An ad hoc committee of the National Academies of Sciences, Engineering and Medicine will examine how our nation delivers finances, regulates and measures the quality of nursing home care with particular emphasis on challenges that have arisen in light of the COVID-19 pandemic. The committee will consider a broad range of issues such as:

• Ways to generate and assess the evidence base for interventions, structures, policies and are models to promote care innovation while assuring quality of care;
• The impact of current oversight and regulatory structures (including enforcement and penalties) on care quality and outcomes, which may include an examination of the meaningfulness of the current five-star rating system and how it is interpreted by consumers and clinicians, and/or the validity, efficiency, and effectiveness of the current survey and certification structures and methods, including inspection standards, training of surveyors and their adherence to standards;
• The appropriateness of current emergency preparedness regulations and strategies for nursing homes in light of different environmental and pandemic threats to residents;
• The influence of current nursing home real estate ownership and payment models on the delivery of high-quality care and regulatory compliance;
• The role of the facility medical director as the clinical leader in nursing homes;
• Strategies to attract, train and retain a more skilled workforce to nursing homes and survey agencies;
• The role of nursing homes in the continuum of post-acute and long-term care.

The committee will develop a set of findings and recommendations to delineate a framework and general principles for improving the quality of care in today’s nursing homes, delivering high-quality care in a consistent manner, and ensuring the safety and well-being of residents and staff in nursing homes. The committee may also consider the relevance of their findings and recommendations to other long-term care settings if applicable.