In an effort to improve staffing, quality and oversight of facilities in response to the COVID-19 pandemic, six U.S. senators on the Senate Finance and Aging committee earlier this week filed ‘The Nursing Home Improvement and Accountability Act of 2021.’ The legislation would require nursing homes to meet minimum staffing standards and would provide additional federal Medicaid funds to states to support workforce and care improvements. The bill includes the following core staffing and accountability components:
- Minimum nursing standards - requires the Secretary of the Department of Health and Human Services (HHS) to conduct a study on staffing within three years and following completion of the first report, the bill requires the Secretary to use the findings from the report to set minimum nursing facility staffing within five years;
- Enhanced funding - provides temporary additional federal resources through Medicaid to increase wages and support the recruitment and retention of staff, as well as support improvements in resident care;
- Infection Preventionist - requires all nursing homes use the services of an infection prevention and control specialist no less than 40 hours per week;
- Registered Nurse (RN) – Requires that RNs are available in nursing homes 24 hours per day;
- Nursing Home Care Compare Webpage (staffing) – requires the HHS Secretary to (1) exclude the hours of licensed nursing staff spent on administrative duties from the Care Compare webpage and (2) add to the website weekend staffing information;
- Nursing Facility Building Modification and Staff Investment Demonstration Program - creates a demonstration program to provide funds to nursing homes to invest in the physical infrastructure of facilities, higher workforce standards, and integration of individual resident preferences. Applications would be accepted beginning in 2023, with participants pledging to meet standards to serve between five and 14 residents, provide private rooms, maintain accessible outdoor spaces for residents, and have standing resident and family councils; and
- Survey and Enforcement – Requires the HHS Secretary to review the effectiveness of surveys and enforcement in nursing homes and requires the Secretary to ensure that no less than five percent of the lowest rated SNFs or NFs participate in Medicare and Medicaid’s Special Focus Facility (SFF) Programs.