The Senior Care Policy Briefing covers important long-term care issues by highlighting policy updates, news reports, and academic research.

Read the full Senior Care Policy Briefing below or download here.

November 15, 2023. 


  • Nursing home lobbyists claim that facilities are struggling and cannot meet safe staffing standards. Meanwhile, the industry press reports that one of the biggest nursing home operators, the Ensign Group, is “eager” to invest another billion dollars, with its CEO telling investors that it would soon meet or exceed its pre-COVID occupancy.
    • Suzanne Snapper, Ensign’s Chief Financial Officer, said she does not anticipate the proposed federal staffing mandate to impact the company’s growth, according to McKnight’s. Meanwhile, Ensign has experienced increased reimbursement rates in various states due to policies intended to address COVID challenges. Company officials also said that wage inflation has slowed, and retention has improved.


  • Dying Broke. The rising costs of home, assisted living, and nursing home care are severely depleting the savings and incomes of older Americans. LTC expenses have reached a half-trillion dollars annually and are projected to increase significantly. As a result, many seniors and families are facing financial ruin, according to a new investigation by KFF Health News and The New York Times. This is prompting calls for a more coherent and adequately funded long-term care system.
  • Substantial Growth. Nursing home care represented one of the fastest-growing categories of national health spending in August, with year-over-year growth of 10.1%, according to Altarum’s monthly Health Sector Economic Indicators Brief, released in October.
  • 22,500 Premature Deaths. “Private-equity investment in nursing homes, to take just one example, has grown from about $5 billion at the turn of the century to more than $100 billion today. The results have not been pretty. The industry seems to have recognized that it could improve profit margins by cutting back on staffing while relying more on psychoactive medication. Stories abound of patients being rushed to the hospital after being overprescribed opioids, of bedside call buttons so poorly attended that residents suffer in silence while waiting for help, of nurses being pressured to work while sick with COVID. A 2021 study concluded that private-equity ownership was associated with about 22,500 premature nursing-home deaths from 2005 to 2017—before the wave of death and misery wrought by the pandemic.” – The Secretive Industry Devouring the U.S. Economy (The Atlantic)


  • A study from the New England Journal of Medicine reveals that a straightforward enhanced bathing routing can significantly reduce serious infections and mitigate antibiotic resistance in nursing homes. Unfortunately, too many nursing home residents go days or weeks without a shower due to the severe understaffing in facilities.
  • Only 23% and 47% of nursing home workers have up-to-date vaccinations for COVID-19 and the flu, respectively, according to the Centers for Disease Control and Prevention (CDC). These data reveal vaccine fatigue and a general decline in vaccination rates post-pandemic. The CDC emphasizes the need for evidence-based strategies to enhance vaccine coverage among nursing home staff.