Re: March 6, 2019 Senate Finance Committee Hearing, Not Forgotten: Protecting Americans from Abuse and Neglect in Nursing Homes
“LeadingAge, the association of nonprofit providers of aging services, including skilled nursing, has long stood for quality nursing home care. We participated in the development of the Nursing Home Reform Act, enacted as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ‘87). We have taken leadership roles in numerous care-improvement efforts, such as the creation and maintenance of dementia care programs. We were a leader in the development of what is now the National Partnership to Improve Dementia Care in Nursing Homes, a program now overseen by CMS.
Let me be clear: we do not excuse abuse and neglect. LeadingAge and its nonprofit members are committed to providing older adults with high-quality care and have long been a partner to CMS and policymakers in establishing best practices. Those who commit illegal acts must be punished and improper care will not be tolerated.
It must be noted that current laws and regulations address unacceptable situations, such as those described in today’s hearing.
That issues of abuse and neglect, along with poor quality care, continue, causes us to ask how all of us might work together to reduce incidents such as these. In the 32 years since OBRA ‘87 was enacted, LeadingAge and its members have joined with CMS and other stakeholders on initiatives like the elimination of restraints and the reduction of the inappropriate use of antipsychotic drugs which have had measurable success in improving the quality of care in nursing homes, even as more work can be done.
Nursing homes must comply with an extensive set of regulations. Will more of them yield better care? Or, should we all question whether the approach established as part of OBRA over 30 years ago is relevant and sufficient to meet the needs older adults and providers today? We believe it is time to forge a new path forward: one of close collaboration between providers, policymakers, regulators, and consumers that will better help providers meet the challenges faced to achieve the type of care older adults need as they age.
Nursing homes play a critical role in our healthcare system and will continue to do so. This is not an us versus them situation. We—providers, policymakers, consumers and elected officials—are all in this together. We ask for an honest conversation about how all providers— and rural ones in particular—can attract and retain the staff they need; the need for a clear assessment about the true costs of care; and how the nursing home oversight system can effectively promote systemic organizational change leading to measurable and sustained quality improvement within nursing homes.
We owe it to older adults and those who care for them to figure this out.”
President and CEO Katie Smith Sloan responds to "Not Forgotten: Protecting Americans from Abuse and Neglect in Nursing Homes"