Bill Overview
Title: LINHQ Act
Description: This bill establishes additional requirements for Medicare skilled nursing facilities and Medicaid nursing facilities with respect to ownership disclosures and quality control, including conditioning Medicare and Medicaid payment on timely ownership disclosures. The bill also establishes dedicated task forces to review disclosures, develop quality metrics, and report violations.
Sponsors: Rep. Schakowsky, Janice D. [D-IL-9]
Target Audience
Population: Individuals associated with Medicare and Medicaid nursing facilities
Estimated Size: 30000000
- The bill targets Medicare skilled nursing facilities and Medicaid nursing facilities, which are healthcare facilities providing long-term care to residents.
- Residents of these facilities, predominantly elderly individuals, will be affected due to the bill's focus on quality control and ownership transparency.
- Facility owners and investors are impacted by the establishment of ownership disclosure requirements and potential changes in reimbursement processes.
- Staff working in these facilities might experience changes in workplace standards and management practices driven by the quality metrics and reviews.
- The broader community, particularly families of residents, will be influenced by changes in care quality and operational transparency.
Reasoning
- The primary targets of this policy are nursing home residents and facility stakeholders.
- Ownership disclosure might not directly affect residents' daily wellbeing but might influence the corporate management strategies that indirectly affect care quality.
- Year 1 budget limits the extent of immediate changes, potentially focusing on establishing disclosure systems and initial quality assessments.
- Long-term impacts will be more significant as quality metrics are enforced and management substitutes are optimized over decades.
- Internal culture and operational changes due to this policy will affect staff wellbeing at these facilities.
Simulated Interviews
Nursing home resident (Florida)
Age: 78 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I hope this means better care and more accountability if they know who owns the place.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Nursing home resident (Texas)
Age: 82 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- I've been through a few facilities, and having clear accountability can improve them overall.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Nursing home care worker (New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- This might mean more paperwork, but if it improves conditions, it's worth it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Nursing home administrator (California)
Age: 52 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Increased transparency is good but could strain administrative resources in small facilities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Nursing home investor (Illinois)
Age: 64 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- Disclosure is manageable, but it may complicate investments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 9 |
| Year 2 | 8 | 9 |
| Year 3 | 8 | 9 |
| Year 5 | 8 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Nursing home resident (Pennsylvania)
Age: 73 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Any improvement in transparency could lead to better care which I really need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Family member of resident (Ohio)
Age: 62 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- I think this is a great step towards ensuring better care in these facilities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Nursing home consultant (Michigan)
Age: 55 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- This policy could streamline improvements across many of the homes I work with.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Policy analyst (Massachusetts)
Age: 35 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- An essential policy for long-term improvement in facility management and accountability.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Nursing home nurse (Indiana)
Age: 48 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- Maintaining transparency is vital; however, it must come with support, not just new rules.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Cost Estimates
Year 1: $75000000 (Low: $50000000, High: $100000000)
Year 2: $80000000 (Low: $55000000, High: $105000000)
Year 3: $85000000 (Low: $60000000, High: $110000000)
Year 5: $95000000 (Low: $70000000, High: $125000000)
Year 10: $110000000 (Low: $80000000, High: $140000000)
Year 100: $250000000 (Low: $180000000, High: $300000000)
Key Considerations
- The ongoing administrative costs versus potential long-term savings from reduced fraud and better quality control.
- Impact on smaller nursing facilities, which might face greater relative financial and operational burdens.
- Possibility of improving patient outcomes and reducing healthcare costs indirectly through better quality measures.