Additional nursing home inspection rules are not the answer

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John O'Connor
John O'Connor

Many skilled care operators struggle to keep up with a seemingly never-ending array of survey and certification regulations. By some estimates, this is the second most heavily regulated field in the nation, trailing only nuclear power.

But if two lawmakers get their way, providers can look forward to a large heaping of additional rules.

A letter cosigned by Sens. Bill Nelson (D-FL) and Charles Grassley (R-IA) calls on CMS to develop additional requirements that “identify problems that exist before they compromise patient care.”

Fortunately for providers, the correspondence does not also include mandates for providers to cure cancer, irrigate the Mojave Desert, or permanently end sibling rivalries. But it's safe to say that the first mandate has about as much likelihood of happening as the other three.

In fairness, the intent of the letter is understandable. It responds to a report from federal inspectors that concluded that about 22% of Medicare beneficiaries experienced an adverse event during a post-hospitalization skilled nursing facility stay in fiscal year 2011 — and that most of these events were preventable.

In case you're wondering, an adverse event was defined as an incident of patient harm that extended the SNF stay, sent the beneficiary back to the hospital, required a life-sustaining intervention or resulted in death.

Lest I be accused of being an apologist for the nursing home field, let's make one thing clear: All possible steps should be taken to avoid such mishaps.

That includes going after operators who are not living up to their end of the bargain. If facilities are engaged in shoddy or illegal activities, they should be arrested and prosecuted to the fullest extent of the law. Or sued. Or both. You want to clean up a preventable mess, those are the best, quickest ways to do it.

What's not needed are additional rules on top of the thousands of pages of regulations that these two lawmakers insist are not working.

The reality is that most operators are doing their level best to provide good care and play by the rules. These are not the people that lawmakers and regulators should be targeting.

As for the field's incompetents, swindlers and other scam artists: The sooner they are put out of business, the better.


John O'Connor is Editorial Director at McKnight's.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.


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