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Appendix D: Recommendations by Responsible Partners
Pages 565-572

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From page 565...
... HHS as the lead agency (includes individual agencies within HHS) Fund research to identify and rigorously test specific minimum and optimum 2C staffing standards for direct-care staff based on resident case mix, and type of staff needed to address the care needs of specific populations.
From page 566...
... (HHS/CMS) Advocate for increased funding for LTC ombudsman programs with additional 5C resources allocated toward hiring additional paid staff and training staff and volunteers, bolstering programmatic infrastructure, making data on state LTC ombudsman programs and activities publicly available, and developing summary metrics designed to document the effectiveness of these programs in advocating for nursing home residents.
From page 567...
... (CMS, HRSA) Fund rigorous evaluation studies to explore use of HIT to improve nursing 7D home resident outcomes; disparities in HIT adoption and use across nursing homes; innovative HIT applications for resident care; and assessment of clinician, resident, and family perceptions of HIT usability.
From page 568...
... to 4A test a model for a federal long-term care benefit that would expand access and advance equity for all adults who need long-term care, including nursing home care. Ensure Medicaid payments are at a level adequate to cover the delivery of 4B comprehensive, high-quality, and equitable care to nursing home residents across all domains of care as required by existing statute.
From page 569...
... (Federal and state governments, together with nursing homes) Update the regulatory requirements for staffing standards in nursing homes to 2C reflect new minimum requirements and account for case mix based on research on minimum and optimum staffing standards for direct care staff.
From page 570...
... of the National 1C Response Framework: • Revise ESF 8 to give greater prominence to nursing homes with the goal of clarifying that nursing homes, specifically, and long-term care facilities more broadly are included within ESF 8 to ensure that state and local emergency management documents and plans contain specific guidance for nursing homes during an emergency. • Revise ESF 15 to include nursing home residents as part of the target group of "individuals with disabilities and others with access and functional needs." States Ensure the development and ongoing maintenance of formal relationships, 1D including strong interface, coordination, and reliable lines of communication, among nursing homes and local, county, and state-level public health and emergency management departments.
From page 571...
... Collect and report data to CMS regarding 2H • Baseline demographic information of medical directors, administrators, and directors of nursing, including name, licensure, contact information, and tenure; • The geriatrics or long-term care training and expertise of medical directors, APRNs, social workers, physicians, and physician assistants; • The numbers and staffing patterns for these professionals; and • The numbers and staffing patterns for all contract and agency staff providing services in nursing homes. continued
From page 572...
... NOTES: ACL = Administration for Community Living; AHRQ = Agency for Healthcare Research and Quality; APM = alternative payment model; APRN = advanced practice registered nurse; CAHPS = Consumer Assessment of Healthcare Providers and Systems; CDC = Centers for Disease Control and Protection; CE = continuing education; CMMI = Center for Medicare and Medicaid Innovation; CMS = Centers for Medicare & Medicaid Studies; CNA = certified nursing assistant; CSWE = Council on Social Work Education; DOJ = U.S. Department of Justice; EHR = electronic health record; ESF = emergency support function; FEMA = Federal Emergency Management Agency; HHS = U.S.


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