The U.S. Department of Health and Human Services has made a sweeping range of proposals intended to improve the safety and functioning of the 15,000 or so long-term care hospitals (LTCH) and nursing homes that operate in the United States.
The proposal, to be published in the Federal Register by the end of this week, would require nursing homes and LTCHs to consider the health of residents when making decisions on staffing; improve and better coordinate care planning, including discharge planning; make infection control training mandatory among staff and assign an infection control officer; and expand the rights of patients, including minimizing the use of binding arbitration agreements if a dispute arises over care. All staff would be trained in what constitutes abuse of patients. Such conditions would have to be met for the facilities to participate in the Medicare and Medicaid programs.
"This proposal is just one part of the administration's overall commitment to transform our health system to deliver better quality care and spend our healthcare dollars in a smarter way," said HHS Secretary Sylvia M. Burwell in a statement. "When a family makes the decision for a loved one to be placed in a nursing home or long-term care facility, they need to know that their loved one's health and safety are priorities."
The proposal comes at a time when there have been some seismic shifts in how nursing home care is being provided in the United States. Nursing homes are expected to become the nexus of much of healthcare delivery in the coming decades as the population ages. Mass numbers of nursing home patients enrolled into Medicaid have been moved into managed care programs in recent years. At the same time, readmission rates for nursing home patients have been quite high.
The proposal will enter a lengthy public comment period and likely will be subject to extensive changes in the coming months.