What Isn’t Happening In AL Regulation…

Our author, searching for evidence of things not seen...

Our author, wearing his Serious Face, searching for evidence of things not seen… (Photo courtesy Andrew Harnik.)

Bill Myers

Good morning, ProviderNation. Sorry to distract you from all the mesquite and margaritas down Texas way,* but the fine folks at the Assistant Secretary for Planning and Evaluation in the Department of Health and Human Services (say that 10 times, real fast) have done some thinking on state regulations of assisted living centers.

The short version seems to be: There’s a lot of them. The full report is here and the executive summary is here.

Most folks agree that the business of elder care is in its revolutionary age (and many assisted living advocates see their sector as the vanguard of that revolution), so it’s interesting to note what isn’t happening even as the profession grows.

Regulatory Certainty

In many other areas, as the businesses grow and diversify, it’s reasonable to expect that at least some of the bigger players advocate for federal regulations. The shibboleth here is, of course, “regulatory certainty,” in which bigger players argue simplifies political economy for everyone. Take whatever you like about the argument, what’s fascinating is the extent to which you just don’t see that kind of advocacy from assisted living providers.

Part of it, a Royal Smart Person tells me, is that, having taken a look a good look at what “regulatory certainty” means for their skilled nursing cousins, many assisted living providers offer a polite, “No, thanks.” (There’s also the fact that, however large assisted living companies have grown, no single player—or even combination of players—is big enough to warp the market.)

But part of it goes to the very revolutionary character of the profession, the smart person adds. Assisted living providers pride themselves on person-centered care, above all else. However you define person-centered care, the essence of it is flexibility. Therefore, any effort to govern from On High jeopardizes the very innovation, dynamism, and rapid-fire responsiveness that many advocates feel defines assisted living.

Alphabet Soup

Speaking of the alphabet soup of regulatory agencies, the good people of CMS and the National Coordinator for Health Information Technology have released final rules that backers say will “simplify requirements and add new flexibilities [cq] for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information.”

CMS’ version of the rules is here and the coordinator’s rules are here.

*And, if you’re not following all of the white-hot, provider-on-provider action as reported by our Managing Editor, the Formidable Jackie Oberst, on Twitter, well,  you go to penalty box…

Bill Myers is Provider’s senior editor. Email him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers.

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