By Steve Moran
The harsh reality of senior living is that things will go wrong — even in the very best communities where there is a massive commitment to quality and to doing the right thing, to doing what is best for residents and their families.
As we serve residents, there are frequently choices that need to be made, and none are perfect. Protecting residents from falls requires a measured balance between protecting against falls and ensuring good quality of life. We know we can, in theory, prevent all falls if we keep people strapped into bed and into wheelchairs. For almost every resident, the risk of falls is worth a higher quality of life.
That risk could be from an employee that simply makes a mistake, but is otherwise a good employee.
It could also be from a rogue bad employee you thought was going to be a good employee, who did something really bad in spite of the safeguards you have in place.
Good and Not So Good Communities
I am realistic enough to know that there are some operators — not many — that really don’t care as much about quality as they should. They give lip service to quality, but in practice, shaving costs is a higher priority than protecting residents.
When it comes to those communities, the entire senior living ecosystem should raise a loud cheer when they get in trouble.
Regulating Everyone
Here is the problem. The very best communities are regulated — and judged by the media and the public — by the same standards as the worst communities. Lumping them together is simply unfair, and doing so hurts society, hurts residents, and leads to overregulation and higher costs for everyone. It creates unnecessary and unreasonable fear in the eyes of the public.
What happens in reality is that poorly run communities actually end up being judged less harshly, because when inspected, there are so many terrible things happening that the less terrible infractions get ignored (those same infractions that would be cited in well-run communities). When great communities are inspected, those doing the inspecting feel like they need to find “some things.” And because the regulations are so complex and detailed, there always is something.
It’s a bit like traffic regulations. I promise that pretty much every time any one of us drives, we break a multitude of rules. Mostly these instances get ignored, even when observed, because our entire system would break down if we were cited each and every time.
A Better Way
I don’t know if it has ever been done in any industry, but we need a regulatory system where those who are committed to quality and are executing on that quality should have more grace and more cooperation from the regulators.
The regulatory approach should be, “We know your commitment to quality and to quality of life for residents. Let’s sit down at the same table and figure out how to make it work together.”
I do know that in some jurisdictions this does happen, but too often it is combative and contentious, which results in making it worse for everyone.
The Promise We Make
When a resident moves in, they receive a set of promises about what the community will do for that resident. When it goes wrong — really wrong — even in those well-run communities, there need to be consequences, but those consequences need to be proportional to both the damage that was done and the pattern of the operator.
We need to be having these frank conversations with the public, with politicians, with the press, and even with those activist gadflies who think there never can be enough regulations. Right now what we have is not working. It hurts quality of life for residents, and it makes senior living more expensive.
