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Biden to launch overhaul of nursing home standards and safety

Experts say staffing levels are a critical marker for nursing home quality, and many facilities lack sufficient nurses, nursing assistants and other workers.

WASHINGTON — President Joe Biden will launch a major overhaul of nursing homes standards in his State of the Union speech, White House officials said Monday, outlining a series of measures long sought by advocates and opposed by the industry.

Taken together, the measures would raise the bar on quality, increase government oversight, and continue efforts to keep COVID-19 out of nursing homes.

The cornerstone of Biden's plan is a new requirement for minimum staffing standards for nursing homes. He's ordering the Centers for Medicare and Medicaid Services to conduct a study on staffing and publish proposed regulations within a year.

Experts say staffing levels are a critical marker for nursing home quality, and many facilities lack sufficient numbers of nurses, nursing assistants and other workers involved in providing direct care to patients.

Lawmakers in Congress have been debating legislation to require minimum federal standards for facilities that accept payment from Medicare and Medicaid, as virtually all do. The original plan was to include new standards in Biden's domestic agenda bill, but with that legislation stalled the administration seems to be shifting to using its regulatory powers to bring about changes.

Biden's plan also calls for moving nursing homes toward private rooms for their residents, directing federal regulators to explore how to phase out living arrangements that house three or more residents in the same room.

Beefed-up oversight is another priority. Biden's plan calls for increasing the nursing home inspection budget by $500 million, a boost of nearly 25%. Nursing home inspections are generally carried out by the states, following guidelines from Medicare. Biden will also ask Congress to give Medicare new legal authority to weed out nursing home chains that operate substandard facilities.

The COVID-19 pandemic has killed more than 200,000 residents and staff of long-term care facilities, according to the nonpartisan Kaiser Family Foundation. While nursing home residents and staff account for a tiny share of the U.S. population, they have accounted for about 1 in 5 deaths.

Biden's plan calls for the government to keep a focus on vaccinating and boosting nursing home residents and staff, along with regular testing. While the omicron wave saw increased cases and deaths in nursing homes, facilities were largely spared a repeat of last winter's grim experience.

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