My colleague May Akamine, Executive Director of the Ko'olauloa Community Health and Wellness Center has been kind enough to keep me up to date on the editorials from Consumer Reports and a new commentary by Guest written by Mary Jane Koren, M.D., assistant vice president, the Quality of Care for Frail Elders program at http://www.cmwf.org/aboutus/aboutus_show.htm?doc_id=392798&#doc392798.
Once again, you get some good advice on what to look for in a good nursing home and a call to action from consurmers to demand "better quality". Specifically she states: "Consumers must push industry to provide the kind of care America's elders deserve."
In my neck of the woods in our nursing facilities we work on quality consistently. But, we are finding that the strain to improve quality, increase staffing and develop a elder centered culture is caused not be lack of interest or committment but by a declining revenue stream. As costs go up faster than the increase in the infalation factor which Medicaid provides (and this applies to 80-90% of our residents), we find ourselves in a "no win" situation. Dr. Bill Thomas was here at our facilities last month and he noted that culture change "is very hard work". Boy, is that an understatment. But we are committed. What Dr. Koren fails to acknowlege is that the majority of customers in long term care, that is the residents and their families do not pay for the cost of care. And yet, as time goes by customers are more educated, well read and therefore more demanding in what they expect from the nursing home industry. Nursing homes are the most highly regulated industry below nuclear power. More regulations, more inspections, fines etc will not improve quality in the long run. What is needed is for the nursing home industry, government, consumers and consumer advocacy groups to sit down and re-design the system and the incentives for that system. More on that later
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