Published in Health Affairs, June 17, 2024
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In his 2022 executive order on nursing home resident safety and care quality, President Joe Biden “committed to building a long-term care system where all seniors can age with dignity, where people with disabilities can receive high-quality services and supports in the setting of their choice.” In part, this executive order was a response to the crisis in nursing homes wrought by the COVID-19 pandemic. As of January 2022, long-term care residents and staff accounted for at least 23 percent of all COVID-19 deaths in the US. Since then, the federal government has taken a number of steps to bolster nursing home staffing, safety, and quality; increase oversight of nursing home ownership; and encourage vaccination. Even so, the continued struggles of US nursing homes in each of these areas suggest the need for more fundamental transformation.
Indeed, President Biden’s use of the term “building” in his executive order speaks to an underlying challenge. As his administration advances major infrastructure projects across the country through implementation of the bipartisan Infrastructure Investment and Jobs Act enacted in 2021, the US’s 15,000 nursing homes, which are in need of their own physical redevelopment, should not be overlooked. We can no longer rely on traditional nursing homes to house 1.2 million of our most vulnerable community members. Nursing home residents, providers, advocates, and experts agree that nursing homes built in the mid-twentieth century need to be redesigned to serve the needs of residents in the twenty-first.
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