America's nursing homes and long-term care facilities face the daunting challenge of instituting sweeping reforms in their operations and approaches to serving long-term care consumers, as a “perfect storm” of events—longer life spans, a growing elderly population and increasing costs of care—threatens to develop into a national crisis.
That is a major conclusion of a report issued early in December by the National Commission for Quality Long-Term Care, headed by former Senator Bob Kerrey (D-Neb.) and former House Speaker Newt Gingrich (R-Ga.), who both called on the nation's political leaders, including presidential candidates, to address the crisis in their campaigns and party platforms.
“We hope our political leaders and the candidates for President will begin to understand the seriousness of the long-term care problem and that it leads to bigger problems in health care,” Kerrey said during a conference call with journalists. Gingrich expressed the hope that the next president and new Congress will work for a solution when they take office in 2009.
To prepare, the Commission urged Congress to hold hearings in 2008 to investigate and recommend workable strategies to design and implement a new and better long-term care system. It said the President should lead “a multifaceted transformation of the current system” so it can serve consumers for decades to come.
The Commission's final report focuses on four critical elements: quality, workforce, technology, and finance. It stressed that these areas are interconnected and that success or failure in one area will affect all others, and offered these general recommendations:
Quality. The nation can reform the long-term care system by developing innovations that focus on improving an individual's quality of life and quality of care, including developments for standardized measurements for quality, moving towards a system of consumer-centered care, dissemination of comparative quality information, and supports for family caregivers.
Workforce. With a shortage of long-term care professionals nationwide, those who provide care must receive support. That means improving compensation and incentives, providing better training, leadership development and opportunities for advancement, and ensuring respect for the workforce as distinct from the healthcare labor market.
Technology. Strengthen federal and industry efforts to develop health information technology and conduct innovative research that enhances consumer independence, while safeguarding privacy, along with open communication and data sharing.
Finance. Financing the long-term care system is a national problem that requires a national solution. The system should include ensuring access to quality care for all, affordability for individuals and society, and promoting a shared responsibility among government, individuals, and the private sector.
Three leading long-term care advocacy organizations immediately issued a statement praising the Commission's work and recommendations. “We believe the policy road map [the Commission] has put on the table today, as well as the plan we will offer in January, will engender a detailed, thoughtful, much-needed discussion of these key issues as the 2008 presidential race unfolds,” said Bruce Yarwood, president and CEO of the American Health Care Association.
Alan G. Rosenbloom, president of The Alliance for Quality Nursing Home Care, said that “adequate, stable funding is integral to ongoing quality improvements,” adding that “substantial structural changes” in the way long-term care is financed are required.
David Kyllo, executive director of the National Center for Assisted Living, said the Commission's recommendations on quality, workforce, technology, and financing reform “are of major importance across the entire spectrum of long-term care—from nursing homes to assisted living to home-based care.” He said a public discussion “of the most important healthcare policy issues not currently being discussed in appropriate detail” is now essential.
The Commission's report commended the “Quality First” program sponsored by those organizations and the American Association of Homes and Services for the Aging, a program that offers technical assistance and resources to help providers make quality improvements. The Commission noted that “providers in all segments of the long-term care field have a critical role to play.”
However, “voluntary efforts are only one way to address quality,” the Commission observed. “Providers also have a responsibility to meet existing statutory and regulatory quality standards; doing so is another critical way to help ensure quality.”