CMS to set standards for nursing home staffing

Photo: Adene Sanchez/Getty Images

In his State of the Union address, President Joe Biden called for Medicare to set higher standards for nursing homes.

The most controversial is the president's call for "sufficient" staffing.

Kathryn Brod, president and CEO of LeadingAge Ohio, said, "... 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."

The Centers for Medicare and Medicaid Services will be establishing minimum nursing home staffing requirements and will conduct new research to determine the level and type of staffing needed, the White House said. CMS will be issuing a proposed rule within one year. 

Action will be aided by federal government funding, according to Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services. 

"When we talk to people on the front lines in nursing homes, the number one issue that we hear about is staffing, and I think funding is a part of that, but it is not the whole picture," Brooks-LaSure said, according to Bloomberg News.

WHY THIS MATTERS

Poorly performing nursing homes will be held accountable for improper and unsafe care or face having their funding cut from taxpayer dollars.

"The Administration is committed to these urgent actions as first steps toward fulfilling a broader commitment to ensure taxpayer dollars go toward the safe, adequate, and respectful care seniors and people with disabilities deserve – not to the pockets of predatory owners and operators who seek to maximize their profits at the expense of vulnerable residents' health and safety," the White House said. 

Other steps outlined by the Biden Administration include reducing resident room crowding, strengthening the Skilled Nursing Facility Value-Based Purchasing Program, and reinforcing safeguards against unnecessary medications and treatments to reduce the use of antipsychotic drugs.

REACTION

Terry Fulmer, president, The John A. Hartford Foundation, a member of the Coronavirus Commission for Safety and Quality in Nursing Homes Commission, said, "The past two years have been cataclysmic for America's nursing homes. President Biden's commitment to overhauling care for older adults is urgently needed and welcomed. While there are many issues that need to be addressed, adequate staffing is the most essential starting point for improving quality and safety." 

Kathryn Brod, president and CEO of LeadingAge Ohio, said, "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 payer in long-term care, Medicaid, is also the most underfunded. Medicaid only covers a portion of the costs of care. The connection between Medicaid payments and nursing home quality has been well documented, exacerbating health disparities."
 
THE LARGER TREND

A recent study of one state's nursing facilities found that increasing registered nurse staffing by just 20 minutes per resident day was associated with 22% fewer confirmed cases of COVID-19 and 26% fewer COVID-19 deaths, the White House said. 
 
The Government Accountability Office found that, from 2013 to 2017, 82% of all inspected nursing homes had an infection prevention and control deficiency, including a lack of regular handwashing, that was identified through Medicare and Medicaid surveys.

ON THE RECORD

Statement from CMS Administrator Chiquita Brooks-LaSure: "Tragically, nursing home residents and staff have made up roughly one-fourth of all COVID-19 deaths in the country. Without the hard work, dedication and sacrifices of our frontline care workers, we know the number of deaths from COVID-19 would be even more staggering. I am deeply grateful to the nursing home staff who are doing this critical work every day.
 
"The President has outlined a path forward to improve conditions for both nursing home residents and the staff who care for them. CMS is ready to implement this vision and at the foundation is the establishment of minimum standards for staffing in nursing homes."