On March 4, AHCA/NCAL held a Post-State of the Union call as a response to President Biden’s proposals for nursing homes. Here's the replay link, as well as our summary of what was discussed.

In general, don't panic! 

• Major reforms often fail in Congress
• Rulemaking takes time
• Some of the proposals require Congressional action
• AHCA/NCAL is working on a response plan

Proposed for Nursing Homes

Quality Measures

• Phase-out rooms with 3 or more beds
• Reduce inappropriate use of antipsychotics
• SNF Value-Based Purchasing (VBP) includes more staffing and resident experience measures

Readiness for Pandemics

• Continue to support COVID testing
• Continue to support vaccine efforts
• Review on-site infection control rules and increase the standards
• Review emergency preparedness rules to improve readiness

Proposed for CMS

Transparency

• Create a new database of building owners and operators
• Make Nursing Home Compare easier to understand
• Examine the role of REITS and private equity

 Jobs

• Make nurse aide training cheaper
• Support state training programs
• Work with Dept. of Labor to launch a national campaign for recruiting, training, retaining, and transitioning workers to long-term care.

Proposed Oversight

• Add $500 million for survey inspections
• Change Special Focus Facility Program
• Increase civil fines (CMP) to $1million
• Consider CMPs on a per diem basis
• Congress to develop standards for chain owner participation in Medicare/Medicaid
• Congress to give CMS more authority to validate data and enforce incorrect reporting

AHCA/NCAL Plan of Response

• Determine what AHCA/NCAL can support
• Determine which proposalsAHCA/NCAL might make more acceptable
• Try to kill proposals AHCA/NCAL can’t modify or support
• Question Minimum Staffing Study
  • Where can nursing homes find the workers?
  • What’s their implementation timeline?
  • What are the penalties for non-compliance?

As you may have seen this week, the AHCA/NCAL action plan is already underway. AHCA/NCAL contacted the Secretary of the U.S. Department of Health and Human Services to outline their position and request a meeting.