New nursing home enforcement rules cause a bit of a boom

Booster rolls are popular in the nursing home industry as a way to get residents involved in recreational activities, including ballroom dancing, and to enhance the residents’ memories. Although policies and guidelines requiring nursing homes to offer resident-driven booster programs have existed for a while, data has not always been collected for each facility. In the first month and a half after the U.S. Department of Health and Human Services issued its National Nursing Home Reform Policy Directive, the rate of services offered per resident was lower than prior years. Almost half of the homes visited were not using booster programs on a regular basis. Some homes had not offered the programs for one year, and in most states the booster programs are only offered on a once-a-week basis.

The scope of the policy directive made this voluntary initiative a double-edged sword. “It is of concern to us when states and facilities using their discretion not participate fully,” noted Richard Armstrong, director of the Division of Older Adult Care for the HHS Administration on Aging. Armstrong noted that these policies are meant to be life-changing experiences for residents. “Booster programs and physical activities are important for the senior’s well-being,” he said. “This directive may, in a short time, directly impact whether there are opportunities for better access to this kind of assistance for those needing it.”

The manager at one home in Hawaii said, “It is absolutely not the case that the directive has impacted the pace of recruiting residents to programs. We are investing the time and effort to bring someone in every few weeks, that is going to make their life a lot better because it is there and they can participate in it.”

The policy directive is intended to prevent nursing homes from using finances and facilities as barriers to enforcement of the Federal Nursing Home Inspection Act. In addition, the director of the Division of Older Adult Care urged providers to explore ways to embrace the new policies. If the results are similar to other progressive policies, including the Affordable Care Act, doctors and facilities will be able to demonstrate the policy’s positive impact in the marketplace. According to Secretary of Health and Human Services Alex Azar, “Nursing home inspections are intended to give consumers and facilities an accurate portrayal of the quality of care delivered. As we have seen with other major reforms in the healthcare industry over the past several years, the promise of these changes is that we will have clearer, more transparent information from which patients and families can evaluate care. We expect the investments we are making today will help us achieve that goal.”

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