The Moving Forward Coalition - a National Movement to Improve Nursing Home Quality

In April 2022, the National Academies of Science, Engineering, and Medicine (NASEM) issued a bracing report of nursing home quality in the wake of the disproportionate number of COVID-19 related deaths in nursing homes and assisted living communities during the pandemic. The 600-page report offered an array of recommendations for improved quality. Shortly thereafter, The John A. Hartford Foundation funded efforts to convene experts across sectors and disciplines - including nursing home residents - to work together to address the NASEM recommendations and entrusted this effort to LeadingAge, a non-profit long-term care advocacy organization. The resulting Moving Forward Coalition (MFC), is now in its second year and closing in on starting to test a variety of improvements in nursing homes across the country.

The Coalition's work was originally divided up among seven committees reflecting the seven goals outlined in the NASEM report. Over the first year of the Coalition's work, as individual committees created action plans to structure and organize the work ahead of them, it became clear that there was overlap among the committees. As a result, the nine formal Action Plans laid out on the MFC website, reflect deep study and collaboration to generate as much positive change in nursing home care as possible in the short term. Longer term efforts are also needed and the Coalition is laying the ground work for federal and state policy and culture change that is long overdue. 

As one example of change, Goal Committee One has focused on developing a guidebook that will help nursing home leaders and managers deepen the conversations with residents and family members around each resident's preferences and priorities for daily care. Too often care staff make decisions on behalf of residents that, while well-meaning, may not truly reflect what is important or meaningful for that particular resident. The guidebook will support nursing homes with training content, assessment forms, and templates that encourage including residents and their family members in care conversations in ways that are better aligned with individual sensitivities, personality, temperment, capacity, and identity, with the goal of identifying and delivering care that is truly person-centered.