U.S. Lawmakers Begin To Introduce Nursing Home Reform Bills

New York state, once ground zero for the COVID-19 pandemic and where long-term care tragedies have left many in shock, may soon become the new epicenter for nursing home care reform. State lawmakers began passing several measures on Feb. 22, as scandals break and the coronavirus pandemic continues to haunt residents, their families, and underpaid and overworked care teams. And on Wednesday, Mar. 3, the New York Assembly passed another series of nursing home-related bills to increase the transparency of facility violations, require quality assurance, and study long-term care facilities in the state. The lawmakers have said the sweeping reforms were designed to “increase safety and improve the quality of life for New Yorkers living in nursing homes.”

These are the highlights focused on New York’s four overall nursing home quality and coronavirus care-related issues addressed in the reform package. A detailed statement regarding the legislation was released by New York’s Assembly Speaker Carl Heastie (D) on Mar. 4 and can be reviewed in more detail here.

1. Quality Improvements

The legislative package includes establishing the Reimagining Long-Term Care Task Force with advocates from across the long-term care system. The task force would be required to study and produce a report to the governor and Legislature on the state of long-term care services, both in home-based and facility-based settings. The group would also examine the impact the COVID-19 pandemic has had on long-term care in New York on issues including but not limited to staffing shortages, visitation bans, and infection control protocols and enforcement. The Assembly has already passed this measure.

Other focuses included would:

• Prioritize sanitation efforts in nursing homes and adult care facilities, including a bill that would require the establishment of an antimicrobial stewardship program and training on antimicrobial resistance and control.
• Require adult care facilities to include infection control in their biannual plans regarding quality assurance activities.
• Codify New York regulations and federal law to establish specific requirements before an individual is transferred or discharged from a residential health care facility.

2. Visitation

For many individuals living in nursing homes, visitation from family and loved ones provides critical informal healthcare channels crucial to their well-being. The Assembly passed a measure to allow personal care visitors exemptions and enhanced compassionate care visitation during declared local or state health emergencies.

3. Oversight and Transparency

In recent years, for-profit nursing homes in New York have grown from about one-third of the market to two-thirds. National data shows that for-profit nursing homes do worse on staffing, infection control, and other quality indicators. They have higher rates of patient deaths and cost more. Another bill the Assembly intends to pass would prohibit granting new for-profit nursing home licenses or expanding existing for-profit nursing homes.

The oversight and transparency focused legislation also includes:

• The Long-Term Care Ombudsman Program Reform Act increases the program’s effectiveness. The act would promote greater awareness of the Long-Term Care Ombudsman Program, strengthen communication between ombudsmen and the agencies responsible for licensing or certifying long-term care facilities, and include ombudsmen within a residential care facility’s pandemic emergency plans.
• Another bill would codify the Health Emergency Response Data System (HERDS) under the Department of Health (DOH) and require information collected under the system to be published on the DOH website. HERDS was created in response to the World Trade Center disaster on Sept. 11, 2001. It is a statewide electronic web-based data collection system linked to health care facilities across the state through a secure internet site that allows hospitals to relay resources or needs to the DOH during emergencies or respond immediately to rapid request surveys in preparedness planning efforts.
• Other legislation would require each residential health care facility to provide residents and their families with a separate document as part of an intake application that includes information on how and where a potential resident and their family members can look up complaints, citations, inspections, enforcement actions, and penalties taken against the facility, as well as nursing home quality information provided by the state and federal governments.

4. Immunity from Liability

Another bill in the package would repeal Article 30-D of the Public Health Law, also known as the Emergency or Disaster Treatment Protection Act, to ensure that health care facilities, administrators, and executives are held accountable for harm and damages incurred.

These nursing home problems outlined by New York lawmakers are present in all U.S. states. The pandemic has only significantly exposed and exacerbated the preventable failures in communities and care systems that were not prepared or decided not to do enough for their residents and staff.