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Improving America’s Nursing Homes by Learning from Tragedy & Implementing Bold Solutions for the Future​

Care For Our Seniors Act

Care For Our Seniors Act

The COVID-19 pandemic has exposed and exacerbated systemic issues impacting the nursing home sector, such as workforce shortages, aging physical plants, and underfunded government reimbursements for care. Many of these issues were raised by the American Health Care Association (AHCA), LeadingAge and other stakeholders for years prior to COVID but were never fully addressed by policymakers. Through the Care For Our Seniors Act, AHCA and LeadingAge are calling on lawmakers once again to help resolve systemic challenges, as well as reflecting on ways nursing home providers themselves can improve.

AHCA and LeadingAge have released a reform agenda, the Care For Our Seniors Act, to address long-standing challenges affecting the quality of care provided in America’s nursing homes.

Four Reform Principles

AHCA and LeadingAge are advocating for meaningful action in Congress and the Biden Administration to protect seniors and prepare for a growing elderly population that deserves a robust, quality long term care system. The proposal prioritizes four principles for nursing homes that can be applied to support better pandemic management, help prevent such devastation from happening again, and strengthen nursing home care. Each policy principle is supported by several white papers that provide an overview of how the proposal was framed and how it can be accomplished.

Clinical - Enhance the Quality of Care

Enhance the quality of care in nursing homes by developing clearer standards for infection preventionists, requiring that each nursing home have a registered nurse on-staff, 24 hours per day, and requiring a minimum 30-day supply of personal protective equipment in all nursing homes.


Workforce - Strengthen & Support Frontline Caregivers

Strengthen and support our frontline caregivers by implementing a multi-phase tiered approach to attract, retain and develop more long term care professionals leveraging federal, state and academic institutions


Oversight - Improve Systems to be More Resident-Driven

Implement improvements establishing a more resident-driven system by developing an effective oversight system and processes that support better care and protect residents. This would include implementing a process to help turn around or close facilities that are chronic poor performers and adding customer satisfaction to the government’s five-star rating system to help monitor the quality of a facility for family members and guide consumer choice.


Structural - Modernize for Resident Dignity & Safety

Modernize nursing homes by conducting a national study on how to shift to more private rooms, which promote resident privacy, autonomy and dignity, as well as support infection control best practices.


Investing in Meaningful Change

AHCA and LeadingAge say reform will be costly, but long overdue. The nursing home sector has been facing a financial crisis for years due to low Medicaid reimbursements, the primary coverage for nursing home residents. With providers dedicating extensive resources in response to COVID and a significant drop in new residents moving in, the financial shortfalls have only worsened. Each policy proposal in the Care for Our Seniors Act must include government resources, and AHCA and LeadingAge propose several interrelated investment strategies to help reinvest in America’s nursing homes to ensure quality care, including:

  1. Enhanced Federal Medical Assistance Percentages (EFMAP)Increased federal Medicaid funds are provided to states to pay for the mandatory nursing facility benefit, with requirements that additional federal funds be used for nursing facility rates.
  2. Federal Framework for “Allowable Cost” or “Reasonable Cost”: Establish federal guidelines for state allowable cost definitions.
  3. Medicaid Rate Adequacy Requirement: Medicaid rates are brought up to equal the cost of care and subsequently updated regularly to keep pace with increases in costs of care.
  4. State Nursing Facility Value-Based Purchasing (VBP) Committee & Required Design Report: The state will be required to form and maintain a state health plan and nursing facility VBP committee with specific guidelines and deadlines to submit reports. This offers the potential for additional resources.

Resources and Materials