October 18, 2022 – To call something “imperative” means it is urgently needed. But merely calling something “imperative” won’t necessarily make it happen. For example, the urgent need to reform how nursing home care is financed, delivered and regulated may be imperative, but financing substantial improvements in the nursing home environment – including bricks-and-mortar changes, such as private rooms and easy outdoor access for residents – is the tough part.
This year, the National Academies of Sciences, Engineering and Medicine (NASEM) released a 350-page report titled, “The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff.” It follows by 36 years the 1986 Institute of Medicine report on “Improving the Quality of Care in Nursing Homes,” as well as the Omnibus Budget Reconciliation Act of 1987 (OBRA 87), which established more stringent standards for nursing homes in a wide range of areas.
Some quality improvements have occurred since 1987, the NASEM authors point out, but the COVID-19 pandemic “lifted the veil,” revealing and amplifying long-existing shortcomings in nursing home care, such as inadequate staffing levels, poor infection control, failures in oversight and regulation, and deficiencies that result in patient harm. The pandemic highlighted nursing home residents’ vulnerability and the pervasive ageism evident in undervaluing the lives of older adults, they said