THE GOOD PROVIDER

By MICHAEL WEISSKOPF/WASHINGTON

By the standards of last year's high-rolling presidential race, Donna Shalala's appearance at a Democratic dinner for business executives seemed like just another effort to lend star quality to one of Bill Clinton's ambitious fund-raising ventures. But to Alan Solomont, a Massachusetts nursing-home mogul who was host to the June 3 event in Washington, the Secretary of Health and Human Services shone brightest of all. A few weeks before the dinner, Solomont had visited Shalala with a team of lobbyists to press for less stringent enforcement of nursing-home regulations. Solomont, a leading Democratic fund raiser and an occasional jogging partner of Clinton's, kept on lobbying throughout the campaign to win major concessions for his industry over the objections of consumer advocates. He got much of what he wanted.

Ever since questions were raised about the legality and propriety of Clinton's fund-raising practices, another big question has hung in the air. What, besides overnight stays in the Lincoln Bedroom, did the large donors get for their money? Last week, speaking at the first news conference of his second term, Clinton asserted, "I never made a decision for anybody because they were contributors of mine." But the story of Solomont--his giving, his lobbying and his rise to become the Democratic Party's new finance chairman--suggests that at least one Democrat's generosity might have yielded a policy payoff. It also suggests to critics that people like Solomont might not be the best suited to carry out Clinton's solemn promises to, as he said last week, "clean up the system."

Solomont gave the party $160,000 and helped raise $1.1 million more from nursing-home owners. But his most remarkable--and dubious--accomplishment was successfully lobbying the President's appointees for regulatory changes while chairing his party's Business Council of $10,000-a-year donors. This is the same council that handed the Democratic National Committee $1 million a week after Clinton heralded its "reform" era with such new leaders as Solomont.

A nationally recognized expert in elder care, Solomont, 45, is a registered nurse who built his ADS Group into one of the largest nursing-home chains in the Northeast. After supporting Clinton in 1992, he joined Washington's special-interest pleaders as the new Administration was finalizing nursing-home regulations that toughened enforcement of quality standards and resident rights. Solomont says he saw his role as a "bridge between the provider community and this Administration." Although health-care bureaucrats knew of his Clinton ties, he says, "I didn't approach them as a supporter of the President but as someone who honestly had something constructive to say."

He approached not only Shalala but also Medicare- and Medicaid-programs administrator Bruce Vladeck, whose office had written the sharper guidelines and who offered to consider revisions. Solomont says he was the "impetus" for at least two meetings with Vladeck and an exchange of letters. In one memo, Solomont asked Vladeck to review suggested changes: "Put it in your own words and send it back to us in a letter [to show] our mutual direction." To consumer advocates such as Toby Edelman of the National Senior Citizens Law Center, "it's disturbing they had access that ordinary people don't have."

Last month Vladeck loosened state enforcement authority by suggesting that fines are "most appropriate" for life-threatening offenses. The new guideline accedes to the industry's demands to make fines the "remedy of last resort." But Edelman says the guideline ensures that nursing homes will escape responsibility for the vast majority of offenses--like poor nutrition and lack of privacy--that do not rise to the level of "most serious" but can dominate nursing-home life.

Another proposed revision that Solomont sought and obtained has added more hoops to the informal process of resolving disputes between nursing-home owners and their regulators. Specifically, Vladeck recommended that state authorities meet face-to-face with nursing-care providers who dispute alleged offenses and that these discussions be joined by officials who have had no earlier involvement in the dispute and could thus provide a more "objective" point of view. Advocates like Edelman who oppose this change in the guidelines say it adds to the load of hard-pressed state regulators and thus undermines their ability to enforce the laws.

Vladeck, while acknowledging that industry lobbying was influential, says he would "comfortably defend each change on its merits." He also notes that the industry did not get all it asked for. Shalala, who was traveling in Europe, could not be reached for comment. Solomont, meanwhile, says that with his new job as finance chairman, the pressure increases "not to create an impression I was using that role in a way that was self-serving" and "not to be seen as representing any particular group." But then he adds, "Having said that, I'm not about to check what I believe in at the door." And in Washington it's a door that appears to swing both ways.