03/01/2022

Biden Administration announces “crack down on unsafe nursing homes"

Biden Administration announces “crack down on unsafe nursing homes"

Yesterday, the Biden Administration announced a "crack down" of "unsafe nursing homes" designed to ensure, per the release, 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 off from taxpayer dollars; and the public has better information about nursing home conditions so that they can find the best available options."

In its FACT SHEET: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes, the Biden Administration lays out sweeping reforms and priorities, including the following:

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 on 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

• CMS will create a new database that will track and identify owners and operators across states to highlight previous problems with promoting resident health and safety.
• 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 Join 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. 

While the planned reforms include some shared goals, such as boosting nurse aide training, supporting workforce recruitment and retention, and launching a career pathways campaign, LeadingAge Ohio is greatly concerned that the reforms are not paired with appropriate funding and resources for providers. The largest payor in long-term care nationwide is also the most underfunded, with Medicaid covering only a portion of costs of care. The connection between Medicaid payments and nursing home quality has been documented, exacerbating health disparities. In addition, LeadingAge Ohio is concerned that the sector already carries an enormous regulatory burden, and these additional requirements will expedite the flight of nurse managers and other leaders from long-term care, leaving vulnerable elders without the protections offered by experienced administrators and nurse leaders. The announcement comes just as providers work to rebuild from the effects of COVID-19. 

For more details on the Biden Administration's proposed plan, please read the fact sheet. McKnight's provides informative write-ups in the following two articles: BREAKING: CMS wallops nursing homes with planned staffing requirements and increased penalties and Providers decry major ‘crack down’ without major funding. LeadingAge President/CEO Katie Smith Sloan responded here.

The President's State of the Union Address will take place at 9:00PM and can be viewed on most TV news networks. LeadingAge Ohio and LeadingAge will continue to report on this plan as it develops.