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August 1, 2023
In this Issue:
- Send a Message to Congress: Support a Strong Staffing Standard in Nursing Homes
- CMS Increases Medicare Rates, Keeps Turnover Measure
- New Podcast Episode on the U.S. Supreme Court Case on Nursing Home Residents' Rights
- Materials Available from Webinar on Using the New CMS Nursing Home Affiliation Data
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Send a Message to Congress: Support a Strong Staffing Standard in Nursing Homes
 On February 28, 2023, President Biden announced a historic set of nursing home reforms. The centerpiece of these reforms was the promise to create a minimum staffing standard in nursing homes. For the first time, nursing homes will be required to provide, at a minimum, a certain amount of direct care each day to each resident. Since this announcement, residents, families, nursing home workers, and their advocates have been working tirelessly to support the Biden proposal.
Over twenty years ago, the Centers for Medicare & Medicaid Services (CMS) commissioned a study that found that a nursing home resident needed, at a minimum, at least 4.1 hours of direct care per day (hpd). Since then, nursing home residents have become sicker and in need of more care, while more functional individuals choose to remain at home. Any minimum staffing standard below 4.1 hpd will be unacceptable.
The nursing home industry is spending millions of dollars to try and derail this historic reform by the Biden Administration. Nursing Home residents need your help!
Use our online form to send a message to your members of Congress urging them to support a strong staffing standard in nursing homes.
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CMS Increases Medicare Rates, Keeps Turnover Measure
In a Centers for Medicare & Medicaid Services (CMS) final rule set to be published on August 7, nursing homes will receive a 4% increase in Medicare Part A payments in fiscal year 2024, higher than the expected 3.7% noted in the proposed rule from April 2023. This increase comes despite a MedPAC recommendation earlier this year that rates be reduced by 3% due to Medicare margins exceeding 10% for multiple straight years. In the final rule, CMS also addressed changes to CMS' quality reporting and value-based purchasing programs. CMS has retained a total nurse staffing turnover measure for the value-based program, yet declined to adopt a resident-satisfaction measure based on the AHCA-developed CoreQ based on concerns raised in public comments, including by Consumer Voice. Additionally, CMS is eliminating the requirement that facilities notify CMS in writing that they waive their right to an appeal hearing of a civil money penalty (CMP), thus giving facilities a 35% reduction of the CMP. Instead, CMS is treating as a "constructive waiver" when the facility does not submit a request for a hearing.
Review the advance notice of the final rule.
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New Podcast Episode on the U.S. Supreme Court Case on Nursing Home Residents' Rights
 Few lawsuits make it all the way to the U.S. Supreme Court. However, one brought by the family of Gorgi Talevski did just that -- and they won! The Talevski case decision is important in that it addresses the rights of nursing home residents, their ability to sue a state run (publicly owned) nursing home, and addresses the importance of the Nursing Home Reform Act in establishing the standard of care.
Join our discussion with Suzana Talevski, attorney and daughter of Mr. Talevski; Maame Gyamfi, Senior Attorney at AARP Foundation Litigation; and Toby Edelman, Senior Policy Attorney with the Center for Medicare Advocacy. Ms. Gyamfi authored an amicus curiae, or friend of the court, brief on behalf of AARP and several other groups, including Consumer Voice. Ms. Edelman authored an amicus brief addressing the background and history of the Nursing Home Reform Act.
In this episode, we discuss the lawsuit, the Supreme Court decision, and what this means for residents. To access the U.S. Supreme Court decision and briefs filed in this case, visit the U.S. Supreme Court website, Docket No. 21-806.
Listen to the podcast on Spotify, Apple Podcasts, YouTube, SoundCloud, Facebook or our website.
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Materials Available from Webinar on Using the New CMS Nursing Home Affiliation Data
 On June 28, 2023, the Centers for Medicare & Medicaid Services (CMS) began to publish on its Nursing Home Care Compare website information regarding a facility’s affiliation with other nursing homes under common ownership or control. In addition, CMS published a data set entitled “Nursing Home Affiliated Entity Performance Measures”. For the first time, consumers will be able to see how nursing homes in a chain or under common ownership or control perform in various quality measures, including the Care Compare Five-Star rating system, staffing levels, regulatory violations, and many other performance measures.
For nursing home residents and their families, making a decision about what facility to choose to reside in can be a daunting and frustrating process. Knowing who owns a nursing home can be a matter of life and death. For instance, research shows that residing in a nursing home owned by private-equity investment organization raised resident mortality by 10%. However, for too long, it has been difficult to determine who actually owns a nursing home. CMS’s new affiliation data is a critical and important step in ensuring increased transparency in nursing home ownership.
The webinar demonstrated how to use this newly available information, with step-by-step guidance on how to access and interpret ownership and performance data.
Get materials from the webinar.
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