‘Stop Blaming Nursing Homes’: Biden’s Proposed Reforms Garner Mixed Reactions

The Biden administration’s announcement of expansive nursing home reform on Monday elicited varied responses from industry trade groups and advocacy organizations.

Groups representing skilled nursing providers expressed particular concern that the reforms would impose stricter expectations without providing the needed resources to meet new mandates related to staffing minimums and other proposed requirements.

The reforms, developed by the Department of Health and Human Services (HHS) through its Centers for Medicare & Medicaid Services (CMS), are aimed at improving the quality and safety of nursing homes, protecting residents and staff and cracking down on “bad actors,” according to the White House.


President Joe Biden is set to talk further on these proposed plans, among other topics, on Tuesday evening during his first State of the Union address.

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and LeadingAge – while grateful the Biden administration seems to be prioritizing long-term care – questioned how these policies would be implemented and enforced without adequate funding and investments.

Mark Parkinson, president and CEO of AHCA/NCAL, said in a statement to Skilled Nursing News that additional oversight without necessary assistance will not improve resident care.


“To make real improvements, we need policymakers to prioritize investing in this chronically underfunded health care sector and support providers’ improvement on the metrics that matter for residents,” Parkinson said in the emailed statement.

He also went on to note the progress the nursing home industry has already made prior to the pandemic, including reduced hospitalizations, more one-on-one care for nursing home residents and the decline in the use of antipsychotic medications over time.

“It’s time to stop blaming nursing homes for a once-in-a-century pandemic … Together, we should focus on meaningful solutions that can attract and retain the frontline heroes we need and strengthen delivering the quality of care and services that our nation’s seniors deserve,” Parkinson said.

Katie Smith Sloan, LeadingAge president and CEO, called on officials to keep in mind Medicaid’s insufficiencies when it comes to covering the cost of service.

“We know that transparency, quality improvement, and workforce investments are critical to building better nursing homes for America’s older adults and families,” Smith Sloan said in the statement. “Yet Medicaid, the dominant payer of long-term care services, doesn’t fully cover nursing homes’ cost of quality care. Regulations and enforcement, even with the best intentions, just can’t change that math.”

The Long Term Care Community Coalition (LTCCC) and the Center for Medicare Advocacy (CMA) likened the proposed changes to “the biggest and most positive news for nursing home residents in the 35 years since Ronald Reagan signed the Nursing Home Reform Act.”

CMA Senior Policy Attorney Toby S. Edelman said the federal government’s agenda tackles issues that have “plagued” the nursing home industry for decades.

“For years, we have watched as an increasingly sophisticated and corporatized industry has, too often, cut back on staffing and essential services to maximize profits,” Richard Mollot, executive director of the Long Term Care Community Coalition (LTCCC) said in a statement. “We are profoundly grateful to the [p]resident for taking this bold stand for vulnerable residents, their families, and American taxpayers, who foot the bill for most nursing home care.”

Mollott’s comments about a “corporatized industry” echo the White House’s criticism of private equity ownership of nursing homes and practices that make it difficult for consumers and watchdogs to track corporate ownership of facilities. The Biden administration is seeking to address these issues with provisions related to greater transparency, heightened penalties and standards related to “corporate competency.”

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