Federal and state lawmakers must work with nursing homes on six actions related to care quality and support, Alice Bonner, PhD, RN, FAAN, told the House Select Subcommittee on the Coronavirus Crisis at a hearing Wednesday.
The actions, Bonner, chair of the Moving Forward: Nursing Home Quality Coalition, told the subcommittee:
- Address the workforce crisis through workforce development and funding,
- Improve state survey processes for oversight of nursing homes,
- Strengthen nursing home transparency,
- Fairly reimburse the cost of care and reducing purchasing costs,
- Prioritize equity among racial and ethnic groups, and
- Incentivize the adoption of certified electronic health records and information technology interoperability in nursing homes.
The pandemic has brought “an intensified sense of urgency to longstanding issues of care quality and inadequate support facing nursing homes,” Bonner said, adding that “nursing homes are a part of the healthcare system that is often overlooked.”
Subcommittee members heard from David Grabowski, PhD, a professor of healthcare policy at Harvard Medical School; Adelina Ramos, a certified nursing assistant from Greenville, RI; Jasmine Travers, MHS, RN, an assistant professor of nursing at the New York University Rory Meyers College of Nursing; and Daniel Arbeeny, the son of a nursing home resident.
Grabowski said that the pandemic “lifted the veil on nursing home care in America” and provides an opportunity to address “issues that we have ignored for far too long.”
Ahead of the hearing, the House subcommittee released a report on the shortcomings of nursing homes it perceived from March through June 2020, including understaffing, deficient care and neglect in the early days of the pandemic.
American Health Care Association President and CEO Mark Parkinson said ahead of the hearing that the nursing home industry had made “tremendous progress” on issues it faces but that “there is still a lot of work that needs to be done.”
“The pandemic has amplified long-standing challenges — many of which have been raised by the long-term care profession for years — that must be solved,” he said. “Our profession is facing historic staffing and financial challenges — due in part to inadequate Medicaid funding — which have left many facilities struggling to keep their doors open. Hundreds of nursing homes have closed as a result, and more will follow without additional support.”
Parkinson said that the industry “saw tremendous progress in reducing cases and deaths” once it received financial aid and once public health agencies prioritized nursing home residents for coronavirus vaccination.
“However, serious challenges remain, including a historic labor crisis,” he said. “If we want to learn from this pandemic, we need to focus on these larger issues that are faced by all nursing homes and would make a significant difference in the lives of our residents.”
LeadingAge President and CEO Katie Smith Sloan said the organization supports the Biden administration and the House Select Subcommittee’s “concern for and interest in the well-being of nursing home residents and the professionals who care for them.”
“Ensuring quality long-term care should indeed be a top priority for Congress, the president, CMS and other federal and state agencies,” she said in a statement. “Unfortunately, this has not always been the case. For decades, our country’s long-term care system has failed older adults and the aging services providers who care for them. Never was that failure more catastrophic than during the COVID public health emergency’s early days.”
Terry Fullmer, PhD, FAAN, president of the John A. Hartford Foundation, called the hearing “a critical step toward accountability and action to improve America’s nursing homes,” adding that “policymakers have an actionable roadmap to address the most daunting issues facing nursing home staff, residents and their families.”
