President Joe Biden’s proposals to reform America’s nursing homes are “short-sighted” and may push providers over the edge during the ongoing workforce crisis, the former leader of the Centers for Medicare & Medicaid Services said Monday.
Biden’s reform plan was unveiled earlier this month. It includes more than 20 initiatives to improve quality of care, with minimum staffing requirements a top priority. The effort, however, could “decimate” the nursing home industry if it fails to address underlying funding and workforce challenges, warned Seema Verma, CMS administrator during the Trump administration.
“A one-size-fits-all staffing ratio concocted by federal bureaucrats won’t consider differences in a patient’s acuity or local factors, but it will thwart innovation in operational and technological advances that can improve care with existing workforce numbers,” she wrote in an op-ed published Monday in Modern Healthcare. “Moreover, Medicaid is the largest payer of nursing home care and its low reimbursement directly contributes to lower staffing levels.”
A request for comment from McKnight’s Long-Term Care News was not returned by CMS before production deadline. Current CMS Administrator Chiquita Brooks-LaSure last week clarified that “ funding” would be part of the solution for the minimum staffing requirement “but it is not the whole picture.”
The American Health Care Association has called the minimum staffing proposal “unrealistic and impossible,” considering the ongoing workforce shortage.
Individual penalties on poor-performing facilities would rise from from $21,000 to $1 million per instance under one of Biden’s proposals, and would require Congressional approval.
Verma agreed that there is a “critical need” for a modern strategy to improve nursing home care, but she argued against more “government micromanagement.”
She instead pushed for a value-based payment system that requires higher quality and better outcomes.
“A modern, results-oriented approach that focuses on outcomes has a better chance of improving quality than the president’s outdated policy prescriptions,” she concluded.
