On February 28, 2022, President Biden announced a set of reforms designed to improve the safety and quality of nursing home care, hold nursing homes accountable for the care that they provide, and make the quality of care and facility ownership more transparent. The reforms were developed and will be implemented through the Department of Health and Human Services (HHS). President Biden initiated the reforms because of his belief that the 1.4 million individuals who live in over 15,500 Medicare and Medicaid certified nursing homes deserve to have reliable, high quality care. He believes that transparency will help potential residents make informed decisions about care.
The set of reforms include:
- Every nursing home will provide 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.
- The public has better information about nursing home conditions so that they can find the best available options.
The Centers for Medicare & Medicaid Services (CMS) has launched four new initiatives that align with the reform to provide a sufficient number of staff who are adequately trained to provide high quality care. These initiatives include:
- Establish a Minimum Nursing Home Staffing Requirement – CMS will conduct a new research study to determine the level and type of staffing needed to ensure safe and quality care and will issue proposed rules within one year.
- Reduce Resident Room Crowding – CMS will explore ways to accelerate phasing out rooms with three or more residents and to promote single-occupancy rooms.
- Strengthen the Skilled Nursing Facility Value-Based Purchasing (VBP) Program – CMS intends to propose new payment changes based on staffing adequacy, the resident experience, as well as how well facilities retain staff
- Reinforce safeguards against unnecessary medications and treatments – CMS will launch a new effort to identify problematic diagnoses and refocus efforts to continue to bring down the inappropriate use of antipsychotic medications.
The full White House Fact Sheet, which contains the details regarding the reforms and initiatives, can be accessed at FACT SHEET: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes | The White House.
Issue:
High quality and safe resident care should be the top priority when providing nursing home services. All staff should be well trained and knowledgeable in the policies and procedures that ensure implementation of high quality, safe care. Failure to meet standards for quality of care can result in poor outcomes for residents, citations for substandard quality of care, and fines and other sanctions.
Discussion Points:
- Review your policies, procedures, and staffing guidelines to ensure they are designed to result in provision of quality care for all. Review your Facility Assessment as required by F838 to ensure it addresses the needs of all residents. Update your policies and Facility Assessment as necessary.
- Train staff on their responsibility to provide safe, high quality nursing care or to provide support services that help meet resident needs. Document that these trainings occurred and file the signed document in each employee’s education file.
- Periodically audit to ensure staff are following policies for delivering safe, quality nursing care and support services. Ensure your Facility Assessment is current, thoroughly assesses the needs of all residents, and determines the resources required to provide high quality resident care and services. Review your QAPI initiatives to ensure that safe, quality care is monitored as an initiative of the QAA/QAPI committee.
