Image of nurses' hands at computer keyboard

While appealing for more collaborative efforts from government regulators, the leader of one of the nation’s biggest nursing home associations also issued his most blunt challenge to his members to date.

Surveyors should be allowed to offer helpful suggestions to the providers they inspect rather than simply citing deficiencies, said Larry Minnix, president and CEO of the American Association of Homes & Services for the Aging. But at the same time, providers need to be more aggressive about weeding out peers who consistently perform poorly, he said at a news conference Tuesday.

“We need to move the culture from crime and punishment to continuous quality improvement. People who work in these facilities are not criminals,” Minnix said. “At the same time, the bad apples have got to get out. The government is not doing a good job of doing it, and providers are not doing a good job saying, ‘You’re screwing up — you need to get out.'”

Former U.S. Sen. Bob Kerrey, who now oversees a key long-term care quality commission, agreed.

“Self-regulation means you have to regulate your self AND others in the association. Otherwise, you could be in for a lot of trouble,” he said. “One bad apple will, in modern parlance, go viral and affect everyone in the organization.”

More than 8,000 participants, including 4,500 providers, both records according to organizers, are attending the AAHSA meeting this year in San Francisco. The event began Sunday and concludes Wednesday.