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If Senator Charles Grassley (R-Iowa) has his way, a new bill proposed this month may change this trend and hold nursing home operators accountable. He has proposed the Nursing Home Transparency And Improvement Act of 2008 which would require disclosure of identity of owners and their affiliated entities, together with other remedies aimed at improving care and fairness to nursing home residents and their families. This bill is a good start, but even if it passes, it probably does not go far enough to assure fairness and a level playing field in the civil justice system. While it does require operators to identify and disclose entities involved in the operation of nursing homes, it does not address many other concerns prevalent in cases we see every day when seeking justice for nursing home residents and their families. Concerns like unfair arbitration clauses in admission agreements that residents and family members sign unwittingly and at an extremely stressful time when subject to undue influence from caregivers, social workers, and nursing home administrators. Concerns like the lack of mandatory liability insurance or self-insurance in adequate amounts to assure that nursing home operators are financially responsible and can pay for damages, injuries, or death that they cause while taking in millions of Medicare and Medicaid dollars for profit.