Senate Bill Seeks to Bolster Nursing Home Staffing, Infection Control In Wake of Pandemic Losses

Following the devastating impact COVID-19 had on nursing homes nationwide, two U.S. Senators have introduced new legislation designed to increase nursing home staffing levels and strengthen requirements for facilities to maintain infection control programs.

Senators Ron Wyden of Oregon and Bob Casey of Pennsylvania introduced Senate bill S.2674 on August 10, as part of reforms for nursing home and long term care facilities, which proved to be too unprepared and understaffed when the coronavirus pandemic emerged, exposing the nation’s most vulnerable citizens to the greatest level of risk.

With more than 1.3 million residents in over 15,000 Medicare and Medicaid-certified nursing homes throughout the United States, significant attention has been placed on COVID-19 outbreaks in nursing homes, which caused more than 135,000 COVID-19 deaths among residents and staffing members.

As a result of the tragic losses, Democratic Senators have introduced a bill designed to address many of the problems linked to nursing home issue such as low pay, turnover rates, understaffing and lack of registered nurses, all of which are well known to increase the risk of nursing home neglect.

Specifically, the bill would require nursing home facilities to maintain a documented infection control policy and keep an infection prevention and control specialist on staff. Facilities would also be required to keep a registered nurse available 24 hour a day, increasing the current requirement from eight hours per day.

The bill seeks to address problems resulting in a nationwide shortage of nursing home staff, by raising the salaries and benefits of nursing home employees and giving states the option of an increase in federal Medicaid matching funds.

From an oversight perspective, the bill would also bolster state inspections of nursing homes, and require low performing facilities to create a special focus program intended to improve quality control measures and patient safety.

Bill Seeks To Restrict Arbitration Clauses

Other provisions outlined in the bill include revoking the ability of nursing homes to require residents and family members to sign pre-admission arbitration agreements, which waive their rights to go to court over disputes of care. Typically, nursing home arbitration agreements are tailored to benefit the facility by allowing the facility to select the arbitrator, location, and rules that will govern the proceedings.

These sometimes mandatory agreements also prevent loss of reputation and business to nursing homes because they require non-public arbitrations, leaving new residents seeking care in the dark about past violations and cases of nursing home neglect.

Prior research has shown nursing home residents are more likely to receive poor care when facilities are understaffed, leaving them prone to suffering from bed sores, falls, fractures and other forms of nursing home injuries when staff at a facility are stretched thin.

The U.S. Centers for Disease Control and Prevention published a study in September highlighting a link between COVID-19 and nursing home quality of care, indicating facilities which scored better in federal ratings have been less likely to experience severe outbreaks at their facilities.

A report released in January by New York Attorney General Letitia James, highlighted a number of failures by long-term care facilities and state regulators, which contributed to the high number of COVID-19 deaths at nursing homes in that state last year. Specifically, the report indicated New York nursing homes with lower pre-pandemic staffing ratings had a higher number of fatalities during the pandemic, when compared to facilities with sufficient pre-pandemic staffing rates.

As a result of the report’s findings, New York Governor Andrew Cuomo signed the Standard Minimum Nursing Home Staffing Levels bill (A7119/S6346) into state law in June, which appointed a Commissioner of Health to enforce minimum staffing levels requiring every nursing home to maintain increased daily staffing hours. The bill also granted the Commissioner of Health to impose civil penalties for nursing homes that fail adhere to the minimal staffing standards and record retention.