The Centers for Medicare and Medicaid Services (CMS) is responsible for developing standards for rehabilitation facility and nursing home care (includes rehabilitation facilities) and ensuring those standards are met. Every nursing home that accepts Medicare and/or Medicaid is required by law to abide by the regulatory standards developed by CMS.
However, Federal regulations designed to protect the safety and well-being of residents in the nation’s nursing homes are facing mounting pressure from Congress. A group of 146 lawmakers, many of whom have received substantial campaign contribution from the nursing home industry, has urged the Trump Administration to revise safety standards in nursing homes. The industry contributed more than $2.5 million to the campaigns of 128 lawmakers who signed the letters, according to the website FollowTheMoney .org, which trackspolitical contributions. The industry gave a total of more than $1.98 million to 104 House members, and $587,000 to 24 Senators, who signed the letters seeking the re-evaluation of the standards, according to FollowTheMoney.
Nursing home experts, and advocates for residents contend the regulations are needed for safety, quality of care, and transparency; the measures will expand care plans, offer greater freedom for residents, increase the amount of training for nurses and aides caring for residents with dementia and provide grievance officers to help handle complaints. Nursing home residents have higher needs than in 1991, when federal regulations were first enacted. Nursing home care is one step below the hospital setting and half of all residents have a form of dementia.
The changes in the standards offer greater focus on residents’ safety and well-being, according to the National Consumer Voice for Quality Long Term Care , an advocacy organization in Washington, D.C. For instance, says the organization, the changes:
- Would stress greater residents’ freedoms in choice, from food selection to daily schedules, such as when to go to bed and when to wake up. Also, visitors can stop by at any time.
- Require nursing homes to perform a baseline care assessment within 48 hours of a resident’s arrival. The plan sets out initial goals for residents, including physician and dietary orders. Under the previous regulations, nursing homes could take up to three weeks to develop a care plan.
- Include a grievance officer at each facility, who would handle complaints of residents and families. An infection prevention specialist would be added as well. This would not require an additional hire, as a nurse on staff, with increased training, could be assigned the position.
- Add enhanced training for nurses’ aides to deal with residents suffering from dementia.
Advocates for nursing home residents have pushed for years for the CMS to come up with specific regulations for nursing homes regarding the number of nurses and nurse’s aides needed per shift.