Biden Unveils Nursing Home Quality Improvement Plan

President Joe Biden announced reforms Feb. 28 to boost nursing home staffing and oversight, citing COVID-19 death data showing 200,000 nursing home residents and staff deaths from the virus.

The plan, which will be carried out by CMS, has three main goals: improve the quality and safety of nursing homes, protect vulnerable residents and the healthcare heroes who care for them and crack down on “bad actors.”

There will be 10 main initiatives to achieve the program’s goals:

1. Establishing a minimum nursing home staffing requirement

2. Strengthening the Skilled Nursing Facility Value-Based Purchasing Program

3. Reinforcing safeguards against unnecessary medications and treatments

4. Reducing resident room crowding

5. Adequately funding inspection activities

6. Beefing up scrutiny of poor-performing facilities

7. Expanding financial penalties and other enforcement sanctions

8. Increasing accountability for chain owners and substandard facilities

9. Providing technical assistance to nursing homes to aid in improvements

10. Improving transparency so that  potential residents and their loved ones can make informed decisions about care

Groups representing skilled nursing facilities had mixed reactions to President Biden’s announcement.

Mark Parkinson, president and CEO of the American Health Care Association, thanked the administration for the increased efforts but questioned the implementation of some components.

“Additional oversight without corresponding assistance will not improve resident care,” Mr. Parkinson stated. “To make real improvements, we need policymakers to prioritize investing in this chronically underfunded healthcare sector and support providers’ improvement on the metrics that matter for residents.”

Katie Sloan, president and CEO of LeadingAge, a nonprofit advocate of services for older adults, also expressed gratitude about the initiatives, but called on policymakers to recognize Medicaid’s shortcomings.

“We know that transparency, quality improvement, and workforce investments are critical to building better nursing homes for America’s older adults and families,” Ms. Sloan wrote in an emailed statement. “Yet Medicaid, the dominant payer of long-term care services, doesn’t fully cover nursing homes’ cost of quality care. Regulations and enforcement, even with the best intentions, just can’t change that math.”

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