since the formation of the association 3 years ago, conducted 4 training institutes for operators; developed and distributed the first correspondence course in nursinghome operation in the Nation; established Nursing Home Day, declared each year by the Governor of Kansas to acquaint the public with the nursing home, its service to the community, the community's need for these services, and to make such operation respected and appreciated; and inspired many reforms in administration and operation of nursing homes and nursing-home laws in Kansas. We feel that the passage of this bill will have a definitely destructive effect upon the self-improvement programs presently engaged in by private operators because the incentive to improve standards of care and expand facilities will have been removed. The reason is simply that the private operator will feel the futility of such further effort on his part, realizing that it will be only a matter of time until the nonprofit homes engulf the field. Since legislative wheels grind slowly and it will take a period of time to establish these proposed nonprofit homes, there will occur a considerable number of years during which facilities will definitely not meet the need because of failure of private industry to expand, since it anticipates extinction in the field. In Kansas alone, even on a grant basis, Congress could not appropriate enough funds to replace and expand, to meet needs, the beds presently provided by private enterprise when the private operator abandons the field in the face of forthcoming federally subsidized competition. We hope the foregoing material will be of assistance to you in your deliberations. Please feel free to call upon us for any information or assistance we may be able to provide. Respectfully submitted. ESTELLE C. BIFFER, President. Senator HILL. Is the gentleman through? Mr. MUSE. I am through. Senator HILL. In that connection, Mr. Chairman, Mr. Edmund F. Jacobs, executive secretary of the Washington Association of Licensed Nursing Homes, was in to see me a few days ago, and I know that he was also seeking to see the chairman of the subcommittee, Senator Purtell. I don't know whether he saw Senator Purtell or not, but I know he was seeking to see Senator Purtell, and I suggested to him that he might send me a wire or a letter expressing his views. I have that wire here, together with several other wires on this very subject of the nursing homes, which I would like to put in the record at this point. Senator GOLDWATER. They will be received. (The telegrams referred to are as follows:) Senator LISTER HILL, PUYALLUP, WASH., March 18, 1954. Labor and Public Welfare Committee, Washington, D. C.: Am setting forth herewith results of recent survey of nursing-home facilities, State of Washington, per your oral request on my recent visit your office. Of 8,197 beds licensed by Washington State, 5,126 belong to association, presently 559 association beds empty; 1,681 additional association beds under construction or awaiting approval of plans. Figure does not include potential new entrants into field. Forty-eight-bed fireproof modern State-approved convalescent class 1 home recently opened at cost of $2,200 per bed. Nineteen patients transferred directly from general hospital, Kitsap County, to this new home where care given at cost of $6 per day. We find no need for additional nursing-home beds in our State that cannot be met by our industry. We feel Senate bill 2758 is definite threat to private industry. EDMUND F. JACOBS, Executive Secretary, Washington Association of Licensed Nursing Homes. Senator LISTER HILL, SEATTLE, WASH., March 18, 1954. Labor and Public Welfare, Washington, D. C.: Senate bill 2758, we feel, is detrimental to private industry. A survey in Washington State shows approximately 800 to 1,000 available beds today for the convalescent and chronically ill and senile patients in licensed nursing homes. ETHEL MAY HILL, R. N.. Senator LISTER HILL, Labor and Public Welfare, Capitol Building, Washington, D. C. Hill Convalescence Home. SEATTLE, WASH., March 19, 1954. Senate bill 2758 lets be fair to private enterprise. We all ready have vacant beds in our licensed nursing home. Mrs. JOHN C. HEWITT, Senator LISTER HILL, SEATTLE, WASH., March 19, 1954. Labor and Public Welfare, Capitol Building, Washington, D. C. Senate bill 2758 due to adequate space in licensed nursing homes in the State of Washington I feel this bill should be vetoed. Senator LISTER HILL: NORMA SHANE, Sunset Manor Sanitarium. SEATTLE, WASH., March 19, 1954. I am definitely opposed to Senate bill 2758 subsidizing State resthomes, a glorified name for back to the poor farm speaking for State of Washington, statistics show hundreds of vacant beds, no shortage of space. If this is a genuine do good appropriation why not divert these millions to improving penal institutions where the need is desperate. Privately owned nursing