CMS Encourages States to Use Medicaid Payments to Nursing Homes to Drive Better Health Outcomes for Residents, Improve Staffing

In support of President Biden’s plan to improve the nation’s nursing homes, CMS outlines actions for states to improve safety and quality of care for residents

Today, the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin detailing actions that states can take using existing Medicaid authorities to drive better health outcomes for nursing home residents and improve staff pay, training, and retention efforts. The informational bulletin – issued by CMS’ Centers for Medicaid and CHIP Services (CMCS) – also provides examples of current state Medicaid initiatives to support this work.

Earlier this year, President Biden announced a comprehensive set of reforms to improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent so potential residents and their loved ones can make informed decisions. As part of the implementation of these reforms, CMS is working to support state Medicaid agencies in ensuring the best care possible for beneficiaries living in nursing homes.

“Our loved ones living in nursing homes deserve the highest quality of care, dignity, and respect,” said Health and Human Services (HHS) Secretary Xavier Becerra. “At HHS, we’re taking another critical step to implement President Biden’s bold set of reforms to improve our nation’s nursing homes. We call on all states to work with us and ensure everyone has access to the high-quality care they deserve.”

“Today’s action is an important step toward accomplishing the Administration’s goals of strengthening the quality of care, accountability, and transparency in our country’s nursing homes for Medicaid enrollees. States can implement a number of initiatives described in this guidance immediately,” said CMS Administrator Chiquita Brooks-LaSure. “Medicaid enrollees residing in nursing homes will only experience better care through collaboration between states, CMS, providers, and other partners, and we look forward to working closely with them on this important effort.”

To ensure nursing homes are adequately resourced and staffed, CMS is urging states to tie Medicaid payments to quality measures that will improve the safety and quality of care.

“We know that low wages for staff can contribute to frequent turnover and dangerous staffing shortages at nursing homes, so we encourage states to work with these facilities to find solutions for training and improving staffing,” said Administrator Brooks-LaSure.

In addition to this informational bulletin, CMS continues to encourage states strongly to achieve a more equitable balance between the share of spending and use of services and supports delivered in home and community-based settings relative to institutional care like nursing homes. As another key priority of the Biden-Harris administration, CMS is committed to strengthening the availability of Medicaid-covered home and community-based services (HCBS) as an alternative to institutional care. As a result of the American Rescue Plan, states are planning to invest $25 billion to expand, enhance, and strengthen HCBS, the largest investment ever in HCBS.

Read the full informational bulletin sent to states: Medicaid nursing facility payment approaches to advance health equity and improve health outcomes

Read the White House fact sheet: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes