Sweeping changes are needed at a systemic level in order to improve the quality of care in nursing homes, according to an April 6 report from the National Academies of Sciences, Engineering and Medicine's Committee on the Quality of Care in Nursing Homes.
The committee examined the delivery, finances, regulation and nursing home quality of care in the U.S., with an emphasis on challenges that have arisen from the COVID-19 pandemic, to inform the recommendations in the 605-page report.
"The way in which the United States finances, delivers and regulates care in nursing home settings is ineffective, inefficient, fragmented and unsustainable," the report said.
Five key recommendations:
- Given death rates in nursing homes from COVID-19, nursing homes should be included in emergency planning, preparedness and response at federal, state and local levels.
- Nursing homes should identify and document care preferences of residents and families, with oversight from CMS.
- Staff should ensure care plans address medical, psychosocial and behavioral health needs of residents and revisit plans at least quarterly.
- Federal agencies, academic institutions and private foundations should fund research on care models and specific factors that affect care to best meet the needs of nursing home residents.
- CMS should establish minimum national competency and education standards for workers and immediately implement requirements for 24/7 registered nurse staffing and add a full-time social worker in all nursing homes.