In response to an invitation from the U.S. House Ways and Means Health Subcommittee, LeadingAge has submitted 15 recommendations for changes in laws and regulations governing cafe centers, home health care and hospice providers and the application of technology in the post-acute care field.
Nursing Home Relief:
- Quality Measures: simplify, integrate and risk adjust the various quality measures to which nursing homes are subject under Nursing Home Compare, the IMPACT Act, value-based purchasing and other initiatives;
- Requirements of Participation: delaying Phases II and III and reconsidering several, including the facility assessment;
- Observation stays/3-Day Stay Requirement: count all time a beneficiary spends in the hospital toward the 3-day stay requirement. Establish a demonstration program to test the elimination of the requirement;
- Survey and Certification: allow joint training of nursing home and survey agency staff and permit state agencies to focus enforcement on poor performing nursing homes;
- 5 Star: develop national criteria, without a bell curve, applicable to all nursing homes. Lift the current 18 month freeze on 5-Star ratings;
- Fire Safety: permanently waive the requirement for fireproofed structural steel members for nursing homes that are fully sprinklered;
- Prompt Pain Medication for residents: permit nurses to act as physician agents and recognize chart orders as authorization for scheduled medications;
- Use of Patient Lifts by teenaged CNAs: allow 16 and 17-year-old certified nursing assistants with appropriate training to operate patient lifts.
Home Health and Hospice Relief:
- Elimination of the Home Health and Hospice physician face-to-face encounter requirements;
- Simplification and streamlining of the Notices of Hospice Election and revocation.
- To facilitate application of technology in the post-acute care field, we called for:
- Financial support for post-acute and long-term services and supports providers to adopt and use interoperable Electronic Health Records;
- Give rural home health agencies Access to Affordable Internet access through the Universal Service Fund’s Rural Health Care Program.
Now that the deadline for submitting ideas has passed, the subcommittee’s next step will be to hold roundtables with stakeholders across the country to continue the conversation and identify solutions.