Long Term Care Sector Advocates For Substantive Change With New Reform Agenda

The COVID-19 pandemic has shined a light on many systemic issues facing nursing homes across the country. Ongoing challenges such as underfunded government funding for care, workforce shortages and aging physical structures have worsened throughout the pandemic, underscoring the urgent need for reform. 

The American Health Care Association (AHCA) and LeadingAge released the Care For Our Seniors Act to address some of these long-standing issues and improve the overall the quality of care provided in America’s nursing homes. The Care For Our Seniors Act includes four main principles with policy proposals in each of the key areas: 
  • Clinical: Enhance the quality of care in nursing homes by developing clearer standards for infection preventionists, requiring that each nursing home have a registered nurse on-staff, 24 hours per day, and requiring a minimum 30-day supply of personal protective equipment in all nursing homes. 
  • Workforce: Strengthen and support our frontline caregivers by implementing a multi-phase tiered approach to attract, retain and develop more long term care professionals leveraging federal, state and academic institutions. 
  • Oversight: Implement improvements establishing a more resident-driven system by developing an effective oversight system and processes that support better care and protect residents. This would include implementing a process to help turn around or close facilities that are chronic poor performers and adding customer satisfaction to the government’s five-star rating system to help monitor the quality of a facility for family members and guide consumer choice. 
  • Structural: Modernize nursing homes by conducting a national study on how to shift to more private rooms, which promote resident privacy, autonomy and dignity, as well as support infection control best practices. ​
Along with determining key areas that need improvement, AHCA and LeadingAge have proposed several interrelated investment strategies to help reinvest in America’s nursing homes to ensure quality care. Reform will be costly, but is long overdue. The investment strategies include: 

  1. ​Enhanced Federal Medical Assistance Percentages (EFMAP): Increased federal Medicaid funds are provided to states to pay for the mandatory nursing facility benefit, with requirements that additional federal funds be used for nursing facility rates.

  2. Federal Framework for "Allowable Cost" or "Reasonable Cost": Establish federal guidelines for state allowable cost definitions.

  3. Medicaid Rate Adequacy Requirement: Medicaid rates are brought up to equal the cost of care and subsequently updated regularly to keep pace with increases in costs of care.

  4. State Nursing Facility Value-Based Purchasing (VBP) Committee & Required Design Report: The state will be required to form and maintain a state health plan and nursing facility VBP committee with specific guidelines and deadlines to submit reports. This offers the potential for additional resources. 
Long term care facilities have experienced devastating losses throughout the past year, and now it’s time to apply the lessons we’ve learned to strengthen our industry. Mark Parkinson, president and CEO of AHCA said, “With a growing elderly population soon needing our services, the moment is now. We must pay tribute to all those who lost their lives to this vicious virus and resolve to bring forth a brighter future.” AHCA is eager to begin working hand-in-hand with Congress to implement bold solutions that will ensure all seniors have access to high-quality long term care options. 

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org.