The sweet irony of a nursing home report card

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James M. Berklan
James M. Berklan

It's said that politics, among other things, makes for strange bedfellows. Add long-term care quality improvement efforts to the list.

When last we heard from Brian Lee, he was doing his level best to point out any nick or flaw discernible in Florida long-term care facilities. Again. And Again. And Again. And again …

It had become so unrelenting and predictable, you could be excused for viewing him like the acquaintance who emails you IN ALL CAPS! ALL THE TIME! 

You tend to stop listening and reading.

Lee, of course, is the former Florida state long-term care ombudsman who became embroiled in some nasty political battles and lost his job. Which came first, the nasty politicking, the battles with provider associations over the request for more ownership information or the loss of job gets a bit tangled.

But it's safe to say, he, the state's outspoken long-term care operator association and former Gov. Rick Scott firmly were not on amiable talking terms after Lee's dismissal.

Refusing to slink away with drooped shoulders, Lee has fought back with ALL CAPS!-type vigor. Part of his campaign was the founding of Families for Better Care, a consumer-based organization advocating for better nursing home and skilled nursing care around the country.

The endeavor includes a grading system for each state's nursing facilities. And that's where our story gets interesting.

The second annual batch of Nursing Home Report Cards was released Friday and who do you think emerged in the national Top 10? If you said Florida, you earn a sand dollar.

In fact, if you said Florida would get an “A” and be ranked No. 6, up from a “B” and the No. 11 ranking a year ago, you get to go to the head of the dessert line.

In a remarkable display of candor, Lee's watchdog group gave props to the same professionals that got him fired three years ago. Lee's report card did not shy from noting that staffing levels had improved and deficiencies were down in Florida. (His group also duly noted other states' grades, including extremely poor performers such as Texas, Louisiana, New York and Illinois.)

Emmet Reed, the executive director of the Florida Health Care Association, found the irony delicious.

"Even our harshest critics have no choice but to acknowledge that Florida's nursing facilities are among the best in the nation," he said in a statement.

Lee acknowledged his unusual position and paid a measured compliment, followed by a caution.

"Florida should be proud of this year's nursing home ranking, but let's not break out the champagne and caviar just yet," he told Barbara Peters Smith of the Sarasota Herald-Tribune. "Roughly 20 percent of our nursing homes remain on the state's watch list for dangerous conditions. So it seems we still have a host of nursing home problems that need correcting, starting with hiring enough professional nurses to supervise, train and support frontline caregivers who care for our loved ones."

Florida's and all other providers should take his words to heart — and then get to work on rising even higher in the grading system next time. Put the champagne and caviar on Lee's tab if it happens.

James M. Berklan is McKnight's Editor. Follow him @LTCEditorsDesk.

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.

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