‘Reverse the narrative’ on bad staff to improve nursing home accountability

Healthcare leaders and policymakers must “reverse the narrative” around incompetent or neglectful nursing home staff and work collaboratively to ensure care teams meet regulatory requirements, according to the medical leader of a large skilled nursing chain.

Deep mistrust between frontline healthcare workers in nursing homes and industry overseers has led to an accusatory survey process that pits the sides against each other, said Arif Nazir, M.D., chief medical officer of Signature HealthCARE, during a presentation at AMDA’s virtual annual conference Friday.

“There’s no room for punitive and punishment approaches … in a complicated system like healthcare,” Nazir said.

He called on surveyors to stop looking at mostly well-intentioned workers as if they are all out to do wrong. He compared the current survey approach to beating children who make an error because they don’t know better.

“Nursing homes represent the same issue with all the regulatory issues and patients being sicker,” he said. “You need me to improve, and you’re going to take a million dollars away from me? That doesn’t work anymore.”

He also called on regulatory agencies to reduce the amount of required reporting and to streamline data collection processes.

Nazir is past president of AMDA and served on a survey task force that last year called for engaging geriatric experts in the survey process and recognizing high-performing and innovative facilities rather than assigning blame and focusing on punishments for providers. That group also included geriatrician Michael Wasserman, M.D., then-AMDA president-elect Karl Steinberg, M.D., Alan Horowitz, Esq., RN, and James Lett II, M.D.