Marvin Mandel, Governor                        1823

tion between the goals of profit-making nursing homes and the ideals
of our society. Nursing homes, if they are to make a profit, must
keep their beds occupied. On the other hand, the aim of our society
must be to move aged patients out of beds and into the community
to lead as normal a life as possible.

"Further, the concomitant of substantial size in business in
America is political power. In the hearings held by this panel, various
indications were heard of influence upon the state government by
the nursing home industry. Testimony suggested a very strong 'nurs-
ing home lobby' exists in the Maryland State Legislature, and that
this lobby has had sufficient political power to prevent passage of
legislation in Maryland that might set stricter standards for nursing
homes. Our investigation disclosed evidence suggestive of political
interference with a nursing home inspection.

" * * * We do not question that legislators are entitled to have busi-
ness interests. We do, however, suggest that the possibility of conflict
of interest should be examined. Given this kind of worrisome infor-
mation, this panel must raise the question of how to control such
powerful monetary interests. Have we opened our nursing homes to
profiteering?" (pp. 26-27)

"2. Responsibilities of State and City Health Departments. The
panel is concerned by the bewildering tangle of bureaucratic regu-
lations and inadequate laws which govern licensure and inspection
of nursing homes. As stated during the hearings, the confusion be-
tween responsibilities of state officials and city officials, differences
in reporting forms for infectious disease, and many other evidences
of overlapping and potentially conflicting areas of monitoring have
led to a situation where 'everybody is responsible yet nobody is
responsible.'" (pp. 27-28) (Subsections a, b & c & d follow with
specific recommendations to improve the present system.)

"3. During its inquiry the panel received testimony suggesting
that improper influence could be applied to those responsible for the
inspection of nursing homes. Clearly the inspection system must be
above reproach, and individual inspectors must be free to inspect
nursing homes without fear. This commission recommends, there-
fore, that an independent nursing home inspection board be created
in Maryland that will include physicians, members of the community,
and specifically representatives of local senior citizens groups." (pp.
28-29)

"4. Responsibilities of the Medical Profession. The medical pro-
fession and its organized spokesman, the Medical and Chirurgical
Faculty, must insist upon stringent inspection and adequate stand-
ards of care in all nursing homes in Maryland. We urge the Faculty
to strengthen its existing committee on nursing homes and insist
that it independently develop acceptable standards and methods of
supervision to insure that Maryland nursing homes are the best in
the nation." (p. 29)

"5. Establishment of Independent Commission on Nursing Homes.
Our brief examination of nursing homes in Maryland has shown us
the serious deficiencies of how we provide for our aging and infirm
who can no longer manage their own affairs. It is clear that the
citizens of Maryland need to know more about nursing homes. We
strongly urge, therefore, that the Secretary of Health and Mental