Biden to launch ambitious overhaul of nursing home quality

WASHINGTON (AP) — President Joe Biden will launch a major overhaul of nursing home quality in his State of the Union speech, White House officials said Monday, outlining a series of measures long sought by advocates and opposed by the industry.

Taken together, the more than 20 separate steps would raise the bar on staffing and quality, increase government oversight, continue efforts to keep COVID-19 out of nursing homes, and shine a spotlight on a growing trend toward investor-owned, for-profit facilities.

One major missing element: New sources of federal financing to pay for the ambitious upgrade.

“Overall these are very positive developments,” said Harvard health policy professor David Grabowksi, who tracks long-term care. “If you ask the industry, they'll tell you this will put them out of business. If you ask an advocate, they'll say there's plenty of money in the system. I think the truth is probably somewhere in the middle.”

Nursing home residents represent a disproportionate share of deaths in the coronavirus pandemic, and the Biden administration has also been working to develop home- and community-based care as an alternative.

The cornerstone of Biden's nursing home plan is a new requirement for minimum staffing standards. He's ordering the Centers for Medicare and Medicaid Services to conduct a study on staffing and publish proposed regulations within a year.

Experts say staffing levels are the single most important marker for nursing home quality, and many facilities lack sufficient numbers of nurses, nursing assistants and other workers involved in providing direct care to patients. The coronavirus pandemic has led to many workers leaving the industry, even as nursing homes raised wages, so a new federal staffing requirement may take time to put into...