The long-term care community responded following a federal hearing Thursday that featured calls for increased oversight of nursing homes to ensure quality standards are being met and prompted interest in another federal study on the use of antipsychotic medications on residents. 

Mark Parkinson, president and CEO of the American Health Care Association, noted that quality of care in skilled nursing facilities has “improved dramatically” over the last seven years. He also said the number of residents receiving antipsychotic medications has declined significantly since 2011. 

Mark Parkinson
Mark Parkinson

“Without question, abuse and neglect have no place in a nursing home or in any healthcare setting. One instance of abuse or neglect is one too many, but the facts show that such instances are rare and the vast majority of nursing home staff provide high-quality resident care,” Parkinson said in a statement following the hearing. 

“AHCA has made several recommendations to Congress for measures that can continue to improve care and prevent abuse and neglect. We look forward to continuing our work with lawmakers, regulators and other stakeholders to advance these recommendations, including policies that help facilities retain more high-quality staff, bring more clarity and transparency to abuse and neglect reporting, and provide consumers additional information to help them make informed decisions,” he added. 

LeadingAge in a statement to McKnight’s Long-Term Care News said it plans to submit “written testimony for the record, further setting out our views on addressing the issues raised.”

November 2018 LTCN, Katie Smith Sloan
LeadingAge President and CEO Katie Smith Sloan

LeadingAge President and CEO Katie Smith Sloan said the hearing “highlighted in painful detail” the toll the industry places on caregivers. It also highlighted the need for “public long-term services and support insurance to backstop private insurance and out-of-pocket costs.” 

She also noted the organization supports legislative efforts aimed at addressing several issues raised during the hearing.  

“We appreciate that the committee explored the breadth of caregiving issues, and look forward to working with the Committee on legislation implementing the many excellent ideas advanced at the hearing,” Smith Sloan added. 

Aging advocates with the Elder Justice Coalition and Long-Term Care Community Coalition were among witnesses invited to speak during Thursday’s hearing in Washington, D.C. Topics discussed ranged from caregivers’ and families’ well-being, hospice, Alzheimer’s and dementia, coverage for long-term health care services and the quality of nursing home care. 

Due to the “absence of effective enforcement” by the federal government, nothing is stopping nursing home companies from maximizing profits at the expense of resident care, Richard Mollot, executive director for the Long-Term Care Community Coalition, said at the hearing. 

Mollot pushed for better enforcement of minimum care standards to stop repeated incidents of abuse, neglect and crimes against residents. 

“Some nursing homes honor their promises to residents and families but far too many do not,” he said. “Most, though not all nursing homes, have insufficient staffing to meet residents basic clinical and hygiene needs. Over 40% of U.S. nursing homes have, what we call, chronic deficiencies — repeated violations of the same regulatory requirement year after year after year.”

He also criticized at the hearing the use and overuse of antipsychotic medications in residents and suggested another Office of the Inspector General investigation into the matter. 

“The overuse and inappropriate use of antipsychotic drugs on residents in nursing homes and in assisted living, and other settings, is really disgraceful, frankly, and harms hundreds of thousands of people everyday,” Mollot said. 

Other topics also arose at the hearing. Raising reimbursement rates for nursing homes and not moving forward with Medicaid block grant systems could help with the costs of care, urged Robert Blancato, national coordinator for the Elder Justice Coalition. 

However, he also called on lawmakers to consider tougher consequences for facilities with issues of abuse. 

“Please note, there are many fine nursing homes in this country… but where problems exist we must act,” he said.