Nursing Home Transparency: A Critical Tool to Improve the Quality of Nursing Home Care

Why is it so difficult to hold nursing homes accountable for providing the level of care for which they are being paid? How can it be that at the height of the COVID-19 pandemic, an investment firm with a record of providing substandard nursing home care could buy more than 20 facilities across multiple states with little to no scrutiny? How can regulators better pinpoint these “bad actors” and prevent them from causing harm to nursing home residents? How can we be assured that public funds are being spent as intended, on resident care?

Transparency – the availability of high-quality, complete, interoperable, and accessible data on nursing home ownership, management, and financing – is a critical tool for assuring quality care and program integrity. This policy brief highlights efforts to increase transparency over the years and provides thoughtful recommendations for critically needed reforms.

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Substandard care remains widespread in US nursing homes despite massive amounts of public funding. Why is it so difficult to hold nursing homes accountable for providing the level of care for which they are being paid? This brief focuses on transparency and how policymakers can use this critical tool to assure quality care and hold nursing homes accountable. Read more…

Poor quality in nursing homes has been studied and documented for years. This section provides a timeline of efforts to increase transparency including a 1986 Institute of Medicine study, the 1987 Nursing Home Reform Law, and the 2010 Affordable Care Act. Read more…

The ACA’s transparency provisions were intended to promote transparency in nursing home ownership, financing, and expenditures, but the devastation wrought by COVID in nursing homes revealed that serious gaps remain. This section discusses recent efforts to improve transparency. Read more…

The following recommendations for action (several of which have already been enacted by state legislatures and/or proposed in the Biden Administration’s nursing home package) will require further development and championing by policymakers and advocates, understanding the critical need to seize this unique moment to act. Read more…

Holding nursing homes accountable requires greater transparency of ownership, management, and financial data, along with sufficient oversight and enforcement authority and the necessary funding to effectively carry out these activities. Read more…