Across the United States, thousands of nursing homes serve more than 1.2 million frail older adults and people with disabilities. Nursing home care quality varies widely, and there are significant disparities in care and outcomes for residents. A history of underinvestment and inadequate enforcement of state and federal quality standards has led to a long-term care system that is challenged to effectively meet the needs of nursing home residents. Emerging evidence and innovative models offer opportunities to address these systemic challenges and provide care and services that are more person-centered and equitable, as well as improve outcomes for nursing home residents.

Health care stakeholders, including policymakers, health plans, and nursing home providers, can use this Better Care Playbook Collection to understand recent evidence on improving nursing home quality of care, including policy and practice reforms related to care models, organizational factors, staffing, and transparency. The Collection includes evidence-based strategies that promote greater dignity and equity for residents and staff, as well as highlights promising nursing home models, particularly small-house nursing homes.