Wide-Ranging Systemic Changes Needed to Transform Nursing Homes to Meet Needs of Residents, Families, and Staff

Ferrell BR, Alexander GL, Ersek M, Galambos C, Grabowski DC, Greenlee K, Kaplowitz LG, Konetzka RT, Mueller CA, Rantz MJ, Saliba D, Scanlon W, Sloane PD, Stevenson DG, Travers JL, Tucker-Seeley R, Werner RM. Wide-Ranging Systemic Changes Needed to Transform Nursing Homes to Meet Needs of Residents, Families, and Staff. Washington, DC: The National Academies Press; 2022 Apr 6. 604 p.

WASHINGTON - Providing high-quality care for all nursing home residents requires collaboration among federal and state governments, health care providers, payers, and others to completely transform the way nursing home care is delivered, financed, and regulated, says a new report from the National Academies of Sciences, Engineering, and Medicine. Strengthening the nursing home workforce, improving emergency preparedness, and increasing the transparency and accountability of nursing homes' finances, operations, and ownership are key actions among the report's comprehensive recommendations. "The way in which the United States finances, delivers, and regulates care in nursing home settings is ineffective, inefficient, fragmented, and unsustainable," said Betty Ferrell, director of nursing research and education and professor at City of Hope Medical Center, and chair of the committee that wrote the report. "We must stop viewing nursing home residents as 'them' - they are our grandparents, parents, friends, siblings, and veterans. The recommendations in this report could profoundly change the delivery of care, and we're confident they align with what we would want for ourselves and our loved ones if we or they were in a nursing home." The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff starts with a foundational goal - providing person-centered care that honors residents' values and preferences. The report calls for the development of quality measures for areas such as palliative care and psychosocial and behavioral health, the development of an overall health equity strategy for nursing homes, and the collection and reporting of information about resident and family satisfaction via Care Compare, the Centers for Medicare and Medicaid Services (CMS) website that reports on nursing home quality. For many decades, the nursing home sector has experienced underinvestment in ensuring the quality of care and a lack of accountability for resource allocation. The report's recommendations likely will require a significant investment of additional financial resources at the federal and state levels and from nursing homes. However, the committee noted that key partners, such as CMS, may not currently have the full authority or resources to carry out the actions recommended, and therefore, congressional action may be required.