Nursing Home Commission Report Released

September 18, 2020
Policy Snapshot

Last week the independent nursing home commission established by an executive order from President Trump back in May and convened by the MITRE Corporation released its findings. The Commission called on the Centers for Medicare & Medicaid Services (CMS) to take immediate action to implement each of the 27 recommendations that were put together in themes. “To reduce suffering and to save the lives of residents and staff, CMS can implement or initiate the Commission’s actionable recommendations in relatively short order,” the commission concluded.

The overall themes of the report covered:

  • Ongoing supply and affordability dilemmas related to testing, screening, and personal protective equipment (PPE)
  • Tension between rigorous infection control measures and quality of life issues that exist in cohorting and visitation policies
  • A call for transparent and accessible communications with residents, their representatives and loved ones, and the public
  • Urgent need to train, support, protect, and respect direct-care providers
  • Outdated infrastructure of many nursing-home facilities
  • Opportunities to create and organize guidance to owners and administrators that is more actionable and to obtain data from nursing homes that is more meaningful for action and research
  • Insufficient funding for quality nursing home operations, workforce performance, and resident safety

In its press release, CMS stated that the Commission’s findings validated the “unprecedented response” to the pandemic to control the spread of COVID-19 in nursing facilities. CMS also issued a response to each of the recommendations following the release of the report.

Society President David A. Nace, MD, MPH, CMD, was appointed to the 25-person Commission. “It was a great honor to participate on the Commission. We had extensive, thoughtful discussions around many important and challenging issues. I believe we came up with some valuable recommendations that will be extremely beneficial to our residents and staff members,” Dr. Nace said.

Society Executive Director Christopher E. Laxton, CAE, noted: “The Commission did some excellent work in short order. We were sorry to see that certain things were missing in the final report, mostly dealing with clinical leadership and expert oversight, and the importance of being able to identify facility leaders to aid public health responses, such as through a national medical director registry. The latter is something the Society has been working toward for a long time, and we will continue to push for its creation.

“We were also disappointed in CMS’s response following the report’s release. CMS seems to be saying that it had already completed all of the necessary steps even before the report was issued—its analysis appears to close the door on taking further action on the report’s many good recommendations. On the contrary, a great deal of work remains to be done, much of it involving agencies and partners well beyond CMS. The report provides a useful framework for this work for many years to come.”

A copy of the Commission’s report can be found here.