Nursing home care is ‘broken,’ U.S. panel reports


Critical flaws in the U.S. nursing home system threaten the health and safety of millions of residents, and urgent change is needed, according to a report the prestigious National Academies of Sciences, Engineering and Medicine issued Wednesday.

“Nursing home care in the United States is broken,” David Grabowski, a Harvard Medical School professor who serves on the federally chartered organization’s Committee on the Quality of Care in Nursing Homes, said during a telephone briefing.

During the COVID-19 pandemic, more than 150,000 nursing home residents and more than 2,300 workers have died from the virus, which underscores the staffing, quality and funding challenges the industry faces.

“Sadly, we’ve all seen through social media and the news what has happened in nursing homes before COVID, and certainly during COVID,” Betty Ferrell, the committee’s chair, said during the briefing.

In its 600-page report, the 17-member panel calls for fixing an “ineffective” and “unsustainable” system by transforming how nursing home care is delivered, monitored and financed.

“The time to act is now,” said Ferrell, who is director of nursing research and education at City of Hope Medical Center in Duarte, California.

The committee recommends a number of initiatives, such as:

  • Including nursing homes in emergency preparedness planning;
  • Improving resident care by offering smaller, home-type settings;
  • Creating incentives for operators to coordinate care by adopting electronic health records;
  • Establishing national worker education and staffing standards;
  • Enhancing wages and benefits;
  • Changing long-term care financing models; and
  • Strengthening federal oversight.

The report coincides with a push from President Joe Biden to revamp the nursing home industry. Biden offered a slate of policies during his State of the Union address in February, including minimum staffing requirements and stiffer enforcement of federal rules intended to promote safety and quality.

“We have this incredible opportunity right now to really change staffing in this country but it’s going to take political will,” Grabowski said.

The National Academies’ report is a “piercing wake-up call for policymakers,” said Katie Smith Sloan, CEO of LeadingAge, which represents more than 5,000 not-for-profit providers.

“Decades of underfunding have left America’s nursing home system in desperate need of an overhaul. As our nation grows rapidly older, millions of older Americans will need safe, high-quality care. It’s time to act to ensure they can access and afford the vital care nursing homes provide,” Smith Sloan said in a news release.


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