Raising the Bar for Physicians Practicing in Nursing Homes: The Path to Sustainable Improvement

Improving the quality of care provided in nursing homes (NHs) has been the driver behind most of the major governmental sponsored reports and related legislation/regulation in NHs over the past 4 decades. Starting with the Institute of Medicine (IOM) report in 1986 and culminating in the recently released National Academy of Science, Engineering and Medicine (NASEM) treatise on NH quality, there has been a consistent emphasis on the critical role of the health care provider.1,2 The nursing profession [registered nurse (RN) / licensed practical nurse (LPN), certified nursing assistant (CNA)] has deservedly attracted special attention given their critical role in patient care and the fact that they constitute the bulk of the NH workforce.