AHCA/NCAL announces reform agenda for LTC
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.
- 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.
- Federal Framework for “Allowable Cost” or “Reasonable Cost”: Establish federal guidelines for state allowable cost definitions.
- 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.
- 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.
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