HHS Proposes Major Changes to Improve Nursing Home Care

On July 13, the Department of Health and Human Services announced a proposal that would make "major changes to improve the care and safety of the nearly 1.5 million residents in more than 15,000 long-term care facilities or nursing homes that participate in the Medicare and Medicaid programs," according to a statement from the department.

Many of the proposed changes build upon improvements nursing homes have already made since 1991, the last time the conditions for participating in Medicare and Medicaid received a major update.

The changes include:

• Making sure that staff are properly trained on caring for resident with dementia as well as in preventing elder abuse.
• Ensuring nursing homes consider the health of residents when making decisions on the kinds and levels of staffing their facilities need to properly care for residents.
• Ensuring staff members have the right skill sets and competencies to provide person-centered care and that the care plan developed takes the resident's goals of care and preferences into consideration.
• Improving care planning, including discharge planning for all residents, with involvement of the facility's interdisciplinary team and consideration of the caregiver's capacity, giving residents information they need for follow-up and ensuring that instructions are transmitted to any receiving facilities or services. 
• Allowing dietitians and therapy provides the authority to write orders in their areas of expertise when a physician delegates the responsibility and state licensing laws allow it. 
• Requiring nursing homes to provide greater food choices for residents while also providing flexibility. 
• Update the nursing home's infection prevention and control program, including requiring an infection prevention and control officer and an antibiotic stewardship program that includes antibiotic use protocols and a system to monitor antibiotic use. 
• Strengthening rights of nursing home residents, including placing limits on when and how binding arbitration agreements may be used. 

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