There are going to be some hair-pulling, anxious days ahead for nursing home operators.
That much is assured after a federal appeals court recently revealed some of the double-speak silliness providers are going to be subjected to.
In a 2-1 decision, the Second Circuit US Court of Appeals ruled that a nurse does not always have to be part of a government team investigating complaints aimed at, well, a nursing home. Maybe the outcome would have been different if the court filings had always italicized mentions of the investigation location — i.e. a nursing home?
An expert duly pointed out in our reporting on the outcome that a nurse’s perspective in cases involving patients (that is, virtually all cases) would seem to come in pretty handy. Complaints involving falls, wounds, infection control and anything pertaining to nurse aides or patient welfare would benefit from clinical expertise and a trained nurse’s overview. Rather than from, say, a social worker, dietitian or other survey/investigation team member.
The appeals court justices wound up splitting hairs over whether a complaint investigation is the same as a survey, and is thus not bound by the same congressional intent. Extrapolating that logic led to the discounting of nurses’ value. Nursing homes take it on the chin.
On a related front, more and more survey teams have been showing up without a nurse lately. Nurse shortages and the challenge of paying them competitive wages, are partly to blame, officials say. The Centers for Medicare & Medicaid Services and its state partners have struggled to field enough surveyors in recent years, so they’ve compromised on their demands for nurse presence.
The message clearly seems to be that registered nurses aren’t so important all the time so there can be compromises about requiring them so much.
Which brings us back to the double-standard, or at best, mixed signals nursing home operators are having to deal with.
For at the same time that nurses are being devalued in the survey and complaint investigation process, CMS is hyping their importance in its newly promulgated nursing home staffing mandate.
That would be the rule that dictates that registered nurses are so important, nursing homes must now triple their use of them. Given no extra funding to pay for this increase, nursing homes take it on the chin again.
Looping back to that most recent court decision, this seems to be the new slogan: Registered nurses … vitally important, until it’s more convenient to say they’re not.
Such mixed messaging from nursing home overseers is going to do wonders for the growth of the hair implant industry.
James M. Berklan is McKnight’s Long-Term Care News’ Executive Editor and a Best Commentary award winner in the 2024 Neal Awards, which are given annually for the nation’s best specialized business journalism.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
