Building The Long-Term Care System Of The Future: Will The COVID-19 Nursing Home Tragedies Lead To Real Reform?

Categories: In The News, National Media Items

Replace aging and outdated facilities, particularly in low-income communities. Moving forward, nursing homes and other institutional settings should be smaller, with single-occupancy rooms and low staff-to-resident ratios (see, for example, the Green House Project). Environments that offer a more homelike setting can help with infection control and can lead to better health outcomes for residents with Alzheimer’s disease and other dementias. These efforts can be accelerated by strengthening federal and state standards on nursing home size, room occupancy, and minimum staffing ratios.

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  • “A small but growing group of nursing homes are already implementing these changes. Collectively called ‘household models,’ these nursing homes have generated enthusiasm among diverse stakeholders and long-term care experts. Because of its scale and consistency across homes, the Green House approach has been the most frequently studied household model.”

  • “Alternatives to traditional nursing homes for older adults who cannot remain in their own homes has prompted interest in smaller, community-style facilities such as the Green House model. Staff are used more flexibly in the Green House model, and work with small clusters of residents; the model’s success, especially during the COVID-19 pandemic, has attracted interest as an alternative to traditional nursing homes.

  • “The Center for Innovation and its Green House Project is promoting government incentives that support construction of modern, person-directed facilities through targeted grants or Medicaid rate increases. Providers in Arkansas and soon Ohio, for instance, receive Medicaid rate add-ons for private room nursing care.”

  • “Some suggestions included increasing state investment in home care, incentivizing a transition toward fewer-occupant rooms and Green House-style facilities, standardizing the Medicaid reimbursement system with data-based adjustments over time, increasing audits and financial transparency requirements for nursing homes, and building workforce pipelines into the sector through scholarships and more flexible training programs.”