Biden Administration Issues Bold and Comprehensive Nursing Home Reform Agenda

President Joseph R. Biden announced a comprehensive nursing home agenda in his State of the Union address on March 1, 2022.  A Fact Sheet issued by the White House on February 28 set out the agenda in greater detail.  The Center for Medicare Advocacy fully supports the reform platform, which addresses issues that advocates for nursing home residents have been supporting for many years, if not decades.  Improving nurse staffing levels and holding facilities and their corporate owners accountable for the billions of dollars they receive under the Medicare and Medicaid programs are key provisions that, properly implemented, can help achieve the promise of the 1987 Nursing Home Reform Law.

President Biden’s nursing home agenda – “Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes” – is intended to ensure that,

• “every nursing home provides a sufficient number of staff who are adequately trained to provide high-quality care;
• “poorly performing nursing homes are held accountable for improper and unsafe care and immediately improve their services or are cut from taxpayer dollars; and
• “the public has better information about nursing home conditions so that they can find the best available options.”

Reported here are the five themes and the 21 action steps included under them.  Additional detail is provided in the seven-page document.

Ensuring Taxpayer Dollars Support Nursing Homes That Provide Safe, Adequate, and Dignified Care

• Establish a Minimum Nursing Home Staffing Requirement
• Reduce Resident Room Crowding
• Strengthen the Skilled Nursing Facility (“SNF) Value-Based Purchasing (“VBP”) Program
• Reinforce Safeguards against Unnecessary Medications and Treatments

Enhancing Accountability and Oversight

• Adequately Fund Inspection Activities
• Beef up Scrutiny of More of the Poorest Performers
• Expand Financial Penalties and Other Enforcement Sanctions
• Increase Accountability for Chain Owners of Substandard Facilities
• Provide Technical Assistance to Nursing Homes to Help them Improve

Increasing Transparency

• Create a Database of Nursing Home Owners and Operators
• Improve Transparency of Facility Ownership and Finances
• Enhance Nursing Home Care Compare
• Examine the Role of Private Equity

Creating Pathways to Good-paying Jobs with the Free and Fair Choice to Form a Union

• Ensure Nurse Aide Training is Affordable
• Support State Efforts to Improve Staffing and Workforce Sustainability
• Launch National Nursing Career Pathways Campaign

Ensuring Pandemic and Emergency Preparedness in Nursing Homes

• Continued COVID-19 testing in long-term care facilities
• Continued COVID-19 vaccinations and boosters in long-term care facilities
• Strengthen Requirements for On-site Infection Preventionists
• Enhance Requirements for Pandemic and Emergency Preparedness
• Integrate Pandemic Lessons into Nursing Home Requirements

Resident advocates have our work cut out for us – to make this agenda a reality.

“Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes” is at https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/