I had a surreal experience last night after I fell asleep watching TV. I woke up in a fog to the middle of some movie where innocent villagers were being accused by the sheriff of crimes they were certain they hadn’t committed.
But the town newspaper was having none of their protests. It printed the accuseds’ names and alleged crimes anyway, in essence, making them pariahs in their own communities.
There were no stonings like in biblical times nor burnings like at the Salem witch trials. But the “guilty until proven innocent” implication was undeniable. So was the distance-keeping by others in the area. The lack of subsequent contact, of course, was hurtful, both to personal and business endeavors. And the accused could do nothing about it.
As the story unfolded, many of them, however, were given a “Sorry, good man (or woman)!” shrug and sent on their way about two months later. Not that it had the same fanfare as the original allegations.
A stain remained on the accused. And most people who had steered clear never came back around or realized it was just an “Oops!” moment by the sheriff.
Like I said, a really weird society, in a really weird movie.
No, wait. That was just me thinking about what a movie might look like for nursing home operators under certain circumstances.
Like how the Centers for Medicare & Medicaid Services has decided to post accusations of wrongdoing against nursing homes, even before they are verified as true. It’s not the Old West, but we can forgive some fearful providers if they feel like they’re suddenly in it.
CMS regulators say that consumers browsing for a good home for Grandma deserve to know what might be afoot at a suspected facility. This view has merit at a certain level.
Just ask the Chicago White Sox, a baseball team that invested $12 million to bring in a free-agent pitcher over the winter, only to find out shortly after the contract was signed that Major League Baseball had already been quietly investigating him over accusations of spousal abuse. That’s the type of thing that could earn the player a suspension, or worse, and leave the unsuspecting Pale Hose pale-faced with a big hole in their starting line-up to boot. Do they wish they had been made aware of the allegations? You bet.
I imagine health officials also may point to the fact that in the criminal justice system, some citizens who are arrested for serious crimes can be held in jail until their trial takes place. There is indeed precedence for this, as any viewer of “Law and Order” or any other crime shows can attest.
But is that what it has come to — lumping dedicated professional caregivers into the presumptive guilty pool, along with alleged wife beaters, potential murderers and other felons?
Right now, it seems that long-term care providers are being told to wear the scarlet letter “D” (for “Deficiency”), even before any alleged misdeed can be confirmed. Where is the middle ground? Could a compromise be that a notation on the Care Compare website be made only in cases of potential Immediate Jeopardy? That still wouldn’t be perfect. Some of those citations are among the estimated 25% that are overturned, while many lesser accusations do indeed stick.
Most would-be residents/patients have a short timespan to decide about entering a facility. Surely there must be a way to not automatically shoo them away or keep them scrolling down the web page, looking for alternative facilities. That’s what any thinking adult will do if they see a citation warning while trying to find a new home for a loved one.
No doubt, someone will say the solution is for providers to just steer clear of trouble and don’t give anyone a reason to even consider issuing a citation. But that goes only so far, given the subjective nature of surveys.
If that part of the puzzle can’t get fixed, I have an idea that could create an interesting plot twist: How about publicizing the names of surveyors who write up dubious citations that are overturned on appeal but in the meantime led to a provider’s wrongful impugning for months on end?
Now that’s a different picture altogether, isn’t it?
James M. Berklan is McKnight’s Executive Editor.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.