Until recently, nursing homes have not been required to spend a set minimum percentage of the funds they receive on the care of their residents, nor have the public or policymakers had an effective tool to require accountability for these expenditures. We urgently need laws requiring nursing homes to spend an appropriate amount of revenue on the direct care of their residents. These laws will improve safety, quality of care, and quality of life for the nation’s nursing home residents and will provide a critical tool for sorely needed transparency and accountability.

Because of lax oversight, many nursing home owners and operators have become increasingly sophisticated in using taxpayer dollars to benefit themselves rather than those for whom these funds are intended – their residents. Read more…

The principal goal of a direct care minimum spending law is to ensure that nursing home providers spend the bulk of the funds they receive for the care of residents. This section discusses the key components of a direct care minimum spending law and the obstacles that key terms can present. Read more…

This section examines federal and state precedents for a minimum direct care spending law, including direct care spending laws passed in New Jersey, Massachusetts, and New York. Read more…

A number of states, including California and Connecticut, are considering legislation to establish a direct care spending requirement in their 2022 legislative sessions. Read more…

Direct Care Minimum Spending laws, which require nursing home providers to spend a set percentage of their revenue, largely taxpayer dollars, on resident care, are a critically needed, reasonable, and carefully targeted solution to address the failure of too many nursing home operators to provide sufficient staffing and supplies to meet the basic needs of their residents. Read more…

Note: LTCCC’s policy brief on New York’s Direct Care Minimum Spending Ratio is available at https://nursinghome411.org/ny-minimum-spending-ratio/.