Why aren't residential care facilities more closely monitored by the individual states?Why aren't residential care facilities more closely monitored by the individual states?

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litteacher8 | High School Teacher | (Level 3) Distinguished Educator

Posted on

No one has the time or money to monitor residential care facilities. Especially in these times of difficult government budgets, everyone is cutting corners. Areas that have always been neglected now get no attention at all. It's always someone else's problem.
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Lori Steinbach | High School Teacher | (Level 3) Distinguished Educator

Posted on

This may seem rather crass, but it seems to me there's one other reason--in addition to the excellent ones listed above--why residential facilities are often improperly or poorly monitored.  As a country, we don't place much value on the lives of the elderly once they're no longer productive members of society.  Ours is a culture of expediency--what can you do for us, how can you contribute to the greater good, are you producing more than you're consuming.  Once their usefulness has passed, the elderly--and especially those who have been placed in such facilities--are no longer valued members to society.  Individually they have worth, of course, but as a group we dismiss them much too quickly and easily...as evidenced by the increasing number of facilities and residents. 

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brettd | High School Teacher | (Level 2) Educator Emeritus

Posted on

In reply to #5: If the states are short of man-power and money

then why are they allowed to license so many facilities?

  Two reasons.  1)  These facilities are state licensed, not federal, so they can license as many as they want, and as a business this increases tax revenue.  2)  We need more and more of these facilities while the baby boom generation ages.  If we were short of facilities, they would be getting pressure from both business and elderly advocates who would say there is a shortage of retirement and nursing homes.  Pressure to monitor and regulate, unfortunately, usually comes after a scandal about abuse or poor conditions.

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brettd | High School Teacher | (Level 2) Educator Emeritus

Posted on

The previous answers cover this subject quite well, but I would like to add on more factor in this equation, and that is the rapid growth nature of the elder care industry as our population ages and the need for residential care facilities grows.  The states are already cash strapped during the recession, and unable to gather the resources necessary to truly monitor the facilities already in existence, much less the tens of thousands of new ones likely to open their doors in the next two decades.

Also, to monitor these places effectively, you have to micro-monitor - that is, you need patient histories, nurse certification records, staffing background checks, etc. to assure that the people in the facility are adequately cared for by trained and supervised professionals.  This is not easy to do in normal economic times, much less during a prolonged recession.

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besure77 | Middle School Teacher | (Level 1) Senior Educator

Posted on

To an extent they are monitored by the state but it is really not their responsibility to become over involved. First of all, the individual states just do not have the monetary resources to do so. Resouces are so limited right now because of the condition of the economy. I have a grandmother who lives in a residential care facility and I have seen many things that should not be happening. When I see certain things that I do not agree with I make sure I speak with management and I always follow through.
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Ashley Kannan | Middle School Teacher | (Level 3) Distinguished Educator

Posted on

The previous post was quite accurate.  The collusion between monetary interests and government influence is strong enough to prevent more stringent regulation of any industry.  The fact that many residential care facilities are owned by private industry only adds to this.  It costs less to use funds to gain political lobby and advocacy from government than it does to ensure that there is a quality of assurance in meeting supposedly stringent government regulations.  I think that this is part of the reason why such facilities are not as closely monitored as they should be.  In many settings, there is a collusive based element that fills in the missing pieces as to why industry and government regulation is not as stringent as it can be.  This might be one of many narratives in terms of relating it to residential care facilities.

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pohnpei397 | College Teacher | (Level 3) Distinguished Educator

Posted on

To me, there is not a scientific answer for this.  Instead, there is a political or economic reason.  Residential care facilities are not monitored more closely because A) state governments do not have unlimited resources to pay inspectors and B) there is a strong bias in favor of the idea that the government should not regulate businesses too intensively.

This second reason has a great deal to do with the lack of closer monitoring.  The industry has lobbyists who push to prevent closer monitoring.  Lobbyists are generally effective on issues like this.  In addition, closer regulation would surely drive up costs in the industry.  Residential care already costs a lot, and consumers would surely not like anything that increases those costs.

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lilred12 | Student, Undergraduate | (Level 1) eNoter

Posted on

The previous answers cover this subject quite well, but I would like to add on more factor in this equation, and that is the rapid growth nature of the elder care industry as our population ages and the need for residential care facilities grows.  The states are already cash strapped during the recession, and unable to gather the resources necessary to truly monitor the facilities already in existence, much less the tens of thousands of new ones likely to open their doors in the next two decades.

Also, to monitor these places effectively, you have to micro-monitor - that is, you need patient histories, nurse certification records, staffing background checks, etc. to assure that the people in the facility are adequately cared for by trained and supervised professionals.  This is not easy to do in normal economic times, much less during a prolonged recession.

If the states are short of man-power and money

then why are they allowed to license so many facilities?

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