Clif Porter Head of Government Affairs for AHCA/NCAL

Nursing homes’ eligibility for federal mortgage insurance could become dependent on their quality ratings under legislation proposed this week.

The Nursing Home Accountability Act, proposed by Rep. Mark Walker (R-NC), would base eligibility for loans backed by the U.S. Department of Housing and Urban Development on a facility’s star rating through the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. Walker began working on the bill after seeing a local news story on a one-star facility that received a HUD-backed loan, according to The Center for Public Integrity.

Under the proposal, any nursing home that receives a star quality rating of two stars or less for 30 consecutive months, or at least two inspection cycles, would be ineligible for any future mortgages backed by HUD.

American Health Care Association Senior Vice President of Government Affairs Clifton Porter II expressed concern about the bill.

“Because skilled nursing centers use these loans for improvements that enhance patient care, we would not want to see centers that need the loans the most prohibited from receiving them,” Porter said in a statement.

The legislation also could have consequences for individually owned nursing homes that are often the only source of long-term care in economically struggling or rural areas, Cheryl Phillips, M.D., senior vice president for public policy and advocacy, told The Center for Public Integrity.

“I don’t want to support low-performing nursing homes, but I’m not sure that a fiscal stick that punishes them further is the right solution,” Phillips said. “In this kind of sweep, you would also impact homes that are hanging on by the skin of their teeth.”