A most serious problem

John O'Connor
John O'Connor

This field is beset by numerous challenges.

There is never enough funding. Regulations are overwhelming. And staffing concerns never seem to take a holiday.

To be sure, these are all difficult issues. But they are not the sector's biggest problem. The answer to what is should be obvious, but it rarely gets discussed: universal mistrust.

Start with operators. Most clearly don't trust regulators or lawmakers. The reason is fairly simple. Only a masochist would put trust in those who seem to delight in making life miserable. 

Nor do facilities seem to place much trust in residents or their families. That's not to say operators do not try to provide the best care possible. But the reality is that each resident and family represents a potential lawsuit. 

A cynical assessment? Perhaps. But I'm not the one fighting hammer-and-tong to keep arbitration agreements in place. It's a sound legal strategy. But what does this approach tell you about the level of trust operators have toward their customers? 

And it's not like this is a one-way street. Why are regulators constantly adding new rules to the mix? Well, it's not because they believe operators are doing a swell job. Same goes for lawmakers. 

How did we get to this impasse? I don't think there is one answer. 

To be sure, the way many operators have conducted themselves has hardly helped. There's a reason why nursing homes have not historically enjoyed a stellar reputation. Yes, things have improved tremendously. But to believe that every facility is now is a paragon of virtue is to be incredibly naïve.

There are also plenty of families that have behaved less than scrupulously. Chances are you know some of them all too well. Collectively, this universal mistrust has created a less-than-ideal atmosphere. More troubling still is the sticking power this challenge is likely to have.

The usual laundry list of problems facing this sector basically comes down to money. 

But how do you get different parties who have little or no faith in each other to suddenly come around? That sort of lost capital is far more difficult to replace.