title: Nursing homes and the affordable care act: a cease fire in the ongoing struggle over quality reform.
abstract: Most provisions in the Affordable Care Act that affect nursing homes originated in two earlier attempts at reform, both of which failed multiple times in prior Congressional sessions: the Elder Justice Act and the Nursing Home Transparency and Improvement Act. Both of these earlier efforts focused on improving quality and reducing elder abuse in nursing homes by strengthening oversight and enforcement penalties, expanding staff training, and increasing the information on nursing home quality available to consumers and regulators. Each bill addressed problems that were serious, widespread, and had persisted for years, but each failed to pass on its own. The Affordable Care Act, with its own momentum, became the vehicle for their passage. However, the reasons the bills failed in these earlier efforts suggest implementation challenges now that they have ridden into law on the coattails of the more general effort to reform the health care sector.
authors.affiliation: Department of Health Policy and Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX 77843, USA. hawes@srph.tamhsc.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Hawes
authors.forename: Darcy M
authors.initials: DM
authors.lastname: Moudouni
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Edwards
authors.forename: Charles D
authors.initials: CD
authors.lastname: Phillips
mesh_terms: D000368:Aged; D003256:Community Participation / Q000191:economics / Q000379:methods; D004552:Elder Abuse / Q000517:prevention & control*; D018166:Health Care Reform / Q000592:standards*; D006282:Health Personnel / Q000193:education / Q000592:standards; D006801:Humans; D008134:Long-Term Care / Q000191:economics / Q000458:organization & administration; D009735:Nursing Homes / Q000191:economics; D058991:Patient Protection and Affordable Care Act; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D058996:Quality Improvement / Q000191:economics*; D013192:Staff Development / Q000458:organization & administration; D014481:United States; D000078329:Workforce