![]() ![]() ![]() Generally the inspections deal with the basic floor of quality rather than motivating competencies and caring. NH visits focus on policies and procedures, general considerations like cleanliness (the smell of urine), and reported functionalities (time sheets and patient check lists). Generally state oversight is underfunded and understaffed and it is not a particularly gratifying job. I spent a brief time as a NH inspector and again the system is better than nothing. Every physician who tends patients in a NH can tell you which are good and which are poor quality. I have tended patients in NH with similar "ratings" that range from crude, custodial-oriented care to careful, concerned attentive care. While better than nothing, the stars have only a tenuous relation to actual quality and caring within a facility. There is no "Joint Commission"-like oversight. NHs have every incentive to game them and upgrade themselves whenever possible. NH star ratings by CMMS are functionally crude, superficial and depend on check lists rather than actual observed function. ![]() Nonetheless, it mostly explores parameters that have only a tenuous relation to real world function: It does give some guidance for future improvement using a few objective parameters, e.g. This is an important and well conceived study. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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