Transforming Nursing Homes: Modernizing Physical Structures

COVID-19; Advocacy; Skilled Nursing Facilities (SNF)


The American Health Care Association (AHCA) and LeadingAge have proposed the Care For Our Seniors Act, a four-pronged, comprehensive reform proposal that will help strengthen nursing home care. Modernizing facilities for resident dignity and safety is one of the four pillars outlined in the package. 

The average nursing home is around 40 to 50 years old. Persistent financial challenges – due in large part to chronic Medicaid underfunding – prevent many nursing home providers from making the improvements needed to modernize their physical structures. But as nursing homes emphasize a more person-centered approach to care, traditional care models for long-stay residents and short-stay patients need to be updated and reformed.

Modernization includes shifting to more private rooms. They allow for greater privacy and dignity for residents, and promote enhanced infection prevention and control. This is especially important in light of the COVID-19 pandemic, as the virus was airborne and commonly spread through asymptomatic and pre-symptomatic individuals. 

There is a lack of data and research on nursing home room configurations and the number of buildings and rooms with more than two residents. The Care for Our Seniors Act proposes conducting a national study that would assess nursing home design to improve infection control, as well as modernize to meet market preferences. Areas of study should include financial factors, best practice architectural design for patients and residents, feasibility and funding mechanisms. 

As Congress considers the Biden Administration’s American Jobs Plan and efforts to rebuild our nation’s transportation, utility, and manufacturing systems, it is also time to invest our dated health care infrastructure. AHCA and LeadingAge support the Keeping Seniors Safe from COVID-19 Through Home Design Act, which would require the U.S. Department of Health and Human Services (HHS), Department of Housing and Urban Development (HUD), and Department of Agriculture to work together on financing and tax credits for nursing home modernization. Another piece of legislation, the Leading Infrastructure for Tomorrow's (LIFT) America Act, includes $10 billion for upgrading not-for profit medical facilities to increase capacity, strengthen care, and help prevent future outbreaks. In addition, the Fresh Air Act provides tax credits for modernizations, such as upgrading air filtration and purification. AHCA is calling on lawmakers to increase the funding for facility modernization included in these proposals and include all long term care providers, regardless of ownership status, so that every senior can benefit from a more modern and safer nursing home environment. 

America’s seniors deserve a robust, quality long term care system. Modernizing our nursing homes to increase resident privacy is a central component in enhancing quality of care. But with chronic underfunding and now an economic crisis caused by COVID, nursing homes cannot make these capital improvements on their own. Let’s work together to implement substantive reforms that will protect and improve the lives of our seniors in long term care. 

Read more about AHCA and LeadingAge’s modernization proposal HERE, and learn more about the Care For Our Seniors Act at

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