Moving Forward Coalition Seeks Input on Nursing Home Reform Recommendations
On Dec. 2nd, Moving Forward, a coalition of nursing home residents, family members, care partners, health care providers, policy leaders, and advocates funded by the John A. Hartford Foundation and convened by LeadingAge National, published a set of initial priority recommendations to improve the quality of life of nursing home residents. The recommendations were selected from a report issued in April 2022 by the National Academies of Sciences, Engineering, and Medicine (NASEM), which found nursing home care to be fragmented, unsustainable, and urgently in need of fundamental change.
In an effort to ensure quality, person-centered care for each resident, the Coalition’s seven committees identified recommendations based on four overarching and interrelated priorities: (1) strengthening nursing home capacity (including technology and staffing); (2) improving nursing home accountability; (3) improving care provider compensation and retention; and (4) ensuring that person-centered, quality care delivery and oversight is fully and properly financed. Each committee selected a short-term recommendation to test and promote over the next two years, and many also selected a longer-term project requiring longer lead times:
Committee #1: Person-Centered Care
- Create a more collaborative, better-aligned care planning process for each nursing home resident (working in collaboration with the Coalition’s Committee on Health Information Technology (HIT), since technology may be important to reaching this goal)
- Advance an equitable approach to the construction of new small-house or related nursing home models
Committee #2: Workforce
- Develop an evidence-backed approach to improving the benefits and compensation of nursing home staff, with a particular focus on certified nursing assistants
Committee #3: Transparency and Accountability
- Improve the collection, auditing, and sharing of nursing home-level ownership, financing, and operations data, dedicating special attention to the accessibility of data, the ease of data reporting, and alignment with other efforts, such as those enacted or being developed by the Biden administration
Committee #4: Nursing Home Finance Reform
- Develop and pilot an alternative payment model to reduce barriers to care and increase compensation for nursing home staff
- Advance more comprehensive legislation to incentivize small-home construction, related care delivery processes, and staff compensation
Committee #5: Quality Assurance
- Develop a pilot program including a learning collaborative to better integrate quality assurance and oversight efforts, building on Affordable Care Act (ACA) provisions and subsequent Centers for Medicare and Medicaid Services (CMS) rules to mobilize quality assurance methods in nursing homes
- Address the sustainability of the national Long-Term Care Ombudsman Program
Committee #6: Quality Measurement and Improvement
- Develop and test two nursing home quality measures, the first capturing resident experience, including engagement with family members or care partners and resident councils, and the second assessing health equity and disparities in nursing homes
Committee #7: Health Information Technology
- In the short term, work on HIT-enabled methods to improve person-centered care by collecting resident goals, preferences, and priorities, and measuring the alignment of care with those goals
- In the longer term, envision a pathway for national HIT adoption with key nursing home milestones and processes
The Coalition is seeking public input on the recommendations as it begins the process of building action plans to bring them to fruition. Nursing home residents, family members, care partners, government agencies, and policymakers are invited to participate in one of two feedback sessions, on Dec. 8th at 2 p.m. ET or Dec. 13th at 12 p.m. ET, or submit written feedback here throughout the month of December. Stakeholders are also encouraged to join the Coalition’s mailing list to learn about future opportunities for participation.
More information on the Coalition and its recommendations is available here.