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AHCA/NCAL announces reform agenda for LTC

On Monday, the American Health Care Association, representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year and LeadingAge, the association of more than 5,000 aging services providers including nursing homes, released a reform agenda, the Care For Our Seniors Act, to address long-standing challenges affecting the quality of care provided in America's nursing homes. 
 
The COVID-19 pandemic has exposed and exacerbated systemic issues impacting the nursing home sector, such as workforce shortages, aging physical plants, and underfunded government reimbursements for care. Many of these issues were raised for years prior to COVID but were never fully addressed by policymakers. Through the Care For Our Seniors Act, AHCA and LeadingAge are calling on lawmakers once again to help resolve systemic challenges, as well as reflecting on ways nursing home providers themselves can improve. 

The Care For Our Seniors Act has four main reform 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. 
The nursing home sector has been facing a financial crisis for years due to low Medicaid reimbursements, the primary coverage for nursing home residents. With providers dedicating extensive resources in response to COVID and a significant drop in new residents moving in, the financial shortfalls have only worsened. Each policy proposal in the Care for Our Seniors Act must include government resources, and AHCA and LeadingAge propose several interrelated investment strategies to help reinvest in America's nursing homes to ensure quality care, including:
 
  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.
“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,” concluded Mark Parkinson, president and CEO of AHCA. “We have already seen what progress can be made when policymakers come together to make long term care residents a priority and through these reforms, we can significantly improve the quality of care for our current residents and generations to come.” 

Staff Contact: ngrosso@mehca.org

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