Health Care thoughts: Regulatory Weirdness

by Tom aka Rusty Rustbelt

Health Care : Regulatory Weirdness

Nursing homes (SNFs and NFs) are very highly regulated, more regulated than hospitals.

Included in the regulatory regime is a minimum of one survey per year by the state, with additional state and federal surveys possible.

I’ve read hundreds of the voluminous survey reports and am occasionally asked to review a report.

The survey I read recently was quite good, not surprising being a new building with an excellent nursing staff. There were the usual nit-picky citations, and two major cites.

The first major cite was for very minor inconsistencies among nurses notes, QA reports, incident reports and infection control tracking. Emphasis on the “minor.” Dumb.

The second was on the disaster plan. The facility does not have the typical long halls but has a pod structure built around a central area, a very nice building. In the case of wind or a tornado warning each pod would move residents to the safest place in the pod.

The surveyors want everyone moved to the central area, where there are 8 foot high windows facing west overlooking the patio, a perfect source of glass shard shrapnel.

The home has two choices: agree with the surveyors or spend time and money appealing. Agreement is usually the best course of action.

The nurses already have decided – when the tornado siren sounds they will put the residents in the safest place, not the state mandated danger zone.

Never assume regulatory activity really accomplishes its goal.

Tom aka Rusty Rustbelt

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