homes are doing a good job at less expense to the taxpayer. If the resthome patients voted on this bill the answer would be "No." The resthome owner pays for their own buildings at no expense to the taxpayer. This bill has not received the time for statistical investigation it needs and the general public knows nothing of its significance. If the taxpayer is to get any relief from the burden he is now carrying such expenditure as this bill proposes will not find favor when the real facts are disclosed. Your earnest consideration is requested. VICTORIA GARDNER, Member, King County Nursing Home Association. SPOKANE, WASH., March 17, 1954. LUCIA FORD MURPHY, Hotel Shoreham: Review Colfax, Wash., February 27. Hillcrest may be replaced with a new $165,000 50-bed nursing home within the next 16 months. County commissioners met with State officials in Seattle last week and learned that the county may legally rebuild Hillcrest with assurance that the State will use its facilities and underwrite operating expenses. Chairman Bell pointed out that Dr. Kahl, acting State director, suggested Whitman County raze the old structure and build a new 50-bed nursing home at a cost of $165,000, the commissioners would operate it on a separate fund set aside for this purpose. Plans and estimate for the building construction will be discussed by commissioners March 8, when Phillip Austin head of State planning section visits the present Hillcrest site, a possibility of the county obtaining Federal money to aid in the construction lies in the faith of a $10 million appropriation now, Bell exclaimed. The money would be given to the county on a 50-50 basis under the HillBurton Act. If we decide definitely to go ahead with the construction the money will have to be budgeted this July and become available next January. He explained that the construction would not require any special tax levies since the county has surplus funds. County patients would have priority at Hillcrest but paying patients would also be accepted. A letter dated March 12, Thor C. Tollefson, "This measure contains numerous provisions including the one dealing with nursing institutions. There was no real opportunity while the bill was on the floor to delete this particular provison. It is my understanding that an effort will be made to do so on the Senate side. I am well aware of the excellent job that the private nursing homes are doing in the State of Washington, most certainly it is hoped that nothing which Congress does will deprive them of the opportunity to continue rendering their fine service." ROBERT G. AVEY. Senator HILL. Now, Mr. Muse, I want to ask this question: The nursing homes in the several States are subject to standards set by your State governments or State health authorities or some State agency, whatever that might be, are they not? Mr. MUSE. Mr. Chairman, up until about 10 years ago there were very few States with licensing laws. The overwhelming number of the States that now have licensing laws have come into effect with these laws within the last 5 to 7 years, and where they are set up, as I pointed out from the statement made by Mr. George Mustin, there is much to be desired, and we admit it, and we are working with our various State Government authorities in order to make these licensing laws more rigid. Senator HILL. Practically all of them have some license law? Senator HILL. Even though some of the laws and standards maybe should be raised-and you, yourself, favor raising those standardsthe fact remains, with the exception of North Carolina, all the other of the 48 States have licensing laws; is that right, sir? Mr. MUSE. That is right. Senator HILL. I was interested in your testimony about the costsome $2,000-in the bid or offer you had from the architect in Memphis, Tenn., which, of course, could be reduced down to $1,600. Mr. MUSE. In that regard, Mr. Chairman, if I may, I should like to ask Mr. George Mustin, if he could take a minute, to comment on that he is here from Memphis, Tenn.—and explain that. Senator GOLDWATER. Certainly. Senator HILL. That might be interesting. Mr. MUSE. Mr. Mustin. Senator GOLDWATER. It is a very interesting point to me because I raised the same question the other day. Senator HILL. The gentleman raised the question the other day. STATEMENT OF GEORGE T. MUSTIN, SECRETARY, AMERICAN ASSOCIATION OF NURSING HOMES Mr. MUSTIN. Mr. Chairman and gentlemen, here are complete architect plans as prepared for the contractors to cover a 66-bed institution in the city of Memphis. These plans are of my own design and the architect merely implemented them with the usual draftsmanship, and so forth, and, of course, incorporating such architectural changes as were needed, but they represent my conception of what would constitute a nursing home as a result of my 13 years of service in the profession. As I said, it would take care of 66 people, and there are complete