Series on the Survey Process

Caring for the Ages features an ongoing series of articles on the survey process, written by various long-term care thought leaders. Following are the current articles in this series.

1. LTC Regulations: Devil in the Details
   Is the care in nursing homes better than it seems? Are surveyors' expectations unrealistic? Are expectations reasonable but the means of achieving them flawed? All of the above are true, to some extent. (Caring for the Ages, August 2001, Vol. 2, No. 8, p. 26-28)
2. Why OBRA Regulations & Surveys Can't Fix LTC
   A look at why OBRA regulations provide only a partial foundation for proper LTC practice, and the survey process only occasionally promotes--and often inhibits--desired performance. (Caring for the Ages, October 2001, Vol. 2, No. 10, p. 26-29)
3. SOM Shortcomings: Why the Heart of the Survey is Missing Some Beats
   Now is the time to reconsider how surveyors collect and use information to draw conclusions about facility practices and performance. (Caring for the Ages, November 2001, Vol. 2, No. 11, p. 36-38)
4. Simple Fixes for the OBRA Regulatory Process
   This month's column focuses on specific changes that can improve the OBRA regulatory process. (Caring for the Ages, December 2001, Vol. 2, No. 12, p. 32-35)
5. More Fixes for the OBRA Regulatory Process
   This month's column continues the discussion of specific changes in survey instructions that could improve the OBRA regulatory process. (Caring for the Ages, January 2002, Vol. 3, No. 1, p. 26-29)
6. Drawing Conclusions About Compliance
   This month's column considers how to improve the analysis of survey information to draw more meaningful conclusions about compliance. (Caring for the Ages, February 2002, Vol. 3, No. 2, p. 31-33)
7. Improving Compliance Determination
   This month's column offers suggestions for transforming the approach to scope and severity determination and more effectively summarizing compliance. (Caring for the Ages, March 2002, Vol. 3, No. 3, p. 10-12)
8. Improving Enforcement & Plans of Correction
   The execution of plans of correction is too often inconsistent, and the underlying framework for such plans is not always compatible with performance-improvement principles. This month's column offers suggestions for improvement. (Caring for the Ages, April 2002, Vol. 3, No. 4, p. 31-33)
9. Summary & Key Highlights: Recommendations for Regulatory & Survey Reform
   A summary of the prospects and limitations of the survey process and how it should change in order to improve nursing home care. (Caring for the Ages, May 2002, Vol. 3, No. 5, p. 32-35)
10. Are the OBRA Regulations the Source of All Evil?
    Several common problems of nursing homes nationwide often are inappropriately blamed on OBRA regulations and related surveyor guidance and enforcement provisions. (Caring for the Ages, June 2002, Vol. 3, No. 6, p. 22-24)
11. Interdisciplinary Approach: Dream Team or Nightmare?
    Effective application of the interdisciplinary approach typically promotes good care. But often execution is flawed, resulting in major care problems. (Caring for the Ages, July 2002, Vol. 3, No. 7, p. 11-12)
12. Do Practices Make Perfect?
    In many ways, the survey process and various other forces have fostered or permitted questionable care instead of encouraging good practice. (Caring for the Ages, August 2002, Vol. 3, No. 8, p. 6-8)
13. Who's Really Causing Harm in LTC?
    There are interest groups whose actions often influence laws and regulations that perpetuate, but don't fix, nursing home care problems. (Caring for the Ages, September 2002, Vol. 3, No. 9, p. 16-20)
14. A Hard Look at Alternatives to the Current Survey Process
    Is there an acceptable substitute to the federal nursing home survey process? This column looks at the strengths and weaknesses of several options and suggests additional considerations. (Caring for the Ages, October 2002, Vol. 3, No. 10, p. 35-36)
15. Identifying & Implementing Effective Statewide Approaches to Nursing Home & Survey Reform
    The current turmoil in long-term care has led to a good deal of re-examination. This month's column will consider efforts to change the current situation. (Caring for the Ages, November 2002, Vol. 3, No. 11, p. 7-9)
16. Focusing in on the Critical Role of Nursing Home Owners & Administrators
    The final article in a 16-part series on the survey process summarizes key points and looks at how nursing home owners and administrators can institute reforms that would lessen the need for regulations. (Caring for the Ages, December 2002, Vol. 3, No. 12, p. 29-31)

The above articles originally appeared in Caring for the Ages. Caring for the Ages is an official publication of the American Medical Directors Association, published by Elsevier. The above articles may not be reproduced in any form, print or electronic, without permission. The opinions expressed by the authors are their own and not necessarily those of AMDA or of Elsevier.