Bill Overview
Title: IMPROVE Nursing Homes Act
Description: This bill requires the Centers for Medicare & Medicaid Services to establish a grant program to support the conversion of traditional nursing facilities to small-house nursing facilities (i.e., facilities that offer private rooms for up to 12 residents in separate buildings or areas). Grant funds may be used to convert facilities but not for facility operation; grant recipients must agree to provide person-centered care that supports certain resident flexibilities and to operate such facilities for at least 20 years.
Sponsors: Rep. Schakowsky, Janice D. [D-IL-9]
Target Audience
Population: Residents in Nursing Homes
Estimated Size: 2000000
- The legislation targets the conversion of traditional nursing homes to small-house nursing facilities, which will primarily affect residents of nursing homes.
- This change in infrastructure aims at providing privacy and improved living conditions by allowing private rooms for up to 12 residents.
- The bill emphasizes person-centered care, which could enhance the quality of life for nursing home residents.
- The operational timeframe of at least 20 years for these facilities implies a long-term impact on future residents and staff.
- Given the global aging population, numerous countries have a significant number of elderly individuals in nursing care.
- Traditional nursing homes may also exist in various countries, and similar transitions could occur globally due to this model.
Reasoning
- We have identified a diverse group of interviewees, including residents of nursing homes, potential future residents, nursing home staff, and family members of residents, to capture a range of perspectives.
- Each interview considers both the immediate impacts (up to year 1) and the long-term effects (up to year 20) on wellbeing scores.
- Given the policy's budget constraints, we assume not all facilities can be converted immediately, leading to varying impacts among the interviewees.
- The distribution of interviewees also reflects common demographics of nursing home residents (older age, various health backgrounds) but includes younger individuals for future considerations.
- We account for the fact that not all nursing homes will be converted, so some individuals will not be impacted at all
Simulated Interviews
Retired (Florida)
Age: 85 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 15/20
Statement of Opinion:
- I'm glad to hear about the new proposal. Living conditions here could be more comfortable.
- I hope this change happens quickly because I might not have many years left to enjoy it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
Retired Engineer (California)
Age: 70 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- The idea of living in a smaller, more personal setting with individualized care is appealing.
- If implemented well, this could really improve the quality of life during my later years.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 4 |
Registered Nurse in a nursing home (New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- This could provide a better work environment and improve care quality.
- There might be a need for additional training, but it's a positive change overall.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Retired (Texas)
Age: 60 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- More personalized care could reduce my worries about my spouse's well-being.
- The transition might be disruptive at first, but I hope it's worth it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 4 |
Retired (Illinois)
Age: 78 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- This policy makes the idea of moving more palatable.
- Private rooms sound appealing if my health declines.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Retired (Ohio)
Age: 92 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- I'm disappointed my facility isn't changing.
- I hope others at least get the benefit of these new settings.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 3 |
| Year 2 | 3 | 3 |
| Year 3 | 3 | 3 |
| Year 5 | 3 | 3 |
| Year 10 | 3 | 2 |
| Year 20 | 3 | 2 |
Healthcare Administrator (Nevada)
Age: 55 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- The challenge is to manage transition within budget while maintaining care standards.
- Staff training will be essential for the success of these facilities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Retired Teacher (Pennsylvania)
Age: 81 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- Anything that improves care for people like me is welcome.
- I just hope there's adequate support during the change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Retired (Arizona)
Age: 68 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- Improving nursing homes is crucial for my generation.
- I'd like to see this implemented before I consider moving to a facility.
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 | 9 | 7 |
| Year 20 | 9 | 6 |
Healthcare Policy Analyst (Minnesota)
Age: 37 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 20.0 years
Commonness: 2/20
Statement of Opinion:
- IMPROVE Nursing Homes Act is a step forward for infrastructure and care improvement.
- The long-term impact on resident satisfaction and costs needs careful measurement.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $600000000 (Low: $500000000, High: $700000000)
Year 3: $650000000 (Low: $550000000, High: $750000000)
Year 5: $700000000 (Low: $600000000, High: $800000000)
Year 10: $800000000 (Low: $700000000, High: $900000000)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The policy will significantly impact the nursing home residents by improving living conditions.
- The initial high cost could strain federal budgets unless balanced with equivalent savings or tax revenues.
- Long-term operational cost savings and better health outcomes could offset the upfront costs.
- Compliance with the person-centered care conditions will be crucial for the policy's success.