Missouri lawmakers are calling for tightened regulations for long-term care and other eldercare facilities following a controversial nursing home shutdown. A bill proposed last week by Missouri House Minority Leader Crystal Quade (D) aims to increase standards of care and ownership transparency for elder care in the state.
The bill follows the national fallout from the abrupt evacuation of a St. Louis nursing home, which a state oversight department confirmed did not properly handle the transfer of residents to other facilities.
In order to receive a permit to operate, facilities would be required to disclose “all facility owners, facility trustees, and companies that provide the facility or operator with administrative, clinical, and financial services, including real estate investment trusts,” under the bill.
This provision is a strong signal that some lawmakers and advocates see REITs as a threat to long-term care quality in the state. Quade, who has entered the Democratic primary for the 2024 governor’s race, was supported by union leaders last week, including from the state’s SEIU Healthcare branch, which endorsed her candidacy.
In recent months, the Centers for Medicare & Medicaid services also has put a greater spotlight on REITs in healthcare — making similar calls to increase the public transparency of healthcare facility ownership.
Staffing rules ring a bell
Another major provision of the bill would be enacting a requirement of roughly 3.0 care hours per resident per day, split between registered nurses and certified nursing assistants. The requirement would be nearly identical to that of a federal staffing mandate proposed by CMS in September.
Language in the bill currently leaves some question as to which provisions would impact long-term care facilities, assisted living facilities or both. The staffing requirement, for example, may only apply to assisted living facilities in the bill’s current form, which would be a notable departure from how such requirements are typically implemented at the state and federal level.
The bill also notes that the staffing requirement could be waived if a facility can demonstrate the need for a hardship waiver from the state. However, a representative from Leading Age Missouri told McKnight’s Monday there are concerns that such concessions might not adequately address obstacles to care worker recruitment.
The representative added that the nonprofit provider association is considering the implications of the bill and has not yet decided whether to throw its political weight behind supporting or opposing the legislation.
