Nursing Facility Transition

This article from the Administrative Law Commons and the Elder Law Commons reviews the problems in the nursing home industry revealed by the COVID-19 pandemic. The authors of the article provide suggestions to improve oversight practices and accountability through existing statutory regulations that will incentivize nursing homes to provide high-quality care. The article discusses how politics, bureaucracy, and ageism have prevented existing statutory authority from being utilized to its potential.

The Centers for Medicare & Medicaid Services (CMS) has issued updated guidance for nursing home visitation ahead of the conclusion of the COVID-19 Public Health Emergency (PHE) on May 11, 2023. The guidance emphasizes that despite the end of the PHE, nursing homes must continue to uphold infection control procedures and practices. The updated guidance advises nursing homes to follow CDC recommendations and post visual alerts to inform the public of infection control practices. Additionally, it states that indoor visitation during a COVID-19 outbreak should occur in the resident's room.

The National Task Group on Intellectual Disabilities and Dementia Practices (NTG), and the Health Matters Program at the University of Illinois Chicago issued a new brief “Over Medication of Older Adults with Intellectual Disability: Risks for Brain Health”. The advisory cautions readers that arise from over medication and suggestions for steps that can be taken to prevent the over- medication of older adults.

The COVID-19 pandemic has highlighted long-standing issues of understaffing and insufficient care delivery in nursing homes. On February 28, 2022, the Biden Administration announced it would be implementing a minimum staffing standard for nursing homes and increasing scrutiny on corporate owned nursing homes. This report analyzes federal data regarding nursing home staffing levels and how it effects residents' outcomes.

The impact of COVID-19 on nursing facility residents and staff has brought increased attention to existing workforce issues that affect care quality and safety, including staffing shortages and high turnover rates. This analysis presents the most recent national and state-level data on nursing facility-reported staff shortages and describes the Biden Administration’s new policy initiatives to address issues in nursing facilities. National staff shortage trend data spans from May 2020, the first month when nursing facilities were required to report COVID-19 facility data to the CDC, through March 20, 2022, the most recent week of data available.

Attorney General of New York, Letitia James (AG), released a preliminary report on the effect of COVID-19 on nursing homes in New York. The report found that pre-existing short-staffing issues were a defining factor in how a great number of nursing homes in New York fared during the first six months of the COVID-19 pandemic. Consumer Voice for Quality Long-Term Care also released a report detailing harm and neglect resulting from facilities being locked down and inadequate staffing.

AARP has released its fourth iteration of the Long-term Services and Supports Scorecard. This scorecard ranks states and DC in order from 1 to 51 on a wide range of issues pertaining to older adults and people with disabilities. The LTSS scorecard has five domains that states are ranked within, and each of those domains has multiple indicators that are used to derive the overall score.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

This recently released follow-up report was aimed at studying changes in the second year after individuals transitioned out of institutional care into community settings. Participants in the MFP program had higher costs during the first twelve months than non-MFP participants who also transitioned to community-based care. However, this study showed that these costs became comparable after the first year of transition.