November 21, 2023

In this Issue:

1. CMS Issues Final Rule on Disclosure of Nursing Home Ownership
2. Congressional Report Recommends CMS Finalize a Strong CMS Staffing Rule
3. Webinar Next Tuesday on Supporting Residents with Mental and/or Behavioral Health Needs
4. November is National Family Caregiver Month

CMS Issues Final Rule on Disclosure of Nursing Home Ownership

Last week, the Centers for Medicare & Medicaid Services (CMS) released a final rule implementing increased ownership and managerial disclosure requirements in nursing homes. This past April, Consumer Voice offered extensive comments in response to the proposed rule. In our comments, we urged CMS to define critical terms and to use their broad regulatory powers to implement the law in an impactful way.  The final rule reveals that CMS has made few changes, leaving the proposed rule mostly intact.

Knowing who owns a nursing home can be a matter of life or death. It is well documented that certain types of owners are more likely to provide poor care. Ownership information is also necessary to help hold nursing home owners and operators accountable for how they use the tens of billions of Medicare and Medicaid dollars they receive each year. Nursing home owners have learned countless tricks to disguise ownership of homes through the use of shell companies, layered corporations, and other devices. 

Just recently, in a different proposed regulation, CMS stated that a “lack of transparency, regarding nursing home finances, operations, and ownership impedes the ability to fully understand how current resources are allocated.”  In the final rule, CMS has taken a step in the right direction to begin to address the problem of the lack of transparency in nursing home ownership, but much more work needs to be done.

Congressional Report Recommends CMS Finalize a Strong Nursing Home Staffing Rule

Senators Elizabeth Warren, Bernie Sanders, and Richard Blumenthal have published a new report, "Residents at Risk: Quality of Care Problems in Understaffed Nursing Homes and the Need for a New Federal Nursing Home Staffing Standard."  The report is the first congressional analysis of the benefits of the Centers for Medicare and Medicaid Services (CMS)'s recently released proposed rule for minimum staffing standards in nursing homes.  The report is based on a Congressional Research Service review of publicly available staffing and patient outcome data from CMS. It reveals that, across a broad range of health outcomes, nursing homes with higher staffing levels that meet the requirements in the CMS proposed rule provide better quality of care than homes with lower staffing levels.

The report's key findings include:

• Nursing homes with staffing levels below the proposed minimum staffing levels have significantly lower overall ratings in CMS’s Five-Star Quality Rating System (2.7 out of 5) than the nursing homes that meet the proposed, higher standards, which have average ratings of 3.8 out of 5.
• Nursing homes with lower staffing levels are more likely than homes with higher staffing to be in or be a candidate for the CMS Special Focus Facility program, a program for nursing homes that have “a history of serious quality issues.”
• Nursing homes with lower staffing levels have 50 percent more serious deficiencies in care that cause harm to patients, on average, compared to nursing homes that meet the higher CMS proposed staffing standards.
• Nursing homes with lower staffing levels are more likely than facilities with higher staffing to have instances of noncompliance related to patient abuse.

The report concluded that CMS’ proposed minimum staffing standards for nursing homes would have significant benefits for resident care, stating that "the data indicates that implementing such a standard would result in higher quality ratings and fewer serious quality issues, fewer deficiencies in care, and less patient abuse."

The report recommends that CMS finalize a strong version of the proposed rule in order to protect nursing home residents nationwide.

Webinar Next Tuesday on Supporting Residents with Mental and/or Behavioral Health Needs

Join Consumer Voice and the National Long-Term Care Ombudsman Resource Center (NORC) for Resources for Supporting Residents with Mental and/or Behavioral Health Needs webinar on Tuesday, November 28, 2:00 – 3:00pm ET.
 
In recent years, changes in public policy and in living options have resulted in more residents with mental and/or behavioral health needs living in long-term care facilities. Long-term care facilities often lack the training and access to the support necessary to provide individualized care for residents with these needs. Join us to hear about a new free resource for nursing facilities, the Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF).
 
The COE-NF was established in September 2022 by the Substance Abuse and Mental Health Services Administration (SAMHSA) in collaboration with the Centers for Medicare and Medicaid Services (CMS). COE-NF leadership will share what they do, who they help, program goals, and how to connect the nursing facilities you visit with their resources.
 
Speakers:

• Linda Kluge, Senior Executive Director, Quality & Strategic Alliances
• Jacob Berelowitz, Program Manager, Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF)

Register Now

November is National Family Caregiver Month

More than 1 in 5 people in the United States, totaling over 53 million, work every day to care for a loved one.

During National Family Caregiver Month, Alison Barkoff, Assistant Secretary for Aging and Performing the Duties of the Administration for Community Living (ACL) Administrator, published a blog on Supporting Family Caregivers.  The blog emphasizes the importance of family caregivers, ACL's programs supporting family caregivers, and takes a look at the interconnectedness between family caregivers and the direct care workforce.

Consumer Voice provides many resources to those caring for individuals in nursing homes, assisted living facilities, and receiving care and services in their home or community.  View our range of topic-based fact sheets and our Family Council Center for more resources.