Associations call for nursing home reform

Two major national senior care associations, the American Health Care Association and LeadingAge, are teaming up to promote a reform agenda triggered by the pandemic. Embodied in the Care For Our Seniors Act, it is designed to address long-standing challenges affecting the quality of care provided in America’s nursing homes.

The pandemic has exposed and exacerbated systemic issues impacting the nursing home sector, such as workforce shortages, aging physical plants and underfunded government reimbursements. Many of these issues were raised by AHCA, LeadingAge and other stakeholders prior to the pandemic, but were not fully addressed.

Through the Care For Our Seniors Act, the associations are calling on lawmakers to help resolve systemic challenges, as well as reflect on ways nursing home providers themselves improve the quality of care.

“The pandemic has been an unprecedented tragedy, with long-term care facilities being at the epicenter of the crisis,” said Debbie Meade, who chairs the AHCA board.

“We have seen long-standing challenges exacerbated among our facilities and without serious reform, we risk more crises in the future,” she said. “The Care For Our Seniors Act pinpoints the biggest issues facing our industry and provides bold, transformative and meaningful solutions.”

Carol Silver Elliott, who chairs the LeadingAge board, said, “The long term care system that serves our elderly has been too-long ignored in this country. That is untenable. It does not reflect who we are as Americans.”

The act identifies four main reform needs:

1) Enhance the quality of care by developing clearer standards for infection prevention, requiring each nursing home to have a registered nurse on staff 24-7 and require a minimum 30-day supply of personal protective equipment.

2) Strengthen and support frontline caregivers by implementing a tiered, multi-phase approach to attract, retain and develop more care professionals, leveraging federal, state and academic institutions to assist.

3) Establish a more resident-driven system by developing more effective oversight and processes that better protect residents and support resident care. This includes implementing a process to turn around or close chronic poor performers and add customer satisfaction to the government’s five-star rating system to foster better consumer choice.

4) Modernize facilities to provide more private rooms, which promote resident autonomy, privacy and dignity, as well as enhance infection control.

Reform will be costly, but is long overdue.

The nursing home sector has faced a financial crisis for years due to low Medicaid reimbursement, the primary coverage for residents. With providers dedicating extensive resources to combating COVID, and experiencing a significant drop in new admissions, their financial condition has worsened.

AHCA and LeadingAge are propose several interrelated investment strategies to help reinvest in America’s nursing homes:

1) Enhanced federal medical assistance percentages, serving to boost federal Medicaid funds to providers, with a requirement that it be reflected in rates.

2) A new federal framework for “allowable cost” or “reasonable cost” and new federal guidelines governing state allowable cost definitions.

3) A new Medicaid rate adequacy requirement, ensuring Medicaid rates reflect the actual cost of care and be updated regularly in the future to keep pace with unavoidable cost increases.

4) Creation of a network of value-based purchasing committees at the state level. Each state would be required to establish a purchasing committee with specific guidelines and submission of reports on a regular basis.

“With a growing elderly population soon needing our services, the moment is now,” said LeadingEdge CEO Katie Smith Sloan. For addition details on the proposed act, visit www.ahcancal.org/solutions.

The American Health Care Association and its affiliated National Center for Assisted Living represent more than 14,000 senior care centers in the U.S. LeadingAge represents 5,000 other senior service providers.


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