Let’s talk about Federal Over-Regulation

The nation’s nursing homes are rightly and heavily regulated by the federal government.  Our vulnerable elders must be protected. But as often happens, well-intentioned civil service becomes bureaucratic overreach.

A current example is federal abuse regulations. Did you know that if a nursing home employee does anything that could be considered abuse and the nursing home immediately suspends the employee, investigates, notifies regulators, then fires the employee, the federal government will still penalize and fine the nursing home‽. When that happens, a big red stop sign is added to the home’s federal profile for two years. The nursing home cannot stop a bad actor but gets bashed for doing the right thing. That’s akin to the nursing home being penalized for a safety violation because a meteor hit the building.

That punitive action could encourage nursing homes to not report or to hide abuse. So over regulation ends up harming our precious residents!

It is probably easier for me to discuss this; as of today, LSC has no big red stop signs on its webpages and has a strong 4-star quality average. But we could have stop signs tomorrow!

There is a better way. Instead of doling out punitive action on nursing homes, a collaboration between health care providers and regulators could greatly improve care and services. LSC uses the Just Culture model internally.  Just Culture would be ideal for health care regulators. Just Culture develops systems with basic tenants to console the mistake, counsel at risk behavior, and punish the reckless.

One of my all-time favorite books is The Death of Common Sense by Philip K. Howard.  The out-of-control regulatory environment is a great example of the death of common sense. If we keep pointing out that the emperor has no clothes, maybe one day common sense will prevail.