The reform of regulations governing long-term care (LTC) in the United States by the Centers for Medicare & Medicaid Services (CMS) aimed at enhancing services provided for the elderly. According to Wilensky & Teitelbaum (2019), “ the United States spends more on healthcare than most of the other developed countries, yet frequently the care provided does not result in good health outcomes” (p. 68). Therefore, the intention of improvements was based on the need to achieve a higher quality of care in line with the government’s increased funding in healthcare. The phase 3 regulations were implemented from November 28, 2017, and served as the final step in the achievement of the three-year plan. Hence, these regulations form essential aspects of LTC that protect elderly members of the American society at their most vulnerable stage by enhancing their quality of life in nursing homes.
Behavioral Health Services
The role of LTC homes mainly revolves around the maintenance of a resident’s mental and emotional health while under their supervision. Specifically, person-centered care is in line with principles set forth in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) concept of trauma, and guidance for a trauma-informed approach should be followed (NCCNHR The Consumer Voice, 2019). This means that in cases where residents have a history of trauma, they must be given treatment that improves their overall well-being. Additionally, residents with no trauma history should be provided with prevention services to avert the development of symptoms such as withdrawal from society or depression.
Quality Assurance and Performance Improvement (QAPI)
This provision requires nursing homes to present Quality Assurance, and Performance Improvement (QAPI) plans to surveyors annually. Components of the plan further require to be data-driven, comprehensive, and effective by focusing on appropriate indicators of quality of life. Additionally, the QAPI program also requires to be tailored fit to the individual homes to cater to their unique needs and requirements (NCCNHR The Consumer Voice, 2019). The QAPI program represents the right step in the direction for LTC homes, especially with the data-driven approach aimed at using research to make decisions. Wilensky & Teitelbaum (2019) assert that “organizations should develop, implement, refine and expand on these innovative approaches, which can encourage others to adapt and adopt successful models and methods of quality improvement” (p. 289). Constant advancements improve service delivery while imparting necessary skills to staff members in their individual institutions. This ensures that a blanket requirement for all nursing homes is not used to discriminate against particular homes that may have different necessities.
Apart from that, the introduction of provisions for governance and leadership provides a level of authority for nursing homes accountable for all activities. This forms a critical part that ensures the sustainability of QAPI plans in the long run that can identify and prioritize issues and solutions beforehand to improve performance. More so, the use of the quality assessment and assurance committee oversees and recommends actions for the program aimed to implement appropriate plans based on deficiencies. Consequently, such leadership increases efficiency in LTC care by improving the quality of life of residents by using evidence-based approaches.
Infection Control
With regard to taming infections in nursing homes, provisions for infection prevention and control programs (IPCP) were introduced. This forms an important part of protecting residents who are prone to catch communicable diseases due to their age and underlying health conditions. Research by Kaiser Health News estimated that in 2016, America had 3.8 million healthcare-associated infections in nursing homes, with the associated health costs running between $673 million and $2 billion (NCCNHR The Consumer Voice, 2019). This showed the high risk associated with preventable infections that could adversely affect the lives of residents. Ultimately, having an infection preventionist can ensure timely immunization for diseases such as influenza and pneumonia that are widely common seasonally while also providing guidance on special care involving hygiene of residents.
Compliance and Ethics Program
The compliance and ethics programs aim to prevent any forms of administrative, criminal, or civil violations by residents through its appropriate implementation and enforcement. The provision caters to adequate resources and staffing that can ensure compliance with the necessary standards and procedures. Thorough enforcement applied consistently in the nursing home initiates disciplinary mechanisms among responsible members to increase compliance. This means that the identification of violations forms a huge part in making sure that such cases are reported, thus creating necessary actions to prevent future occurrences. Furthermore, ethics are regarded as a core aspect of any nursing home since it involves the lives of residents requiring constant assistance from employees. As a result, having standards and procedures prevents behavior inconsistent with the health code that may result in cases of neglect or discrimination of residents.
Training Requirements and Physical Environment
Nursing home staff require constant training to ensure that they adhere to all guidelines and procedures. Consequently, the training requirements provision calls for training of staff, contract employees, volunteers based on facility assessment and designed based on practicality. More so, training must be adapted to address potential risks to residents and employees while tracking staff participation to ensure maximum adherence. Moreover, the physical environment provisions involve the availability of a communication system that aids residents get in touch with nurses or other staff members when required. Ultimately, such a system would optimally work when available at the bedside and bathrooms with direct connections with directly with staff or the nurses’ station. Furthermore, the sounds should be audible enough for any employee to discern while also providing visual signals to grab attention. This ensures that emergency situations can be appropriately attended to while minimizing the possibility of adverse mental or physical health deterioration that can be swiftly avoided through the use of a proper communication channel.
Discussion
The implementation of the nursing home regulations as completed in the three phases will likely improve the services provided by the facilities through the tough measures aimed at increasing professionalism. The government plays a major role in ensuring that residents can access the best services at nursing homes hence, the culmination of the phase three requirements outlines the efforts to improve the sector. The vulnerability associated with the elderly constantly requires active compliance and ethics programs that ensure swift reporting and reprimanding of involved parties to ensure the best interests of nursing home residents are maintained. Eventually, the goal of such provisions lie in promoting better life standards, while encouraging employees and volunteers to work diligently. In the long run, enhancing the knowledge of staff ensures that residents can get appropriate treatment that improves their stay in LTC, thus improving their quality of life.
Conclusion
Phase 3 of the nursing home regulations thus form essential aspects of LTC that protect elderly members of the American society at their most vulnerable stage by enhancing their quality of life. These provisions aim at enhancing residents’ quality of life by enhancing service provision at LTC facilities. Consequently, the changes reflect the substantial changes and advances in the field, ensuring safety and reducing the burden on service providers. Innovation constantly requires updates; hence the regulations mirror the diversity in nursing homes that have evolved over the years. Therefore, the structural and content improvements contained in these regulations comprehensively cover aspects of professional standards and resident safety by reorganizing and removing any duplicative provisions.
References
NCCNHR The Consumer Voice. (2019). Overview of phase 3 nursing home regulations: A look ahead [Video]. YouTube.
Wilensky, S. E., & Teitelbaum, J. B. (2019). Essentials of health policy and law (4th ed.). Jones & Bartlett Learning.