In late February, the Biden administration announced substantial reforms intended to improve the quality of care at nursing homes. The Department of Health and Human Services (HHS) developed a new set of standards designed to “improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent so that potential residents and their loved ones can make informed decisions about care.”
For decades, the nursing home industry has been allowed to operate with conditions that create a miserable and dangerous environment for residents. Healthcare experts have long criticized the nursing home industry for dangerously low staffing levels. Numerous studies have shown that these low staffing levels directly relate to higher incidence of injuries and death, not to mention miserable living conditions and affronts to human dignity for elderly and infirm residents who depend on staff for daily activities.
“It’s easy to blame the staff, but the underlying problem is the greed of nursing home ownership and management,” said Brian Brown, a founding partner at Brown & Barron, a Baltimore-based law firm specializing in nursing home abuse and neglect cases. “There are some bad apples, but in many, if not most, situations, they’re in a no-win situation with long hours, no support, and dealing with far more residents than they can reasonably care for.”
The Centers for Medicare and Medicaid Services (CMS), which oversees most of the nation’s 15,600 nursing homes, conducts regular inspections of the nursing homes it funds, and data shows that most nursing homes repeatedly violate infection control standards. The inspection system has been criticized for being soft on bad nursing homes that are responsible for egregious violations or repeated problems. Nursing homes also have an appeals process, which has been accused of being overly secretive and enabling nursing homes to hide their worst offenses, even when they lose their appeals.
According to the White House briefing, the new reforms would ensure that:
- every nursing home provides a sufficient number of staff who are adequately trained to provide high-quality care;
- poorly performing nursing homes are held accountable for improper and unsafe care and immediately improve their services or are cut off from taxpayer dollars; and
- the public has better information about nursing home conditions so that they can find the best available options.
“This is long overdue. Nursing homes are doing the bare minimum or worse in terms of staffing levels and safety measures,” said Leah Barron, a founding partner at Brown & Barron, “and the current regulations have set the bar so low and the penalties so toothless, that there’s no real deterrent to nursing home negligence, other than a lawsuit.”
