Leading long-term care industry advocates are eyeing a registered nurse staffing requirement and enhanced Medicaid funding under a set of “bold” reform measures aimed at improving that long-term care system.
The American Health Care Association and LeadingAge unveiled a legislative package proposal targeting systemic issues facing the nursing home sector that have been exacerbated by the coronavirus pandemic.
The policy proposal focuses on four key principles in order to achieve reform — clinical, workforce, oversight and structural — while also proposing how the federal government can step up to fund the reform measures.
“This proposal not only calls for providers to step up with the care in their buildings, it calls for policymakers to step up and put providers at the priority level that they should’ve been at all along,” AHCA President and CEO Mark Parkinson said during a media briefing Monday.
“These two very significant and bold proposals together can materially move the needle of care within our buildings,” he added.
The industry leaders called for a new federal requirement that requires each nursing home to have a registered nurse on staff for 24 hours a day; a minimum 30-day supply of personal protective equipment; and enhanced infection control preventionist resources among the clinical reform measures.
The proposal also highlights the need for an enhanced survey system that focuses on improvement, rather than a punitive approach, and developing a process that identifies chronic underperforming nursing homes and helps those facilities either fix their issues or close.
The package also suggests that providers embrace a shift to private rooms, which better support infection control measures, and make renovations to their buildings.
Regarding workforce reform, the groups support implementing a multi-phased, tiered approach to supply, attract and retain workers. This would include student loan forgiveness, tax credits, affordable housing and childcare assistance programs.
To pay for the reform measures, the groups also proposed four interrelated investment strategies, which include enhancing the Federal Medical Assistance Percentage, establishing federal guidelines for state allowable or reasonable cost definitions, and requiring states to set Medicaid rates to match the cost of care.
The overall package has a price tag of about $15 billion for taxpayers. About $11 billion would be needed for the clinical reform measures and $4 billion to address chronic Medicaid underfunding.
“Now is the time to make fundamental changes in the financing, regulation, oversight and practice of long-term care, and every one of us has a role to play,” LeadingAge President and CEO Katie Smith Sloan said Monday.
“Together, [the policy recommendations] are the starting point for creating a better system in which all nursing homes can be bastions of quality of care and quality of life.”