COVID-19 has surfaced a lot of issues associated with nursing homes, of which the lack of staff and substandard care are some of the driving factors. Based on a KFF analysis, at least 23% of all COVID-related deaths in the USA comes from long-term care facilities (LTCF).
In view of the above, the White House aims to enhance 3 key areas with their initiatives with the intent to create reliable and high-quality care for nursing home residents.
In this article, we will cover what these proposed changes are and what they mean for your nursing home.
Key area 1: quality of care
Quality of care is one of the nursing facilities’ fundamental responsibilities, and a primary focus for families when sourcing an appropriate home for their loved ones. Given residents at nursing homes are vulnerable and at-risk populations, the Biden Administration has focused on enhancing quality of care as a priority.
Previously, there was only one time fines relating to subpar quality of care, up to $21,000. The Biden administration has now called on the Congress to impose a more aggressive per-day fine for their substandard care up to $1,000,000. The Centers for Medicare & Medicaid Services (CMS) is also exploring the option of setting such a per-day fine as the default penalty for non-compliance.
Although increasing fine limits reduce the likelihood for nursing homes to deliver poor care standards, it is not sufficient. The Biden administration has also delegated more resources to inspection activities. This aims to reduce the likelihood of nursing institutions hiring for the sake of making up numbers.
The Biden Administration looks to Congress to increase CMS’s budget survey to a whopping $500 million. This is nearly a 25% increase for inspection activities, which is an indication by the administration to tackle substandard care.
Key area 2: increased transparency and reporting
The CMS looks towards enhancing transparency and reporting quality to hold skilled nursing facilities (SNFs) owners accountable and safeguard nursing home residents.
Firstly, CMS will include more metrics in the Care Compare website. Care Compare is a single source platform which gathers helpful resources for families when choosing a nursing home. Families can now better determine whether their loved ones would receive appropriate care through additional metrics such as staff turnover and weekend staffing levels.
CMS will ensure the validity of the information displayed on Care Compare, even though nursing institutions are the ones managing their portfolio. If inaccurate information is displayed, CMS will enact enforcement actions on the relevant nursing facilities.
Secondly, the Biden Administration is giving CMS new authority. CMS is subjecting nursing homes to minimum corporate competency as an additional criteria for their participation in the Medicare and Medicaid program.
Essentially, CMS will review nursing institutions compliance history before SNFs are granted approval to the program. The scope of the review is not limited to a silo nursing facility, but also other facilities (past and present) owned by the SNFs owners.
Lastly, CMS can carry out enforcement actions on SNFs owners even after a facility’s closure. This further ingrains the importance of transparency and increase accountability. Therefore, closing a facility does not mean the end for irresponsible SNF owners.
Key area 3: nursing homes staffing standards
Minimum staffing level
Researchers have conducted studies to find out the relationship between staffing levels and the outcome of care provided within a facility. The research outcome suggest there is a positive relationship, and a clear association between total staffing levels and high quality care.
As such, the CMS will be “establishing a minimum staffing level”. This ensures “all nursing home residents are provided safe, quality care, and that workers have the support they need to provide high-quality care”.
If nursing homes fail to adhere to the minimum staffing standards, they “will be held accountable”.
CMS will conduct necessary research to determine the minimum staffing levels, and propose it within a year. With the new standards, it translates to more staffing resources allocated to resident care, boosting overall care quality.
Here is a brief recap of the current recommended minimum total nursing hours per resident (hprd). The standard 4.1 hours are broken down into the following:
- 2.8 hours from certified nursing assistants
- 0.75 hours from registered nurse (RN)
- 0.55 hours from licensed practical/vocational nurses
Although CMS pushed forth the recommended 4.1 hours, many states have established their very own hprd standards. More often than not, their hprd standards are below the suggested values. This results in varying degrees of care provided to nursing homes residents across the USA.
SNFs chain owners may have facilities in multiple states. Since each states have their own set of standards, SNFs owners may find it challenging to abide by them. Consequently, compliance issues may arise.
New metrics included in the VBP program
Apart from the upcoming minimum staffing regulations, CMS is including additional metrics in the Value-Based Purchasing (“VBP”) Program. Their new incentive payment proposal seeks to include metrics such as staffing adequacy, residents experience, and staff retention.
This is in addition to the measures they have begun to implement which looks at weekend staffing level and staff turnover rates.
The inclusion of the new metrics are largely staff-dependent. Therefore, building a robust staffing system is crucial for nursing homes to adapt to the new standards.
Taking the first step is always the hardest, which is why Zipline is here to support SNFs. Together, we can review what SNFs can do to conquer the new standards.
How can Zipline help nursing homes like yours?
Through our end-to-end visitor management and compliance platform, you can easily reduce labor cost and administrative burden, whilst monitoring the experience of residents, staff and visitors to your SNF.
Here are the three areas Zipline can help nursing homes, like yours.
Reduced administrative staffing
With Zipline’s automated check in system for various visitors, you can create a better visiting experience for them. You can speed up the check-in process with features like pre-booking, remote vaccination status approvals, COVID-19 tests and Medical Grade Health Screenings. This way, your staff will get up to 4 hours back in their day which is currently being spent on visitor management.
Our visitor management system allows you to have real-time updates of your facility.
Not only will you be able to allocate staff efficiently for timely assistance, but also monitor and manage visitors, contractors and residents. This provides you with greater insights and control over potential infection spread within your nursing home.
In this seemingly never ending COVID-19 era, government often create in an attempt to control the spread. This will have a great impact on service industries, especially the healthcare sectors.
To help you manage and take the load off compliance management, Zipline’s dedicated compliance team automatically updates the regulations through our platform. This allows you to have a greater peace of mind when managing compliance.
Moreover, we offer powerful reporting for trends, contact tracing & audit trails and NPS. With these data, you can easily abide by the compliance regulations. You can also save the hassle of generating these reports by yourself!
These new regulations could mean a major rework for nursing homes.
Nursing homes may find it overwhelming as they attempt to gear up their facility according to the latest standards. This is especially challenging with the labor shortages in the USA.
With Zipline’s experience of working with over thousands of facilities like yours, we are confident of supporting you. Chat with us to find out more about our software and how we can support you.