New Bill Seeks to Ban Nursing Homes From Advance Arbitration Agreements With Residents

A new bill will forbid nursing homes from forcing residents and families to agree in advance arbitration, waiving their rights to sue over disputes involving care, the Associated Press reported.

"Families must have faith that loved ones receiving long-term care or care after a hospital stay will be safe and receive good-quality care," Oregon Senator Ron Wyden said in a statement. "The pandemic, myriad reports of abuse, and critical failures during natural disasters have shattered that foundation of trust and safety."

Other measures are also to take place through the bill. Among them being a 24-hour register nurse being available, increased salaries and staffing and requiring an infection prevention and control specialist.

For more reporting from the Associated Press, see below:

Nursing Home Overhaul Bill
A new bill passed forbidding nursing homes from forcing residents to sign an arbitration agreement, waiving away their right to sue over disagreements in care. Residents and staff gather and dance during an Easter concert for vaccinated residents at the Ararat Nursing Facility in the Mission Hills neighborhood on April 1 in Los Angeles, California. Mario Tama/Getty Images

Responding to the ravages of COVID-19 in nursing homes, senior Democratic senators Tuesday introduced legislation to increase nurse staffing, improve infection control and bolster inspections.

The bill, from a group led by Wyden and Bob Casey of Pennsylvania, is part of a broader overhaul of long-term care just getting started. Separately, President Joe Biden is seeking $400 billion to expand home and community based care as an alternative to nursing homes in the giant domestic agenda bill Democrats are pushing in Congress. His COVID relief law already provided a down payment.

Nursing homes and long-term care facilities house a tiny proportion of the U.S. population but they're estimated to account for about three in 10 deaths from COVID-19. Vaccines have finally brought relief, dramatically reducing cases and deaths, but concerns remain.

Some of the main provisions of the Senate bill would:

— Raise salaries and benefits for nursing home staff by giving states the option of an increase in federal Medicaid matching funds, available over six years. Low wages in the nursing home industry make for constant turnover, a critical problem even before the pandemic. The bill also starts a process for setting minimum staffing thresholds.

— Require nursing homes to have an infection prevention and control specialist.

— Require nursing homes to have a registered nurse available 24 hours a day, instead of the current eight hours.

— Bolster state inspections of nursing homes, and add more low-performing facilities to a "special focus" program that helps them improve quality.

— Forbid nursing homes from requiring residents and families to agree in advance to arbitration, thereby waiving their rights to go to court over disputes involving care.

The Congressional Budget Office has not put a price tag on the bill, but it could reach tens of billions of dollars.

Nursing homes receive most of their financing through Medicaid and Medicare, and Wyden oversees both programs as chair of the Senate Finance Committee. Casey leads the Aging Committee. In the House, Ways and Means Chairman Richard Neal, a Democrat from Massachusetts, and Energy and Commerce Chairman Frank Pallone, a Democrat from New Jersey, are also working on a nursing home overhaul. The four lawmakers wield clout, but prospects for the legislation are uncertain.

"These proposed measures would help improve staffing and increase accountability on the part of nursing homes," Harvard health policy professor David Grabowski said of the legislation. "Historically, we have often underfunded nursing homes but some facilities have also not spent public dollars on direct resident care as intended. Under this legislation, more funding will go to nursing homes for staffing, but more will be expected of them as well."

The bill would also launch an experiment to see if downsized nursing homes lead to better care and quality of life for residents. Those facilities would have between five and 14 residents, make private rooms available, feature accessible outdoors areas, and involve residents and families in decision-making.

Nursing home industry groups have been clamoring for more money from the federal government, but they also complain about the cost of added requirements and the burden of more rules. They're likely to oppose banning arbitration clauses.

Nursing Home Overhaul Bill
Responding to the ravages of COVID-19 in nursing homes, two senior Democratic senators Tuesday introduced legislation to increase nurse staffing, improve infection control and bolster inspections. In this April 1 file photo, May Nast arrives for dinner at RiverWalk, an independent senior housing facility, in New York. Seth Wenig/Associated Press