Recommendations from the Coronavirus Commission on Safety and Quality in Nursing Homes were released on Wednesday and, as expected, they contain a laundry list of steps that both providers and regulators can take for future pandemic conditions or public health emergencies.
The panel included comments that kept its sponsor, the Centers for Medicare & Medicaid Services, on the spot. Report authors said that in some cases, “CMS will need to assume a greater leadership role working with its federal partners and state, local, tribal and territorial” authorities to better sort out which will have the authority to accomplish the commission’s recommendations.
The 186-page report was released by the MITRE Corporation, the independent research firm charged with administering the commission, to CMS on Sept. 1. The agency has had it under review since then. The report identifies seven main areas to focus on.
“To reduce suffering and to save the lives of residents and staff, CMS can implement or initiate the Commission’s actionable recommendations in relatively short order,” the commission concluded.
The commission met numerous times over the summer months and emerged with 27 recommendations, which were paired with action steps for CMS to engage in. Further broken down, the guidance has 10 themes, report authors explained, which address responses to:
• Ongoing supply and affordability dilemmas related to testing, screening, and personal
protective equipment (PPE)
• Tension between rigorous infection control measures and quality of life issues that exist
in cohorting and visitation policies
• A call for transparent and accessible communications with residents, their representatives
and loved ones, and the public
• Urgent need to train, support, protect, and respect direct-care providers
Commission Final Report
• Outdated infrastructure of many nursing-home facilities
• Opportunities to create and organize guidance to owners and administrators that is more
actionable and to obtain data from nursing homes that is more meaningful for action and
• Insufficient funding for quality nursing home operations, workforce performance, and
“The intent is that CMS would implement each principal recommendation in conjunction with its associated action steps to understand and realize the Commission’s vision,” the report summary states.
Some of the 25 commissioners, who signed on to non-disclosure agreements during their summer of meetings and deliberations, expressed optimism that findings would better prepare providers for any upcoming emergencies.
Others speaking off the record, however, expressed skepticism that the recommendations would have enough grit to them or lead to appreciable change.
“The time has come for a turning point in nursing home care. The Commission envisions a person-centered, resilient system of care that is better for the next generation — one that more deeply values and respects older adults and people with disabilities,” report authors wrote, charging CMS with taking greater control to ensure accountability of nursing homes, and for their residents and staff.
A full listing of commission members, which represent a wide array of providers and other long-term care stakeholders, was first announced in this McKnight’s breaking news bulletin back in June. More than half (13) endorsed the full report, with 11 objecting to at least one recommendation and member Eric Carlson, directing attorney of the National Senior Citizens Law Center, not endorsing the report at all.
“Members wrestled with challenging, sometimes competing, issues such as weighing infection control practices against psychosocial needs of residents,” said Jay Schnitzer, M.D., chief medical and technology officer at MITRE, and moderator of the commission. “These complex issues do not have easy solutions, which made the diverse experience and insights of members integral to developing the recommendations and actions endorsed in the final report.”
Several members of the commission, including former American Health Care Association Board Chairman and CEO of PruittHealth Neil Pruitt Jr., as well as Jeannee Parker Martin, president and CEO of LeadingAge California, will take part in a discussion of the final report and recommendations at the White House on Thursday with Centers for Medicare & Medicaid Services Seema Verma, Vice President Mike Pence, Centers for Disease Control & Prevention chief Robert Redfield and AHCA President and CEO Mark Parkinson.
This is a developing story. Please check back for updates.