Rapid Responses to:

EDUCATION AND DEBATE:
Charlene Harrington
Regulating nursing homes: Residential nursing facilities in the United States
BMJ 2001; 323: 507-510 [Full text]
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[Read Rapid Response] Current Political Events Re: U.S. Nursing Homes
Gerson T Lesser   (10 September 2001)

Current Political Events Re: U.S. Nursing Homes 10 September 2001
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Gerson T Lesser,
Assistant Professor, Dept. of Geriatrics & Adult Development, Mt. Sinai School of Medicine
Jewish Home and Hospital, 120 West 106th Street, New York, NY 10025

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Re: Current Political Events Re: U.S. Nursing Homes

To the Editor:

Charlene Harrington’s most informative article on nursing home (NH) regulation (1) appeared almost concurrently with a statement from the U.S. Department of Health and Human Services that the U.S. federal adminstration was planning to ease regulatory requirements on nursing home operators by “…reducing the frequency of inspections and lessening or eliminating some penalties…” for violations (2). The results of such proposed reductions on patient care would have been predictable; the Australian experience with deregulation of proprietary NHs was described by Braithwaite in the first article of the BMJ series as causing “…a crisis in the quality of care…” and a political backlash (3).

Fortunately, the Bush administration retracted its plans almost immediately (4). One would like to believe that the authoritative information from Drs. Harrington and Braithwaite came to the attention of and influenced some politically wiser heads in the Bush administration. In any event, these authors and the BMJ deserve our gratitude for their concerns for and potential protection of the frail elderly, who are relatively powerless in our increasingly commercialized world.

References:

1. Harrington C. Residential nursing facilities in the United States. BMJ 2001;323:507-10.

2. Pear R. U.S. may ease rein on nursing homes. The New York Times September 7, 2001: A1 & A16.

3. Braithwaite J. The challenge of regulating care for older people in Australia. BMJ 2001;323:443-6.

4. Pear R. Bush swiftly denounces nursing home plan. The New York Times September 8, 2001: A14.

Sincerely,
Gerson T. Lesser, MD

DISCLAIMER: I am a salaried physician at a not-for-profit nursing home. I am sole author and have no professional, financial or other conflicts of interest concerning these matters.