Episode 13:6 Dr. David Grabowski on the Best and Worst of Nursing Home Reform

As professor of health care policy at Harvard Medical School, Dr. Grabowski advises the US Congress on Medicare policy issues and nursing home reform. Learn about the recommendations from CMS’s Coronavirus Commission on Safety and Quality in Nursing Homes and the National Academies of Sciences Engineering and Medicine Commission.

About David

David C. Grabowski, Ph.D. is a professor of health care policy in the Department of Health Care Policy at Harvard Medical School. He has published over 200 peer-reviewed research articles with a particular focus on long-term care. He has testified in front of Congress five times on issues related to the care of older adults.

Dr. Grabowski is a member of the Medicare Payment Advisory Commission. He has also served on several Centers for Medicare & Medicaid Services (CMS) technical expert panels, including the recent CMS Coronavirus Commission on Safety and Quality in Nursing Homes. He was also a member of the recent National Academies of Sciences, Engineering and Medicine’s Committee on the Quality of Care in Nursing Homes.

Key Takeaways

• The pandemic has been a “crisis on top of a crisis.” COVID lifted the veil on social ills that have been present in nursing homes for four decades.
• There are two major challenges in long-term care and post-acute care in the U.S. 1. We underfund long-term care and post-acute care services and 2. We spend money on the wrong things without enough accountability for how public funds are being spent.
• Budgets need to transition away from nursing homes and towards home and community-based services. The Biden Administration tried early on to put more money into home-and-community-based services, but the effort failed.
• Nursing home reforms include consideration of minimum staffing standards, greater transparency around ownership and finances, and increased regulatory oversight to make certain facilities are accountable.