Seema Verma, Donald Trump
CMS Administrator Seema Verma speaks alongside President Donald Trump. (File photo)

Leading nursing home stakeholders hope that an expansive report by the government’s national nursing home commission will lead to a better national response and more support for nursing homes responding to the COVID-19 pandemic, and future emergencies.

The Coronavirus Commission on Safety and Quality in Nursing Homes on Wednesday released its expansive report featuring a total of 27 recommendations, featuring 10 themes and more than 100 action steps to aid providers and public health officials. Many of the recommendations made in the 186-page report centered around testing, personal protective equipment, cohorting, visitation and workforce strategies.

“As the COVID-19 death toll in nursing homes reaches over 50,000, we hope the commission report leads to a more coordinated response, and delivery of resources that are backed with adequate funding,” LeadingAge President and CEO Katie Smith Sloan said in a statement Wednesday following the report’s release. 

Some specific recommendations called on the federal government to immediately develop and execute a national strategy for testing and delivering rapid turnaround results in nursing homes; head a collaborative process to ensure nursing homes can procure and sustain a three-month supply of PPE; update cohorting guidance and reimbursement policy to address the differences in nursing home resources; and mobilize resources to support fatigued nursing home workforce and assess minimum care standards. 

The Centers for Medicare & Medicaid Services also released a corresponding sheet that compared the administration’s actions to each recommendation.

Closures threatened

“More than a million Americans require 24/7 stand-alone care from nursing homes, some of which have begun to close their doors as they rapidly deplete their reserves to keep up with the exorbitant costs they are incurring during this pandemic. The federal government must now focus on averting a wave of closures,” Sloan added.

The commission’s report acknowledged what “[providers] have been saying from the beginning — there must be a shared responsibility with public health officials prioritizing our residents in long-term care and helping facilities acquire necessary resources to combat this global pandemic,” said Mark Parkinson, president and CEO of the American Health Care Association. He will be at a White House discussion with top federal health officials this afternoon to discuss the report and said his association would help bring aspects of the report to fruition. 

“The commission’s review and findings lay out some of the important work that is needed to mitigate the impact of COVID-19 in nursing homes and further improve the quality of care we deliver,” Parkinson said. 

“As we prepare for a potential rise in cases this fall, we must arm nursing homes and other long term care facilities with a steady stream of resources to ensure they have adequate tests, personal protective equipment and staff support,” he added.

Will the feds act?

Commission member and Harvard health policy professor David Grabowski said the report deftly addresses key concerns for nursing homes. 

“We focused on ten areas in our recommendations including testing, PPE, and support for the workforce. If the federal government addressed all of these areas, I am convinced nursing home residents and staff would be better off as a result,” he told McKnight’s, adding that it’s unknown what recommendations the federal government will ultimately implement. 

“That is the key unknown going forward. I believe this report provides a good roadmap for the federal government. The big question is whether they will choose to follow it,” he added. 

Commission member Lori Porter, co-founder and CEO of the National Association of Health Care Assistants, said she “would have liked for the commission to have had a bit more teeth” but she was proud its report featured as many recommendations as it did on recruitment, retention, respect and the potential neglect and abuse of certified nursing assistants. 

“Funding, implementation and policy will decide if this nation has the will to protect and provide for its nursing homes,” Porter said. “There is no way to provide quality and safety to nursing home residents with a 1:27 ratio.” 

Commission member and LeadingAge California President and CEO Jeannee Parker Martin added that the recommendations can “serve as a roadmap to improve our workforce while enhancing their safety and quality of care.” 

“Coupled with funding for stronger testing and adequate PPE, the recommendations from the commission will provide immediate relief and long-term support to care communities helping older adults continue to age with dignity,” she added.