Regulations in Long-Term Care Discussion
Regulations in Long-Term Care Discussion
Regulations in Long-Term Care Discussion
Description
There are many federal and state regulations when it comes to long-term care.Using the South University Online Library and the Internet, research any four specific regulations related to long-term care and summarize them. Based on the regulations you identified, respond to the following questions:
What are the benefits and shortcomings of your identified regulations? Which of these shortcomings have an effect on the quality and the cost of health care services? How?
Do you believe there is a link between regulations and better care? Why or why not?
Why do you think long-term care services are subjected to so much external control by government agencies? Provide a rationale for your responses.
How is quality measured in long-term care? Is there only one, or are there several approaches to measure quality? What are they? Who should be given the responsibility to measure quality?
Organizations providing long-term care are staffed with professional, paraprofessional, and support staff, and often volunteers. In the final analysis, the quality and safety of long-term care is dependent upon these individuals’ actions, but their actions can be and are influenced by external forces. These forces can provide guidance, often in the form of standards that establish parameters for structures and processes, and can set expectations for outcomes. External forces can also provide incentives, financial or otherwise, for specific actions that will affect access to and safety of care, and the quality of care and life in long-term care settings.
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These external forces include formal quality oversight mechanisms, purchasers of long-term care, and families. This chapter focuses on three formal oversight mechanisms:
1.
regulatory oversight by federal, state, and local governments;
2.
consumer advocacy programs; and
3.
accreditation.
The committee recognizes that other forces—including mass media, care management and monitoring programs, and contractor standards set by purchasers—also influence provider behavior. The approaches of regulatory oversight, advocacy, and accreditation are somewhat different. Their relative strengths and weaknesses may make them differentially suited to different long-term care settings (e.g., nursing homes, residential care, and home health care) and the individuals receiving care in them. They may complement each other in various arrangements such as that of deemed status, complaint investigation and mediation, or independent confirmation of measures of satisfaction of individuals in long-term care and their families.
Beginning with the development of licensure for health workers in the nineteenth century to the current ongoing government initiatives to define and enforce quality standards, regulation and oversight have figured prominently in efforts to assess, protect, and improve the quality of health care. Basic quality standards define and specify the minimum acceptable qualifications for state licensure and for certification for participation in Medicare and Medicaid. 1 This chapter focuses on the government’s central role in setting and enforcing standards of quality for formal long-term care. It highlights the current status of the basic standards, the survey process for monitoring and assessing compliance, and the enforcement of the quality standards for nursing homes, residential care, and home health care. Throughout the chapter the committee provides suggestions and recommendations for further improvements at both the federal and the state levels.