November 2018 LTCN, Katie Smith Sloan

One of the nursing home industry’s top leaders is firing back at a Washington Post opinion piece that alleged that SNF care is declining because of fewer regulations and lax oversight.

LeadingAge President and CEO Katie Smith Sloan wrote Wednesday that such assertions are “not based in fact.” She said it is “simply inaccurate” to draw conclusions that U.S. nursing homes do not meet quality standards, as the Post did previously, based on one organization’s analysis of fines against just 40 poor performers out of a pool of more than 15,000 facilities.

“The focus on fines imposed as a measure of whether nursing homes are meeting quality standards — and even more important, whether they are providing good, person-centered care — is misguided,” Smith Sloan wrote for the Morning Consult.  

Her rebuke came in response to a March 25 piece by a Washington Post opinions editor, in which Robert Gebelhoff argued that some of the biggest victims of President Trump’s deregulatory agenda are America’s nursing home residents. As one example, he cited a March Kaiser Health News report that concluded that SNF fines are down by nearly one-third since Trump took office. An analysis from the Center for Medicare Advocacy also claimed that administration has “largely pulled back” its enforcement of special focus facilities, issuing increasingly smaller fines.

Smith Sloan countered that those facilities account for a tiny fraction of the nation’s nursing homes, and fines are just one component of an entire program surveyors use to address compliance challenges. Equating penalties as an indicator of care quality is flawed, she added, with the number and severity of penalties varying widely by state. “The numbers alone beg questions,” she noted.

The leader of LeadingAge — which represents almost 2,000 nonprofit SNFs — agreed that poor performers must improve, but said making sweeping generalizations based on a small set of data isn’t helping.

“We do not tolerate bad care. But to suggest, based on the analysis of one narrow slice of the whole, that nursing home regulation is not sufficient does a significant disservice to all of us — providers, policymakers and consumers — by misrepresenting the state of care today,” Smith Sloan wrote.