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Press Release Baker-Polito Administration Announces New Nursing Facility Accountability and Supports

Package will establish reforms to improve standards of care and provide up to $140 million in new funding
For immediate release:
9/10/2020
  • Executive Office of Health and Human Services

Media Contact for Baker-Polito Administration Announces New Nursing Facility Accountability and Supports

Brooke Karanovich, Media Relations Manager

BostonToday, the Baker-Polito Administration announced a new Nursing Facility Accountability and Supports package, a set of policy reforms and funding for nursing facilities that builds on the accountability and support measures taken in April to hold facilities to higher standards of care and infection control. The initiative will also invest up to $140 million, and restructures Medicaid rates, consistent with the recommendations of the Nursing Facility Taskforce.

Throughout the public health emergency, the Commonwealth has taken significant steps to support nursing facility residents and staff, including over $260 million in state funding, staffing supports, and providing over 2.8 million pieces of personal protective equipment (PPE), on top of $180 million in federal funding. In addition, the state has enhanced facility accountability through regular infection control surveys and other compliance audits. Since April, new COVID-19 cases in nursing facilities have declined by over 93%, and deaths have declined by 98%, based on 7-day averages.  

“The Nursing Facility Accountability and Supports Package 2.0 continues our financial support and oversight initiated in the spring, and marks the first step in addressing the policy recommendations of the Nursing Facility Taskforce to protect resident safety, ensure access to high quality facilities, right-size the industry, and hold facilities to higher standards for both patient care and investment in the direct care workforce,” said Secretary of Health and Human Services and Head of the COVID-19 Command Center Marylou Sudders. “These reforms and investments will improve the quality of care and safety of residents in anticipation of a potential COVID-19 resurgence in the fall, and for the health of residents in the future.”

Components of the new package include:

  1. New requirements to strengthen staffing and the direct care workforce, ensure adequate spacing in congregate rooms, and improve standards of care;
  2. Long-term, $82 million investment through MassHealth rate restructuring;
  3. Up to $60 million in targeted, COVID-19 funding;
  4. Sustained oversight and monitoring; and
  5. Early identification of issues

“We applaud Health and Human Services Secretary Sudders and Governor Baker for proposing a fundamental redesign on the state’s nursing facility funding system," said Tara Gregorio, President of the Massachusetts Senior Care Association. "Under the reforms, the state is clearly prioritizing the health and safety of our residents and their caregivers and we look forward to continuing to work with the Administration to further these efforts today and in the years to come​.”

“The newest Nursing Facility Accountability and Support Package is the right path forward to stabilize the nursing home industry and bring much needed funding and resources to the frontlines – all of which caregivers have long advocated for and was included in the Skilled Nursing Facility Task Force recommendations," said Tim Foley, 1199SEIU Executive Vice President. "The inclusion of stronger staffing standards and a new requirement that at least 75% of revenue must be spent on the nursing home's direct care staff recognizes the sacrifice caregivers have made and helps recruit additional staff, which is critical to maintain quality resident care. Looking forward, we hope the Baker Administration will implement similar oversight and standards to home care agencies and ensure all frontline workers and those they care for are receiving the same level of oversight and support." 

New requirements to strengthen staffing and the direct care workforce, ensure adequate spacing in congregate rooms, and improve standards of care: Facilities will be required to meet minimum Hours Per Patient Day (HPPD) staffing levels and will be required to invest at least 75% of their revenues towards direct care staff costs. In addition, facilities will be required to ensure adequate spacing in multi-bed rooms, including eliminating 3 and 4 bed rooms, to improve infection control standards and resident quality of life.

Long-term investment through MassHealth rate restructuring: The Commonwealth is making an $82 million new net investment into rates, in line with the recommendations of the Nursing Facility Task Force to promote a high-quality, sustainable nursing facility industry. Specifically, the new rate structure incentivizes high-quality, high-occupancy, and care for high-acuity special populations, including residents with substance use disorder and/or several mental health diagnoses, while ensuring stability for high-Medicaid facilities.

Up to $60 million in targeted, COVID-19 funding: The majority of this targeted funding will only be dispersed in the event that statewide infections rise and the industry experiences staffing shortages, in order to support COVID-19 response actions. The funding will also support continued surveillance testing, and COVID-19 isolation spaces in facilities that meet more stringent criteria.

Sustained oversight and monitoring: The Commonwealth will continue to monitor facilities across several indicators including infection control, staffing, and management to inform the state’s response. Regular infection control surveys using the new CMS survey tool will continue, with increased monitoring of facilities with identified deficiencies. In addition, the state will begin requiring regular reporting on a number of staffing metrics, including hours per patient day (HPPD), and will be monitoring management performance on a number of indicators including compliance with state surveillance testing requirements and CMS recertification surveys.

Early identification of issues: The Commonwealth will proactively respond to issues with targeted supports such as rapid response staffing teams, corrective measures, and enforcement actions. Supports will build off of strategies proven effective during the spring and summer, and facilities with any deficiencies or identified issues will be required to implement corrective action plans. If a facility is consistently unable to correct deficiencies or operate safely, the state will respond with appropriate enforcement actions including financial penalties, termination from the MassHealth program, or DPH actions such as an admissions freeze.

Read more about the policy reforms here.

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Media Contact for Baker-Polito Administration Announces New Nursing Facility Accountability and Supports

Executive Office of Health and Human Services 

The Executive Office of Health and Human Services is the largest secretariat in state government and is comprised of 12 agencies, in addition to 2 soldiers’ homes and the MassHealth program. Our efforts are focused on the health, resilience, and independence of the one in four residents of the Commonwealth we serve. Our public health programs touch every community in the Commonwealth.
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