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Administration Plans Important and Long-Awaited Nursing Home Reforms 

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This week, the Biden-Harris administration announced new reforms to improve nursing home staffing, transparency, and oversight. During the COVID-19 pandemic, nearly 1 million nursing home residents and over 1 million staff have tested positive for the virus, and approximately 150,000-200,000 residents have died. Advocates have pointed to staffing shortages, the absence of long-term care ombudsmen and state regulators, and poor infection control as major contributors to COVID-19’s devastating effect on nursing home residents.

Advocates have long identified staffing shortages as a major cause of inappropriate and inadequate nursing home care, a problem that has been exacerbated by the pandemic. According to Consumer Voice, an organization that works to improve quality in long-term care, “Studies have repeatedly shown that significant numbers of our nation’s nursing homes fail to adequately staff their facilities. Nursing homes with higher levels of staffing, however, provide better care to residents. A review of 87 research articles and reports from 1975-2003 found that nursing homes with higher staffing levels had residents with better health outcomes, including in the areas of functional ability, pressure ulcers, and weight loss.” And a COVID-specific study found that increased nursing staffing reduced COVID-19 infections.

To tackle this issue, the Biden-Harris administration plans to establish minimum staffing standards for nursing homes and support workforce development for nursing home jobs. In addition, the administration plans to strengthen its oversight of the industry, with a particular focus on poor-performing facilities, to better ensure Medicare and Medicaid beneficiary safety.

The administration also cites the need for greater transparency in nursing home funding, operations, and quality. In part, this would help prevent owners and operators from avoiding sanctions by closing facilities. Transparency would also help families find higher quality facilities by enhancing Nursing Home Care Compare to show when facilities are meeting, or failing to meet, their requirements.

Specific to COVID-19 and related issues, the administration is planning to strengthen requirements to combat infections through specially trained staff as well as enhancing rules for pandemic and other emergency preparedness.

Medicare Rights applauds these plans to improve care in nursing homes. These reforms would better protect older adults and people with disabilities, enable people with Medicare and their families to make more informed choices, and hold nursing homes accountable for poor quality care.

Importantly, no nursing home reforms can alter the desires of older adults and people with disabilities who prefer to remain in or return to their homes and communities safely rather than moving to a congregate setting. We will continue to call upon Congress to do more to fund home- and community-based services so that more people can live with dignity and choice.

Read the Biden-Harris administration’s fact sheet on nursing home reforms.

Read the Consumer Voice report on nursing home staffing during COVID-19.

Read more about the need for home- and community-based services.

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