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Congress should make pre-dispute mandatory arbitration provisions in LTSS contracts unenforceable. 

The federal government and the states should not accept accreditation by private bodies in lieu of federal or state licensing, certification, or enforcement of standards.

States considering payments to LTSS providers based on improved quality outcomes should rely on data from pilot projects developed with strong consumer participation.

States should ensure that facility-specific survey results and other information regarding quality are made available to the public in a timely manner.

More federal funding should be provided to the Administration for Community Living to develop and implement its emergency management responsibilities on behalf of older peo

Federal and state policymakers should support unbiased assessment of palliative care needs as well as improved access to palliative care services regardless of setting (e.g., nursing facility, resi

Federal and state governments should monitor compliance with the Nursing Home Reform Act and other laws and regulations affecting nursing facilities.

A progressive income tax is the preferred method of raising revenue at the federal and state levels. Other sources, such as a consumption tax, may be needed. 

Due to their regressive nature, raising state and local sales taxes should not be the first choice for increasing tax revenues. 

States and localities should include services in the taxable base to reduce regressivity and improve neutrality.