Pursuing Quality Long-Term Care

The Upper Payment Limit (UPL) program was established to support city and county-operated nursing homes by providing enhanced Medicaid payments for nursing home residents residing in those homes. Although the program was created with good intentions, over time concerns have arisen that some cities, counties, and states exploit loopholes to redirect these enhanced payments, originally intended for...

Good food is something we all look forward to, something that tastes good, nourishes us, connects us to culture and community, and that we enjoy sharing with friends and family. That doesn’t change when someone moves into a long term care facility. In fact, food often matters more to people living in long-term care. At its best, food supports nutrition and health, triggers positive memories, and p...

When the Biden Administration announced its intent to implement a minimum staffing standard, the nursing home industry immediately responded with cries that a standard would result in closures, loss of money to nursing homes, and that the standards could not be met. These arguments, although unsupported by evidence, were effective and resulted in the current administration rescinding the staffing...

This episode explores the Essential Caregivers Act of 2025 and the lessons learned from the COVID 19 visitation bans in long term care. Our discussion examines how isolation harms residents, why essential caregivers are irreplaceable, and how this legislation aims to protect resident rights during future emergencies. It’s a conversation about dignity, safety, and ensuring that no one in long term...

In this episode, Yiqun Chen and Marcus Dillender join us to discuss their revealing study on how nursing homes respond to government inspections. They explain how facilities often make short-term changes—like boosting staff and discharging patients—just to look better during inspections, only to revert immediately afterward. Despite this gaming, inspection ratings still offer meaningful insights i...

Join us for part two of a conversation with long-term care residents. In spring 2025, Consumer Voice conducted a nationwide survey of residents to learn what daily life is like in their facilities. The questions ranged from whether residents feel they are treated with dignity and respect to how appealing their meals are, and everything in between. In part two of this podcast, we discuss the survey...

In spring 2025, Consumer Voice conducted a nationwide survey of long-term care residents to learn what daily life is like in their facilities. The questions ranged from whether residents feel they are treated with dignity and respect to how appealing their meals are, and everything in between. In this two-part podcast, we discuss the survey results and explore key themes with the residents themsel...

When something goes wrong in long-term care, do you know what to do? In this episode, we introduce Documenting Resident Concerns in Long-Term Care, a new resource created to help residents and families respond with confidence. From falls and pressure injuries to conflicts with staff, knowing what questions to ask and what details to document can be the key to real solutions. Lori Smetanka and Joce...

In this episode, we're joined by three advocates who have worked to raise the personal needs allowance (PNA) and improve the quality of life for nursing home residents in their states. The PNA is a small portion of income that Medicaid nursing home residents can keep each month to cover personal expenses such as clothing, snacks, cell phone bills, and other essentials that make life more comfortab...

When award-winning filmmaker Susie Singer Carter placed her mother, who was living with dementia, in a five-star nursing home in Los Angeles, she never expected to be dealing with substandard care, inadequate staffing, and chemical restraints. Horrified by what was happening, Susie connected with former federal prosecutor Rick Mountcastle, whose prosecution of Purdue Pharma was featured in the min...

Nearly 40 years ago, after repeated reports, articles, and studies highlighting dismal conditions in nursing homes, Congress passed the comprehensive Nursing Home Reform Act, raising the standard of care and expectations for residents of nursing homes across the country. While we are still advocating for the promise of the law to be experienced by all residents, the importance of implementing the...

When a loved one enters long-term care, family members often find themselves stepping into a new and unexpected role: advocate. In this episode, Andrea DuBrow and Heather Tunis share their personal journeys from concerned family members to dedicated advocates for their loved ones in long-term care settings. Join us as we explore the vital role of family councils, the power of effective leadership,...

Consumer Voice’s Public Policy Director, Sam Brooks, talks with Dr. Norma Coe, a professor of Medical Ethics and Health Policy at Perleman School of Medicine, whose research on the minimum staffing rule in nursing homes found that the rule would save 13,000 resident lives annually. Sam and Dr. Coe will discuss the rule, its impact on residents, and the current barriers to its implementation. Guest...

