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Appendix E: Recommendations Timeline
Pages 573-578

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From page 573...
... Recommendations that are • marked for immediate implementation are urgent, and largely can move ahead using existing structures. • identified for short- and intermediate-term implementation re quire action in the short-term to get started, but will require some amount of planning or coordination (such as the planning or coor dination needed to initiate new studies or demonstration projects)
From page 574...
... • Infection prevention and control specialist with sufficient dedicated time Coverage of certified nursing assistant (CNA) time for completing education and 2E training programs Compliance with existing statute to determine adequacy of Medicaid payments to 4B cover comprehensive care Adequate capacity and resources for state survey agencies to fulfill current 5A oversight responsibilities Strong, consistent, responsive, and transparent process for grievances and complaints 5A Greater use of variety of existing enforcement remedies 5B Short-Term Implementation Addition of documentation of emergency plans and staff training to Care Compare 1D Enactment of state licensure decisions to ensure that all new nursing homes are 1E constructed with single-occupancy bedrooms and private bathrooms for most or all residents Incentives for nursing homes to hire qualified licensed clinical social workers at the 2D M.S.W.
From page 575...
... Extension of bundled payment initiatives to all conditions 4D Elimination of certificate-of-need requirements and construction moratoria 5E Increased weight of staffing measures within five-star composite rating on Care 6B Compare Identification of pathway to provide financial incentives for certified EHR 7A adoption Short-Term Implementation (Initiation of Research and Grants) Translational research and demonstration projects to identify the most effective 1B nursing home care delivery models • Prioritize models that reduce disparities and strengthen connections to the community • Evaluate innovation in all aspects of care Research to identify and rigorously test specific minimum and optimum staffing 2C standards for all direct-care staff Training grants to advance and expand the role of the CNA and develop new 2E models of care delivery that leverage the role of the CNA as a member of the interdisciplinary care team Research on recruitment, training, and retention of all nursing home workers 2I (particularly CNAs)
From page 576...
... or Ph.D. level, APRNs, clinical psychologists, psychiatrists, pharmacists, and others Career advancement opportunities and peer mentors for CNAs 2E Pathways for current workers to achieve minimum education and competency 2F requirements Inclusion of geriatrics content in education programs for all health care 2F professionals Real-time, readily usable, and searchable database that can evaluate and track 3B quality of care for facilities with common ownership or management company Assessment of the impact of nursing home real estate ownership models and 3B related-party transactions on quality of care Refine, expand, and report oversight performance metrics of state survey agencies 5A Use of existing strategies of enforcement by CMS when states fall short of 5A expected standards (based on performance metrics)
From page 577...
... 7B Reporting of new measures of disparities in nursing home care 6D Identification of thresholds for action on disparities, and promising pathways to 6D reduce or eliminate disparities Evaluation of state-based technical assistance programs 6E Measurement and reporting of clinician, resident, and family perceptions of 7B HIT usability

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