facilities for cooking, laundry, and so forth. Senator HILL. You mean you have a laundry now in the building? Mr. MUSTIN. Yes, sir. It would be a one-story buildings, and there would be laundry facilities in the building and, of course, facilities for congregating, and so forth. The general construction bid was $62,475; the plumbing, $11,191; heating, $7,600; wiring, $7,228-the total construction cost, $88,492, Now, of course, there are other costs in addition to that. For example, the cost of the land, the cost of the performance bond to see that the work was completed, and the cost of the plans. That raised the total cost for the building, complete, except for equipment, to $105,576 92, which is approximately $1,600 per bed; and I estimate that it would cost about $400 per bed to fully and completely equip it, which would make it cost about $2,000 per bed in my community, and I would say those figures would obtain practically anywhere in the South. Now, of course, in areas where the cost might be higher, the cost might run up as high as $2,500 per bed, complete, but certainly I can't see where it would ever cost $8,000 per bed. If I may venture a personal opinion, for a long time it has been considered that the cost of building hospitals were $16,000 per bed, and I think somebody just cut that figure practically half in two without doing any practical work, which I have done here. Senator HILL. What would be the nature of that construction, may I ask? Senator GOLDWATER. Yes. Senator HILL. Would it be a frame building? Mr. MUSTIN. No, sir. It would not be a frame building. Senator HILL. A brick building? Mr. MUSTIN. It would be a block, sir. Would you like to see it? Senator GOLLWATER. Do you have the specifications? Mr. MUSTIN. Yes, sir; I have the specifications. Senator GOLDWATER. I think it would be proper to include the specifications in the record at this time. We can't put the plans in; but if you have the specifications there, we can put those in. Mr. MUSTIN. Yes, sir. (The specifications referred to are as follows:) SCHEDULE 1. Plans 2. General conditions 3. Matters of constructional relationship 4. Inspection and testing of materials 5. Bonds, insurance, permits, etc. 6. Alterations 7. Commencement of work 8. Excavations 9. Foundations 10. Other concrete work 11. Brick and mortar 12. Concrete blocks 13. Tilework 14. Iron and steel work 15. Carpentry 16. Grounds, furring, and lathing 17. Plastering 18. Exterior woodwork 19. Roof sheathing 20. Window frames and sash and glazing 21. Roof 22. Interior woodwork 23. Closets, doors, etc. 24. Flooring 25. Stairs 26. Exterior painting 27. Interior painting 28. Hardware 29. Metalwork 30. Electric wiring 31. Screens 32. Weatherstrips and caulking 33. Insulation and soundproofing 34. Accessories 35. Linoleum 36. Attic fans 37. Stove hood 38. Toilet room and utility room vents 39. Plumbing, heating, and electric work 40. Addenda SPECIFICATIONS FOR A NURSING HOME FOR GEORGE T. MUSTIN, IN ACCORDANCE WITH PLANS AND SPECIFICATIONS PREPARED BY POLK W. AGEE & POLK W. AGEE, JR., ARCHITECTS, MEMPHIS, TENN. 1. PLANS The plans are to be to a scale of one-quarter inch equals 1 foot and details to scale as marked on same. The size of all compartments, etc. are figured on the plans and where figures appear on drawings, they will preside over the scale of the drawing. If any discrepancies appear in plans, the same shall be immediately reported to the architect for correction. 2. GENERAL CONDITIONS The contractor is to furnish all materials and all labor. The contractor is to superintend all work and to completely execute his contract in a good and sound, workmanlike manner. All to be in accordance with the specifications and drawings and explanations thereon, described and implied, or incident thereto, although not specifically stated or described by the drawings and specifications. Plumbing, heating, and wiring shall be let under separate contracts. 3. MATTERS OF CONSTRUCTIONAL RELATIONSHIP It is understood that these specifications are governed entirely by the general conditions of contract of the A. I. A. documents, pages 1 to 10, inclusive. The documents thoroughly explain the relationship between the contractor, architect, and owner, and both the contractor and the owner should familiarize them. selves with same. All work performed shall meet with the requirements of the building and zoning ordinances of the city of Memphis, Tenn. 4. INSPECTION AND TESTING OF MATERIALS It is understood that all materials delivered on the job are subject to the inspection and test as the FHA and the architect see fit, and the contractor shall, at any time he is called upon, deliver a satisfactory test on any materials needing testing. 5. BONDS, INSURANCE, PERMITS, ETC. The general contractor will be required to furnish all necessary permits, he will be required to furnish an approved surety bond, owner to pay for the cost of the bond. |