As frustration grows over the way the nursing home industry has been regulated and cited over the course of the pandemic, some lawmakers are questioning why the fines and civil monetary penalties being doled out don’t seem to reflect the quality of the care being provided.
In Michigan, for example, there appears to be little correlation between the number of citations that nursing homes receive and the quality outcomes that are trying to improve.
At least, that’s how Michigan State Rep. Bronna Kahle, of Adrian, sees it, and why she introduced House Bill 5609, which was referred to the House Health Policy Committee for consideration last week.
The bill seeks to establish more clear and consistent standards for health care surveyors in Michigan moving forward.
“Why do we need this bill? Because we need to make sure that clear, concise and consistent standards are established and are followed, when it comes to these healthcare surveyors employed by the state going out into our nursing homes,” Kahle told Skilled Nursing News.
Kahle would like to see a regulatory process that recognizes the struggles and successes of individual providers and that offers support and guidance through the pandemic, rather than just creating more hurdles by way of unfair regulation practices.
Kahle referenced a 2020 report comparing citations to outcomes in major metropolitan areas that showed how consistent the survey and regulatory process has become.
“In Michigan, we’ve been cited at more than four times the national average for staffing ratios,” she explained. “The fact is we are well above comparable national staffing ratios.”
Kahle said the bill is not intended to minimize the importance of oversight on skilled nursing facilities, but she wants to bring some consistency to citations for state’s nursing homes, who seem to be an “outlier” in both the frequency, scope and severity of citations.
“Another example is we want our facilities to reduce their use of psychotropic medication,” she explained. “Michigan is a leader in decreasing the use of this medication in our skilled nursing facilities, yet, more than a fifth, 21.8%, have been cited for this, while the national average is 17.8%.”
These numbers show that citation patterns are not supporting the shared goal of a quality outcome, according to Kahle.
“These facilities have struggled and adapted and ultimately have become more agile and innovative through the pandemic and it seems like rather than the state recognizing the struggles they’ve been through … it seems like the state, through the regulatory process, is yielding a big stick that isn’t leading to a better outcome of care,” she added.
