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 Association Offers Recommendations to Curb Abuse and Neglect

Staffing shortages, access to background check information, and the need for satisfaction data in reviews were included in discussions at a Senate Finance Committee hearing March 6 examining recent incidents of abuse and neglect in nursing facilities.

In addition to testimony from two family members of victims of abuse and neglect, the committee heard from representatives of the Centers for Medicare & Medicaid Services (CMS), the U.S. Department of Justice, and David Gifford, MD, senior vice president of quality and regulatory affairs for the American Health Care Association (AHCA).

Joining other advocates, Gifford stressed that egregious acts should be punished severely and recognized the importance of the families’ testimonies to address the issues of abuse and neglect. He also pointed out the progress that has been made in the past several years to enhance quality of care at AHCA’s more than 13,500 member facilities via AHCA’s voluntary Quality Initiative.

“Care at our members’ nursing homes continues to improve and remains high for 18 of the 24 quality outcomes measured by CMS, including fewer residents receiving antipsychotic medications and more people returning home after rehabilitation care,” he said at the hearing.

Stressing that AHCA’s focus is to prevent horrific events like those presented from occurring, Gifford presented three suggestions in his testimony to help curb future incidents of abuse and neglect.

“We should expand federal programs that attract health care workers to the nursing home profession,” he says. “We should strengthen federal regulations around reporting and sharing of information about employees who have engaged in abuse through the creation of a national background check registry. And we should make resident and family satisfaction ratings of nursing homes publicly available.”

In an interview with Provider, Gifford cited a national workforce shortage and staffing as the No. 1 challenge for AHCA’s members. A program is needed to attract more nurses, nurse assistants, and health professionals into the sector, he says. “To this end, we would recommend expanding on other successful federal programs that use loan forgiveness to attract health care workers in needed areas, including nursing homes.”

AHCA plans to continue advocating for the expansion. “We will continue to advocate up on the Hill for that and see what takers we get,” Gifford says.

The second recommendation from AHCA is for nursing facilities to have easier access to and participation in the national practitioner data bank maintained by the Health Resources & Services Administration. Currently, the data bank collects information from hospitals, health plans, and state licensing boards for all health care professionals, including any terminations by providers who participate in the data bank.

AHCA’s position is that the data bank should be available to all Medicare- and Medicaid-certified providers for the purpose of background checks of prospective employees.

A consistent theme in both family members’ testimonies from the hearing is that the staff members committing the abuse or neglect were suspected of having problems in the past, says Gifford. “It’s important to make sure that in the hiring process that providers know they are able to screen people who may be at risk of this. This proposal would significantly improve the profession’s ability to root out bad actors before they are hired,” he says.

Providers currently have access to the database, but it is not easy. A peer-reviewed program is required, says Gifford. “Our proposal is to shift it to make it easier so providers don’t have to have a robust peer-review program. Most nursing homes just can’t put that together.”

If providers can advocate to their member of Congress or senators for easier access to the national practitioner database, that would be helpful, he says.

The third recommendation from AHCA is a mechanism for public reporting on resident and family satisfaction. “Nursing homes are the only sector without a CMS reporting requirement on satisfaction,” says Gifford. “Making consumer satisfaction information available to families and future residents will go a long way toward enhancing transparency regarding the operation of a nursing home.”

Gifford says including consumer satisfaction in reporting requirements can be done without regulations or a statute. “We are advocating for this and will continue to provide information to CMS,” he says.

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