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Critical flaws in the U.S. nursing home system threaten the health and safety of millions of residents, and urgent change is needed, according to a report the prestigious National Academies of Sciences, Engineering and Medicine issued Wednesday. "Nursing home care in the United States is broken," David Grabowski, a Harvard Medical School professor who serves on the federally chartered organization's Committee on the Quality of Care in Nursing Homes, said during a telephone briefing. (Christ, 4/6)

To anyone who saw the scourge of COVID-19 on the country’s most vulnerable, the findings of the National Academies of Sciences, Engineering, and Medicine might seem sobering but unsurprising, as the long-term care system’s inadequacies were made plain by more than 150,000 resident deaths. The authors of the 605-page report insist it could be an impetus to address issues that have gotten little more than lip service for decades. ... The report covers a vast cross-section of long-term care, from granular details such as the way facilities are designed to foundational issues that would require massive political capital and investment to address. Among them: the authors advocate for creating a new national long-term care system that would exist outside of Medicaid, the program that is at the center of most long-term care financing. (Sedensky, 4/6)

"We think it's really important to set a very specific standard that can be measured against, to really make sure staff is adequate to ensure quality," says Chiquita Brooks-LaSure, administrator for the Centers for Medicare & Medicaid Services (CMS), the federal agency that regulates and funds most nursing homes in the U.S. Numerous studies have shown that understaffing nursing homes can harm the health of residents, who suffer more bedsores, more weight loss, more overprescribing of anti-psychotic medications, and — during the pandemic — more COVID-19 cases and deaths. (Hsu, 4/6)

With the measure drawing support from the nursing home industry and a veto request from the senior-advocacy group AARP Florida, a proposal that would revamp staffing standards for nursing homes was among 35 bills that landed on Gov. Ron DeSantis’ desk Tuesday. Among the other measures was a proposal that would broaden doctors’ ability to prescribe controlled substances through telemedicine. The nursing home legislation (HB 1239) was approved by votes of 80-31 in the House and 28-9 in the Senate, with supporters saying it would provide more flexibility to nursing homes and help with staffing shortages. (Turner, 4/6)

After Gov. Pete Ricketts vetoed a portion of the money that would go to raising provider rates at nursing homes and assisted living facilities, many are wondering how many more facilities will close. State Sen. John Stinner, the chairman of the Nebraska Legislature’s Appropriations Committee, said Tuesday that he was “not only disappointed, but pretty angry, frankly.” He said lawmakers have “spent a lot of time” on the issue. Of the $51.8 million cut, about half was intended to boost provider rates for nursing homes and assisted living facilities. The rest included increases for providers of child welfare and behavioral health services. (Martinez, 4/5)

A bipartisan group of state lawmakers passed a measure to address nursing home visits during the pandemic or other public health emergencies. The action comes as countless Illinois families were blocked from visiting loved ones – some denied the chance to say goodbye to their dying family members – in nursing homes at the height of COVID-19. Illinois State Representative Dan Ugaste (R-Geneva) says he and his household knows the pain. “My wife was one of those people,” Ugaste said. She didn’t get to see her mother for three-and-a-half months prior to her mother passing away.” (Crews, 4/6)

Florida health care facilities have a new set of rules for restricting visitation thanks to a bill approved Wednesday by Gov. Ron DeSantis. Senate Bill 988, which sponsors named the “No Patient Left Alone Act,” was largely a response to the early months of the coronavirus pandemic in which the DeSantis administration severely limited visitation at Florida’s long-term care facilities and hospitals. The state put those restrictions in place in 2020 in the hope of controlling the spread of COVID-19. As the months of isolation for residents and patients added up and complaints from loved ones mounted, DeSantis began relaxing those rules. (Wilson, 4/6)