A biennial report on long-term care costs should include specific questions about nursing homes’ complex ownership structures and complete costs to payers, according to the top Republican on the US Senate Special Committee on Aging. 

In a letter sent to the director of the National Center for Health Statistics Thursday, US Sen. Mike Braun (R-IN) said the voluntary National Post-Acute and Long-Term Care Study “provides a unique window into the spectrum of care” from nursing homes and other facilities dedicated to seniors. But “new[,] rigorous questions … will help us better understand the industry.”

More specifically, Braun’s letter says that people making “heart heavy and deep pocket decisions” about senior care want to understand the full costs, know how reliable quality measures are, and how the government “ensures our most vulnerable seniors are safe while in nursing homes.”

While dangling the carrot of cooperation with federal lawmakers, Braun also included the stick of approving funding. 

“Through Medicare and Medicaid, the government funds 52 percent of nursing home care,” he wrote. “New proposals seek to funnel more federal dollars into Medicaid Home and Community Based Services. Before putting more money into an opaque system, we must take stock of current ownership structures across settings of care and how they affect health and well-being outcomes.” 

The National Center for Health Statistics is a unit of the Center for Disease Control and Prevention. Braun stated that since the center is neither a regulator nor a payer, it is “uniquely positioned” to provide information to Congress on the quality and ownership of long-term care facilities.

He included seven questions that he wants answered by June 16, including how the center could improve survey response rates, what administrative data or questions could be added to the National Post-Acute and Long-Term Care Study to better understand costs, and how the survey can better ferret out complex ownership structures “without suppressing the response rate.”

During a hearing in the Special Committee on Aging last week, Braun also said that he is crafting legislation to make Care Compare – the website on which the Centers for Medicare and Medicaid Services posts its Five-Star Quality Ratings – more accessible. A spokeswoman said the site is used less frequently than other review sites and that research shows the site is not “easily findable online.”