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States should require that all beds in a nursing facility be certified for Medicaid and Medicare as a condition for the facility’s participation in Medicaid.
States should require adequate numbers of appropriately trained staff to ensure a high quality of care.
Quality measures: Participant preferences and satisfaction should be used as key quality measures.
States should create a transparent and nonpartisan redistricting process. This process should be led by independent and diverse commissions that include representatives of groups.
Federal and state governments should ensure that long-term services and supports (LTSS) programs cover services that support and supplement caregiving by relatives, friends, and neighbors.
Federal and state governments should provide tax credits, other financial assistance, or both to caregivers.
Federal policymakers should develop a comprehensive system for financing Long-Term Services and Supports (LTSS) that includes a new social insurance program to provide a basic level of LTSS.
Ideally, the federal government should finance LTSS through a universal, comprehensive, and publicly administered program such as Medicare or similar social insurance program of shared risk.