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November 23, 2021

In this Issue:

  1. Consumer Voice Applauds New Protections for Nursing Home Residents in House-passed Build Back Better Act
  2. Key Takeaways from New CMS Nursing Home Visitation Guidance
  3. OIG Report Analyzes Facility-Initiated Discharges in Nursing Homes
  4. Residents Invited to Participate in Survey with Stipend

Consumer Voice Applauds New Protections for Nursing Home Residents in House-passed
Build Back Better Act

Last Friday, the United States House of Representatives passed the Build Back Better Act which includes the most significant increase in protections for nursing home residents in decades.  

Consumer Voice applauds this critical step and calls on the Senate to include these essential provisions in its version of the Build Back Better Act.

The provisions included in the House version would:

  • Require nursing homes to have a registered nurse on staff 24 hours per day;
  • Result in a study of staffing in nursing homes and the implementation of a federal minimum staffing standard;
  • Increase oversight and enforcement in nursing homes;
  • Require increased scrutiny of data submitted to the federal government by nursing homes; and
  • Result in more accountability for how nursing homes spend billions of taxpayer dollars they receive each year.

Consumer Voice appreciates the work of Ways & Means Committee Chair Richard Neal and other members who supported these historic provisions in the House bill.

Read Consumer Voice's press release.

What Happens Next:

The fight to better protect residents and ensure quality of care is not over. The for-profit nursing home industry is intensely fighting provisions to require at least one registered nurse (RN) 24 hours a day and to increase minimum staffing standards. Privately-owned for-profit providers are asking lawmakers to cut these provisions from the Build Back Better plan.

The focus now turns to the Senate.  Your Senators need to hear your voice.  Visit our website find your Senators contact information and a script with talking points.  Tell your Senators to stand with residents and include these important provisions in the Build Back Better Act!

Key Takeaways from New CMS Nursing Home Visitation Guidance

On November 12, the Centers for Medicare & Medicaid Services (CMS) updated their Nursing Home Visitation Guidance. After a year and a half of residents and their loved ones being separated from each other and subject to confusing and often ignored visitation guidance, visitation is now allowed at all times for all residents, this includes indoor visitation.

Main takeaways from the guidance:

  • Facilities must allow indoor visitation at all times for all residents.
  • Facilities can no longer limit frequency and length of visits, number of visitors, or require advanced scheduling of visits.
  • Visits should be conducted in a way that adheres to the core principles of COVID-19 infection prevention and does not increase risks to other residents.
  • Vaccinated and unvaccinated residents can have close contact, including touch. Visitors should be made aware of the risks of physical contact with unvaccinated residents before the visit.
  • Communal activities and dining can occur while adhering to core principals of COVID-19 infection prevention. The safest approach is for everyone, regardless of vaccination status to wear a mask while in communal areas.
  • While CMS strongly encourages vaccinations, visitors, ombudsman, protection and advocacy representatives, and surveyors are not required to be vaccinated.
  • Visitors should be screened upon entry. Any visitor who is positive for COVID-19, or has symptoms of COVID-19, or meets the criteria for quarantine should not enter facilities.
Read further takeaways in Consumer Voice's information sheet.

Plus, watch the recording of our November 18th webinar reviewing the guidance.

OIG Report Analyzes Facility-Initiated Discharges in Nursing Homes

The Department of Health and Human Services Office of Inspector General (OIG) has released a report entitled "Facility-Initiated Discharges in Nursing Homes Require Further Attention."  The OIG report surveyed State Ombudsmen across the country and analyzed CMS administrative data to determine the number of nursing homes that received a deficiency related to facility-initiated discharge.  Officials from ACL and CMS Regional Offices as well as five State Ombudsmen were interviewed. 

The study found that many challenges exist to identifying and addressing inappropriate facility-initiated discharges, including that neither ACL nor CMS collect data on the number of facility-initiated discharges, and many State Ombudsmen do not count or track the notices they receive.  State Ombudsmen reported facing challenges while responding to facility-initiated discharges, such as nursing homes sending facility-initiated discharge notices that lack required information. Moreover, the COVID-19 pandemic exacerbated challenges.

In the report, OIG recommends that CMS provide training to nursing homes, assess the effectiveness of its enforcement of inappropriate facility-initiated discharges, and implement its deferred initiatives to address inappropriate facility-initiated discharges.  It also recommends that ACL assist State Ombudsman programs with a data-collection system for facility-initiated discharge notices and establish guidance for analysis and reporting of data from these notices.  Finally, OIG recommends that ACL and CMS coordinate to strengthen safeguards to protect nursing home residents and ensure that all State Ombudsmen, State agencies, and CMS Regional Offices have an ongoing venue to share information about facility-initiated discharges.

Read the OIG report.

Residents Invited to Participate in Survey with Stipend

Residents of long-term care facilities are invited to participate in a survey from the Mayer-Rothschild Designation of Excellence in Person-Centered Long-Term Care Project. The Resident Survey and the companion Resident-Representative Survey comprise one part of the Designation of Excellence (DoE) project’s effort to obtain resident views on their care.  The survey is available to residents who can provide informed consent to participate in the survey and can complete it with or without staff assistance; and resident-representatives of cognitively impaired residents who consent to participation in the survey.

Communities that wish to administer the survey can register at this link.  Communities who complete the surveys will receive a $250 stipend.  Residents’ input will help in developing a Designation of Excellence in Person-Centered Care which will provide long-term care communities with resources to improve care and service for residents.

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