Currently, the reconciliation process is underway in Congress. At stake are hundreds of billions of dollars in cuts to Medicaid, which would permanently alter the Medicaid program and have long-lasting and devastating impacts on tens of millions of Americans nationwide. In this episode, Consumer Voice’s Public Policy Director, Sam Brooks, will discuss the reconciliation process with Nicole Jorwic...

Although federal law and regulation prohibit the use of third party guarantees, some nursing homes may still attempt to get you to sign documents making you financially responsible for a nursing home stay. Join us for a conversation with experts Anna Anderson and Eric Carlson as they guide you through what you can do if a nursing home tries to hold you financially liable for someone else's nursing...

During this time of year nursing homes can expect to see an increase in people visiting their loved ones. This increase puts everyone at a higher risk of catching a cold or respiratory illnesses. Join us for a conversation as we dive into the latest CDC guidance on respiratory illnesses, including COVID-19, for nursing home residents. We are joined by Dr. Erika Wallender from the CDC, and Lori Wal...

Election season is an exciting time that offers a renewed opportunity to shape public policy. For many long-term care residents, voting is a patriotic duty that has been respected and exercised over the course of their lifetime. Residents of long-term care have the same right to vote as everyone else. Join us for a conversation with Gwen Orlowski, Executive Director of Disability Rights New Jersey...

Guardianship is a tool intended to support individuals who have lost the capacity to make decisions for themselves. However, guardianship is an extreme step and can have a devastating impact on a person's well-being. In this episode, we will discuss guardianship over residents of long-term care facilities, less restrictive alternatives, and strategies for supporting residents under guardianship. G...

Retaliation, and the fear of retaliation, can prevent residents and family members from raising their concerns about care and safety. It also has a chilling effect on the reporting of abuse or neglect in long-term care facilities, leaving many living in fear and without relief from harm. Retaliation can range from very subtle to obvious actions and it may be difficult to determine whether staff ar...

In April 2024, a new federal rule requiring minimum staffing levels in nursing homes was released. This rule is an important step toward improving quality conditions in nursing homes and ensuring that residents receive the care they need. Listen in on a discussion between Consumer Voice's Lori Smetanka and Sam Brooks, who talk about the importance of the rule, what it says, and how we can start th...

The Centers for Medicare and Medicaid Service’s (CMS) new minimum staffing standard requires facilities to provide 3.48 hours of care per resident per day. That translates into three hours and 29 minutes of care over 24 hours for each resident. This number is lower than what Consumer Voice and other consumer advocates, nursing professionals, and nursing home residents have been advocating for, for...

Every April, organizations across the country take the time to celebrate and thank their volunteers. Volunteers are the backbone of many Long-term Care Ombudsman Programs (LTCOP). With the help of volunteers, the Ombudsman program can have a regular presence in facilities and stay in touch with residents. Volunteers lend their time, talent, and voice to make a difference in their communities and t...

Since the pandemic began, there has been significant efforts by advocates to create better laws and regulations to protect nursing home residents. The pandemic and its devastating impact on nursing home residents has resulted in many states passing new laws or creating new regulations regarding a variety of areas, including staffing, transparency, and the nursing home workforce. On this episode, y...

Often the conversation about addressing the chronic poor care that exists in far too many of today's nursing homes is framed around new laws or regulations. Yet, there are steps that can be taken now - using existing federal and state legal authority - to improve care and conditions in our country's nursing homes. In our conversation, we will discuss four levers of opportunity for increasing quali...

Family caregivers have always played an integral role in promoting and achieving quality care for their loved ones living in a long-term care facility. The importance of the informal care and support provided by family members for a resident's physical, mental, and emotional well-being became abundantly clear during the pandemic when those essential supports were taken away during the pandemic. Ye...