Legislation advocacy Statement

Legislation Grid Template

Health-related Bill Name	Nursing Home Reform Modernization Act of 2021
Bill Number	S.315 117th Congress (2021-2022)
Description	The bill intends to alter Social Security Act sections XVIII and XIX to provide excellent care for skilled nursing institutions and nursing facility residents, among other interventions. Several regulations are included in the law for Medicare skilled nursing institutions and Medicaid nursing facilities. The suggested rules should cover whistleblower rights, minimum staffing numbers, and nursing training. In addition, the bill mandates unique consent processes for the administration of certain psychotropic medicines and forbids the employment of pre-dispute arbitration agreements in such institutions. In addition, the law requires particular consent processes for the administration of certain psychiatric medicines and restricts the use of pre-dispute arbitration agreements in nursing care facilities.
Federal or State?	It is a Federal bill introduced to Congress for the first stage of the legislative process, which is a function of the federal government.
Legislative Intent	It establishes minimum nurse-resident ratios for the day, evening, and night shifts and prohibits institutions from retaliating against residents or employees who submit complaints or participate in investigations; violators face civil fines. Nurses must also be trained on emergency protocols and resident rights at facilities. Adopt precise consent processes before giving psychotropic medicines, and prohibit the use of pre-dispute arbitration agreements in nursing homes. Suppose a facility has ignored the standard minimum requirements. In that case, the Secretary shall deny any further payments to beneficiaries within the setting effective after it is discovered and impose a civil penalty in terms of money not exceeding $10,000 for each day of noncompliance.
Proponents/ Opponents	Proponents: They include Congresswoman Jan Schakowsky, a member of the Subcommittee on Energy and Commerce House Committee, and Senator Richard Blumenthal, who introduced the bill to Congress. The bill is also supported by two other members of the Senate and 25 members belonging to the House of Representatives.
Proponents/ Opponents	Opponents include The protection of residents coalition for nursing home facilities.
Target Population	The general public, comprising about 1.3 million patients who receive services from the facilities in the U.S
Status of the bill (Is it in hearings or committees?)	It was presented before the Senate on February 12, 2021, and it is currently in the initial stage of its legislative procedure. It was presented in Congress for review and will now be studied by the committee before being submitted to the House or Senate.
General Notes/Comments	Nurse institutions must offer appropriate healthcare services to meet all clinical requirements of their patients daily, organized into the day, evening, and night shifts (Margadant et al., 2020). Establish the minimum medical staff requirements for every shift following the requirement. To achieve the criteria, facilities would provide a total baseline of 4.1 hours in service delivery per patient each day, with a registered healthcare professional delivering 0.75 hours, a certified practical practitioner providing 0.54 hours, and a nursing aide contributing 2.81 hours, the total minimum. Shifts necessitate the presence of at least one registered nurse practitioner, one certified practical caregiver, and one nursing aide. The Secretary may allow for increased minimum staffing requirements in institutions with a more significant percentage of patients requiring substantial acute care and attention. Therefore, facilities may surpass the typical staffing levels depending on the organization’s demands. If a nursing clinic self-reports and timely rectifies a shortfall whereby a punishment has been imposed within a three-period year preceding the date of the imposition, the Secretary may still decrease the sum of the penalties enforced by a maximum of 50% or less than 25% where the hospital has been penalized underneath the provision within the three-period preceding the date of the implementation and yet had profited from these other waivers within the previous year. The Secretary shall also post on the Department of Health website the names of facilities that violate the minimum staffing clause. In conformity with the staffing provision, the Secretary can appoint interim managers to supervise the institution’s functioning to ensure the security and well-being of the hospital’s inhabitants. A nursing home should not retaliate against anybody who opposes the hospital’s practice, policy, and action that is claimed to breach, violate, or fail to adhere to the legislation.

Legislation advocacy Statement

The Nursing Home Reform Modernization Act of 2021 proposes establishing standards for minimum staffing levels and promotion of nurse training, which supports my advocacy statement. In my advocacy statement, I propose that facilities be required to employ a certain number of employees depending on the size and services offered to increase efficiency by facilitating timely access to services. I would also propose that continued training be carried out for nurses to equip them with the knowledge to handle modern trends in practice. The bill supports my advocacy statement because if passed, facilities would have to comply with the clause, thus improving service delivery to patients. Once a set number of professionals are available within each facility, patients would spend less time queuing for consultations, diagnosis, and treatment services; thus, it would generally improve efficiency and enhance patient outcomes.

Evidence to support my advocacy statement lies in the research showing that patients within understaffed nursing homes are at the risk of an increased rate of in-hospital mortality, a higher rate of postoperative complications, a greater risk of infection, and are exposed to a greater risk of medical errors which affect their health outcomes negatively (Jansson et al. 2020). Anyone opposing the advocacy statement must understand that research shows that understaffing and lack of continued employee training reduce efficiency. To improve and solve the challenges, facilities would have to employ a standardized number of professionals to offer health services, reducing the patient-nurse ratio and thus increasing efficacy since professionals are not overwhelmed and can be efficient. In addition to the increased efficiency caused by standardized staffing, the bill also helps solve the problem of adapting to the rapid evolution of healthcare practices because of technological advancement, which renders some nurses unable to incorporate modern practices. Therefore, training would equip nurses with the necessary knowledge to deal with emerging issues.

References

Margadant, C., Wortel, S., Hoogendoorn, M., Bosman, R., Spijkstra, J. J., Brinkman, S., & de Keizer, N. (2020). The Nursing Activities Score per nurse ratio is associated with in-hospital mortality, whereas the patients per nurse ratio is not. Critical care medicine, 48(1), 3-9.

Jansson, M., Ohtonen, P., Syrjälä, H., & Ala‐Kokko, T. (2020). The proportion of understaffing and increased nursing workload is associated with multiple organ failure: A cross‐sectional study. Journal of Advanced Nursing, 76(8), 2113-2124.

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Question

Assignment: Legislation Grid and Testimony/Advocacy Statement
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Legislation advocacy Statement

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)

Be sure to add a title page, an introduction, a purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?
Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Describe how you would address the opponent to your position. Be specific and provide examples.
At least 2 outside resources and 2-3 course-specific resources are used.

Legislation advocacy Statement