Vincent Mor, Ph.D., Edward Alan Miller, Ph.D., M.P.A., and Melissa A. Clark, Ph.D.
V. Mor, E. A. Miller, and M. A. Clark, "The Taste for Regulation in Long-Term Care," Medical Care Research and Review, Aug. 2010 67(4 Suppl.):38S–64S.
Concerns about the quality of long-term care have resulted in an array of regulations governing the behavior of health care providers. Published in a special supplement to Medical Care Research and Review and drawing from the Commonwealth Fund Survey of Long-Term Care Specialists, this article documents the views of those specialists regarding the quality of nursing homes, home care agencies, and assisted-living facilities, as well as the adequacy and appropriateness of government oversight.
More than half of survey respondents (53.3%) ranked the quality of care provided by the average nursing home as fair or poor, and about one-quarter gave a similar rating to the care in the average assisted-living facility (29.2%) and home care agency (24.3%). There was relative uniformity in opinions about different regulatory strategies for nursing homes: between one-quarter and two-fifths of all respondents felt that the federal government had done well or very well in establishing quality standards. However, less than 5 percent of consumer advocates and only one-fifth of providers and public officials felt that the government had done well or very well in actually enforcing them. Despite the perceived ineffectiveness of the current regulatory regime, the majority of specialists expressed a general willingness to continue pursuing more stringent and enhanced enforcement.
The authors note the “disconnect” between how specialists perceive the quality of long-term care and “their general willingness to continue pursuing more stringent and enhanced enforcement” of existing government regulations. Further examination of this phenomenon, they say, is warranted.