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April 19, 2022

In this Issue:

  1. Consumer Voice's New Report Highlights How Nursing Homes with Higher Staffing Levels Have Better Five-Star Ratings and Less Instances of Abuse
  2. CMS Rescinds Emergency Waivers, including of Training and Certification Requirements for Nurse Aides
  3. It's National Volunteer Week; Webinar from NORC Recognizing the Importance of Volunteers
  4. New Policy Guide from PHI on Strategies for Strengthening the Direct Care Workforce
  5. CA Attorney General Announces $3.25 Million Settlement with Senior Care Operator for Misrepresenting Quality of Care

Consumer Voice's New Report Highlights How Nursing Homes with Higher Staffing Levels Have Better Five-Star Ratings and Less Instances of Abuse

Understaffing has plagued nursing homes for years. Residents have suffered due to insufficient and sporadic care.  The COVID-19 pandemic laid bare for the country the result of years of not investing in resident care.  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. Consumer Voice’s new report, Staffing Matters, looks at federal data regarding nursing home staffing levels and how it effects outcome for residents.

The report found that:

  • Nursing homes with higher staffing levels have higher overall, health inspection, and staffing ratings.
  • As staffing levels decrease in nursing homes, the instances of resident abuse rise.
  • Nursing homes with higher RN staffing levels have higher overall, health inspection, and staffing ratings. They also are less likely to have been cited for abuse.

Read the report.

Consumer Voice's report supports the Biden Administration's call for a minimum staffing standard.  It is urgent that we act now to take steps to address these issues and protect residents of nursing homes. 

CMS Rescinds Emergency Waivers, including of Training and Certification Requirements for Nurse Aides

As reported in last week's issue of The Voice, on April 7, 2022 the Centers for Medicare and Medicaid Services (CMS) issued a memo (QSO-22-15-NH & NLTC & LSC) rescinding several temporary emergency waivers issued in response to the COVID-19 Public Health Emergency with the intent to provide health care providers with extra flexibility in responding to the pandemic.  CMS has acknowledged that the waiver of minimum standards for quality may have resulted in negative outcomes and put residents at risk.  During the pandemic, MDS data and, according to CMS, findings from onsite surveys, have shown significant decline in residents’ condition, including weight loss, increase in pressure ulcers, use of antipsychotic drugs, depression, and abuse.  

Consumer Voice has been particularly concerned about waivers related to the training and certification requirements for nursing assistants.  Federal law requires nursing assistants to complete a minimum of 75 hours of training, and pass a certification exam, within four months of beginning work in a nursing facility.  The CMS emergency waiver allowed facilities to hire individuals who were not certified, and with as little as 8 hours of training, to provide care to residents.  Inadequate staff training puts both residents and staff at risk of harm.

In rescinding the waivers, CMS indicates that it still expects providers to continue taking actions to reduce the likelihood of COVID transmission and to follow all existing requirements.  Additionally, facilities are encouraged to use all available resources to support residents and staff in getting the COVID vaccine.  While the emergency blanket waivers are ending, CMS has indicated that states and individual facilities may request a regulatory waiver for an issue unique to their facility or location.  

Learn more in our summary of CMS' memo.

It's National Volunteer Week; Webinar from NORC Recognizing the Importance of Volunteers

This week is National Volunteer Week, an opportunity to recognize the impact of volunteer service. The theme for the April 17-23, 2022 National Volunteer Week is Shining a Light on the People and Causes That Inspire Us to Serve.

The Long-term Care Ombudsman Program could not be its best without the volunteers who help carry out the mission of advocating for long-term care residents.  In federal fiscal year 2020, 5,152 volunteers trained and designated to investigate and resolve complaints, contributed 250,514 hours of service to Ombudsman programs across in the country (according to the NORS data). The Independent Sector determined the estimated value of a volunteer hour in 2020 was $27.20. For the Ombudsman program, that is $6.8 million of assets due to volunteer service!  Due to the dedicated service of these volunteers, resident access to the Ombudsman program is enhanced significantly and thousands of residents receive information about their rights and have assistance and support in resolving their concerns.

Long-term Care Ombudsman Programs are encouraged to take time this week to thank their volunteers and recognize their work publicly by sending brief messages of appreciation for their dedicated advocacy to the National Long-Term Care Ombudsman Resource Center (NORC).  NORC will post messages on its website and via social media.

Join NORC this Thursday, April 21st at 3:00pm ET for a webinar recognizing the importance of volunteers.  Volunteer Representatives will discuss why they stay with the program and Ombudsman programs will share state and local level examples of successful recruitment and retention activities.

Register Now

New Policy Guide from PHI on Strategies for Strengthening the Direct Care Workforce

PHI published a new policy guide, State Policy Strategies for Strengthening the Direct Care Workforce, which describes 24 specific strategies - with concreate examples - that states have used to improve direct care job quality and strengthen and stabilize this essential workforce, which improves access to long-term services and supports for everyone.

Read the guide.

CA Attorney General Announces $3.25 Million Settlement with Senior Living Operator for Misrepresenting Quality of Care

The California Attorney General, with the Kern County District Attorney, announced a $3.25 million settlement with the nation's largest senior living operator, Brookdale Senior Living, Inc., for failing to adequately notify and prepare residents for transfers and discharges and for reporting false information, including over-reporting to the Centers for Medicare & Medicaid Services (CMS) the number of hours that nurses provided care to residents.  The false information that Brookdale provided to CMS was used to award star ratings to each of Brookdale's California facilities, ratings that were used by consumers as a means of selecting a quality skilled nursing facility. Through its misrepresentations to CMS, Brookdale fraudulently increased its star rating in several categories to attract prospective residents and their families.

For more information, read the statement by the California Attorney General.

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