‘This is Going to be Hard’: Coalition Issues Roadmap to Improve Nursing Homes in Wake of NASEM Report

A national coalition of more than 120 individuals and organizations focused on nursing home reform released a series of action plans on Tuesday, outlining ways to improve nursing homes over the next 12 months.

The Moving Forward Nursing Home Quality Coalition released several action plans to enhance quality of life for residents and working conditions for staff in nursing homes based on a report issued by the National Academies of Sciences, Engineering, and Medicine (NASEM). Each recommendation outlines specific goals, steps to achieve them, and the partners and infrastructure required along the way. The Coalition plans to provide more information through a series of online events and is simultaneously seeking feedback from the larger community.

In speaking to Skilled Nursing News, Alice Bonner, chair of the Moving Forward Coalition, emphasized the consensus achieved on the action plans by a group of diverse organizations that form the Coalition. 

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“The power of having a coalition is that people are not in their silos,” Bonner said. “They’re coming together and they’re starting by saying, ‘Okay, this is going to be hard, but we’re going to find a path forward together. We’re going to really work hard to do that.’ And that’s what the work was over the last year,” she said.

The Coalition and its committees not only have nursing home owners on board, but also certified nursing assistants (CNAs), nursing home owners, government officials, LTC Ombudsman, advocates for nursing homes and advocates for residents as well as residents themselves – all stakeholders that might influence the quality at nursing homes, Bonner said .

“We have nursing home owners and professional associations on the steering committee,” said Bonner, who said some of the “hard work” of the Coalition is reflected in the diversity of voices it represents. “We intentionally brought together people who have very different perspectives …. We have a nursing home residents on our steering committee and on several of our other committees,” she said.

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Over the past year, each of the Coalition’s committees has focused on the feasibility of the action plans by including committee members or partner organizations that represent diverse perspectives, Bonner said. Development of the action plans has been geared toward work that is practical and feasible, even given the staffing challenges, Bonner said. It is all designed to position nursing homes as leaders in public health and in communities, she said.

A major tenet of the Moving Forward Coalition has been to build out local infrastructure in states and regions so that local leaders and collaboratives can take on, and in many cases, lead action plan work, Bonner explained.

“We have nearly 1,000 participants signed up on our website, and many have offered to dive into our work in [the second year],” Bonner said.

The nine detailed action plans cover a gamut of issues from addressing resident concerns and priorities to workforce initiatives to improving surveyor training to developing a more targeted nursing home recertification survey to increasing transparency and accountability of ownership data to creating a technology readiness guide. Its recommendations even include suggestions on financing new nursing home models that are smaller with private rooms.

Coalition leaders say several of the plans are already in progress, including the analysis of more than 10,000 older adults’ preferences, which will be used to inform the care planning tool to better assess progress toward residents’ care goals. Moreover, the Coalition is already working in states like Michigan to facilitate collaboration with government, providers, and advocates to address major nursing home quality issues on workforce initiatives and career pathways for CNAs.

Over the next few months, the Coalition will host conversations detailing specifics about each action plan and ways for interested people and organizations to get involved and advance progress. A full list of conversations is available at https://movingforwardcoalition.org/taking-action/.

“We think these are valuable plans for people to read and think about and send us their feedback.”

The Moving Forward Nursing Home Quality Coalition is funded by The John A. Hartford Foundation, and draws on leadership from LeadingAge, the Institute for Healthcare Improvement, other national organizations and advisors.

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