President Biden will use his State of the Union address Tuesday night in part to announce steps to protect nursing home residents and hold providers accountable for unsafe and substandard care, including by expanding inspections and financial penalties on what the White House is calling “bad actor nursing homes” and “poor-performing facilities.”
More than 1.4 million people in the United States live in more than 15,500 nursing homes, which receive reimbursement with tax dollars through two federal programs: Medicare and Medicaid. The pandemic has thrown into sharp relief the dangers of living in nursing homes, and also the challenges they face.
Nursing homes are caring for some of the nation’s most vulnerable people: older and disabled adults, often with chronic underlying conditions. Like all congregate living facilities, they are places where viruses spread easily. According to the White House, nursing home residents and staff members account for some 200,000 of the nearly 950,000 deaths in the United States from Covid-19.
Jen Psaki, the White House press secretary, told reporters on Monday that Mr. Biden would unveil “new steps to protect seniors and other nursing home residents by cracking down on unsafe nursing homes.” The White House detailed the new initiatives in a fact sheet posted on Monday on its website.
They include: improving staffing levels; expanding inspectors and beefing up “scrutiny on more of the poorest performers”; improving transparency, including by creating a database to track and identify nursing home operators; and ensuring pandemic preparedness.
The administration is also taking aim at private equity firms in the nursing home business. Citing a March 2020 analysis by the Center for Economic and Policy Research, a progressive think tank, the White House said private equity firms’ investment in nursing homes had grown to more than $100 billion in 2018 from $5 billion in 2000, with about 5 percent of all nursing homes now owned by private equity firms.
“Too often, the private equity model has put profits before people — a particularly dangerous model when it comes to the health and safety of vulnerable seniors and people with disabilities,” the White House said.
Katie Smith Sloan, the president and chief executive of LeadingAge, an association of nonprofit providers of aging services, including nursing homes, praised the White House initiative in a statement on Monday.
“If the past two years have shown us anything, it is that our country’s insufficient and fractured aging services infrastructure is in desperate need of an overhaul,” she said. “And nursing homes are a key component of that infrastructure.”
According to the White House, nursing homes routinely fail to comply with federal guidelines. The Government Accountability Office found that, from 2013 to 2017, 82 percent of inspected nursing homes had an infection prevention and control deficiency, including a lack of regular hand washing, the White House said.
“Despite the tens of billions of federal taxpayer dollars flowing to nursing homes each year, too many continue to provide poor, substandard care that leads to avoidable resident harm,” the fact sheet read, adding, “Without decisive action now, these unacceptable conditions may get worse.”
