The National Imperative to Improve Nursing Home Quality : Honoring Our Commitment to Residents, Families, and Staff

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. Ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents. The devastating impact of the COVID-19 pandemic on nursing home residents and staff has renewed attention to the long-standing weaknesses that impede the provision of high-quality nursing home care. With support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff identifies seven broad goals and supporting recommendations which provide the overarching framework for a comprehensive approach to improving the quality of care in nursing homes. Table of ContentsFront MatterSummary1 Introduction2 Evolution and Landscape of Nursing Home Care in the United States3 Quality Measurement and Quality Improvement4 Care Delivery5 The Nursing Home Workforce6 Nursing Home Environment and Resident Safety7 Payment and Financing8 Quality Assurance: Oversight and Regulation9 Health Information Technology10 RecommendationsAppendix A: Biographic SketchesAppendix B: Examples from the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility ResidentsAppendix C: Recommendations by Area of Measurement and by Area of ResearchAppendix D: Recommendations by Responsible PartnersAppendix E: Recommendations Timeline

Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. Ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents. The devastating impact of the COVID-19 pandemic on nursing home residents and staff has renewed attention to the long-standing weaknesses that impede the provision of high-quality nursing home care.

With support from a coalition of sponsors, the National Academies of Sciences, Engineering, and Medicine formed the Committee on the Quality of Care in Nursing Homes to examine how the United States delivers, finances, regulates, and measures the quality of nursing home care. The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff identifies seven broad goals and supporting recommendations which provide the overarching framework for a comprehensive approach to improving the quality of care in nursing homes.