Obama Administration Proposes Updated Nursing Home Regulations

The White House proposed on July 13 a significant update to the standards by which nursing homes are deemed eligible for Medicare and Medicaid payments.

Announcing the proposals during the White House Conference on Aging, President Obama said, “We’re going to update quality and safety requirements for thousands of nursing homes — the first major overhaul in nearly 25 years.”

The updated standards were published in a 400-page proposed rule (pdf) in the Federal Register on July 16.

The new standards are designed to improve care coordination, dementia care, and resident choice, while also reducing re-hospitalization rates, elder abuse, and infection, according to a July 13 statement published by the U.S. Department of Health and Human Services (HHS).

New Sections Highlight Person-Centered Care, Training

The new standards are also designed to ensure that nursing home staff “have the right skill sets and competencies to provide person-centered care to residents,” the HHS statement says.

To that end, a new section within the proposed rule is devoted entirely to “comprehensive person-care planning.”

“We propose to require facilities to develop a baseline care plan for each resident, within 48 hours of their admission, which includes the instructions needed to provide effective and person-centered care that meets professional standards of quality care,” the proposed rule says.

The new standards would require a nurse aide, as well as a social worker and food-service staff member, to be added to the interdisciplinary team that designs the care plan.

A renewed focus on person-centered care and culture change would “not only result in improved quality of life for the resident, [it] can result in improvements in the caregiver’s quality of work life and in savings to the facility,” the proposed rule says.

Another new section would specify “requirements of an effective training program that facilities must develop, implement, and maintain for all new and existing staff,” including targeted training on:

• Communication
• Resident rights and facility responsibilities
• Abuse, neglect, and exploitation
• Quality Assurance and Performance Improvement (QAPI) and infection control
• Compliance and ethics
• In-service training for nurse aides
• Behavioral health training

The HHS is accepting public comments on the proposed revisions during the next 60 days. To submit a comment, visit Regulations.gov and enter 0938-AR61, the proposed rule’s I.D. number.

— by Matthew Ozga