At the Senate Special Committee on Aging hearing, Lori Smetanka of the National Consumer Voice for Quality Long-Term Care urged stronger federal enforcement of nursing home standards, increased staffing and more financial transparency from nursing-home companies.
Smetanka said enforcement of the Nursing Home Reform Act remains inadequate nearly 40 years after its passage and that complaints, serious deficiencies and substandard care persist. “Complaints to survey agencies and ombudsman have increased,” she said, and a 2024 report referenced in testimony estimated that a large share of industry profits are obscured by related-party transactions.
Suggested actions Smetanka offered included increasing Centers for Medicare & Medicaid Services funding for oversight and auditing; requiring audited consolidated cost reports from facilities; and directing CMS to use existing data to hold owners accountable when substandard conditions exist across facilities. She also linked understaffing to poor outcomes, citing pressure wounds, falls and increased citations for abuse and neglect.
Senators and witnesses discussed workforce interventions and legislative options: Smetanka recommended federal funding to recruit and retain direct-care staff, stronger staffing requirements tied to resident acuity, and enforcement of abuse-reporting and investigation requirements.
Discussion vs. decisions: Testimony focused on recommended federal rules and funding; there were no committee votes. Witnesses asked for futures actions including audits, funding increases and staff-recruitment programs.
Ending: Advocates framed reforms as necessary to protect residents’ rights and reduce preventable harm in facilities; they asked Congress and CMS to act on auditing, staffing and data transparency.