OP-ED: Nursing home questions highlight flawed survey system


This summer, Pennsylvania's nursing facilities were the subject of unflattering reports, and even a lawsuit by the state attorney general, when it was alleged that some facilities failed to meet the most basic human needs, falsified records and deceived state inspectors.

With those allegations about one large operator in Pennsylvania came questions about care, records and inspections at every nursing facility around the state.

Yes, there are chronic problem facilities that do not provide quality care, and they need to be penalized. However, most would agree that the vast number of nursing facilities within Pennsylvania provide good care.

Still, the attorney general's case highlights the problems with the federally mandated survey system — a system that must be adhered to by the Department of Health (DOH) and that treats all nursing facilities the same way.

Simply stated, the current survey method does not work. This system lumps historically good with historically poor facilities through an annual inspection that lasts approximately five days utilizing five surveyors. The well-performing facilities are treated exactly the same as the poor performers, which does not help residents, families, friends or employees.

The time has come for this system to change. We need to treat historically good facilities and historically poor facilities differently. For example, a survey for a good facility could be shorter, unless problems are noted, which would allow surveyors to survey poor facilities more closely and more often.

Similar to policing in cities, where more police are devoted to higher crime-rate neighborhoods than lower crime neighborhoods, the DOH needs to be allowed to devote more time to the poor-performing facilities to correct, recommend, fix and address the problem happening, rather than spending the same amount of time at a facility that performs well.

To its credit, the DOH has requested the state auditor general to review its survey and complaint process. It also is forming a Nursing Home Quality Improvement Task Force comprised of industry experts and stakeholders who will be responsible for addressing the quality care in long-term care facilities. Additionally, the department has begun to identify ways it can bolster communication among consumers, agencies and facilities when concerns arise about a specific facility.

This could be a positive first step for Pennsylvania, but the root of the issue still resides in Washington. The federally mandated survey system needs to be reviewed by key stakeholders. We have an aging population that deserves to be treated with respect and dignity before a real tragedy happens.

It is time for those in Washington to address the survey system before another troubling story makes headlines, sullying the reputation of all providers.

— Ron Barth is president and CEO of LeadingAGe PA, a trade association representing more than 370 not-for-profit providers of senior housing, health care and community services across the commonwealth.