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Why We Might See a Resurgence of Resident Rights Citations

Updated: Dec 23, 2022

The world is civil for the most part because of rules and rights. Those are established and maintained by the rule of law. The last 2 years we've seen a suspension of many of these rights because of a public health scare. We are now starting to see the impact of some of these actions taken and some that were even forced upon us. In our industry, Long-Term Care, we saw drastic actions taken to protect the elderly. During the throes of the pandemic, i remember a resident asking me "Do you know how long it's been since i've seen someone smile at me?" That statement hit me hard. I have very strong opinions about lockdowns, but I'll withhold my preaching and focus on a more poignant element of this post.

When we look at what we've done and what we've allowed over the course of the pandemic it is tough for me to say that we did the right thing. There are several studies out there that have concluded that getting vaccinated has no effect on preventing death from COVID19. Of course, these studies are not done by the Pharmaceutical Companies or the CDC as that would require them to admit that forced vaccinations was possibly the wrong answer. The point being that we've suspended many of our basic rights out of fear. We made our residents talk with their families through a glass window like prisoners. We've required residents to stay in their rooms all day, every day for over a year. Our residents' quality of life has been greatly affected. Basically, we suspended almost all of our resident rights. We ignored F550 through F586 for years. In the process we've likely changed our own perspective about what rights our resident have. It is natural.

There is a principle called the Overton Window that is rooted in politics. The basics of the Overton Window is that we have a small perception of what is considered to be acceptable behavior. What is acceptable is within that window frame. But when radical changes or extreme circumstances intervene that window shifts and we have a broadened concept of what is considered acceptable behavior. So how does this affect residents in LTC? As i mentioned previously, we suspended their rights. We largely ignored F550-F586. Even though we've been told to go back to the way things were, we'll likely have some challenges in doing so and we'll likely see a resurgence in citations involving resident rights.

The Top 50 most frequently cited F-Tags accounts for over 80% of all citations given. If you focused your team on those 50 citations you'd almost be guaranteed excellent survey results year in and year out. Of those Top 50, nine of them fall into the Resident Rights category. F-Tag Journal currently has training videos on almost all of the 35 resident rights citations. There are easily over 1,500 specific examples taken from real surveys for the resident rights category. There are over 400 examples for F550 alone. Everyday i see nurses and administrators posting on social media about issues they are having with residents and families that give me the impression that our industry had not fully reverted back to not only respecting the rights of our residents and their families but actively advocating for those rights as we are supposed to. Not just because it is the right and moral thing to do, but because that is actually what is written in the interpretive guidelines. As leaders in the LTC industry, one of our mandates is to educate and advocate for the rights of our residents and their families.

Respecting the rights of others these days seems to be more challenging in recent years. We all want our lives and our environments to be simpler, more cohesive and aligned with our own perspectives and ideology. We choose our friends based on similar values and beliefs. We follow social media influencers that reinforce our convictions. Tolerating differing opinions and opposing viewpoints appears to be a triggering event for a lot of people. It is a sad state of affairs and the reality is there may be no incentive for a solution to this trend of intolerance to differing opinions.

But we must seek to understand that the overwhelming majority of our residents came from another time. They grew up in a time when the internet did not exist. We had rotary dial phones. Our trucks got 8 miles to the gallon. Coffee cost $0.25 cup. They grew up in an era where talking about politics, money and religion were discouraged because it led to conflict. We live in a world of reality television where you can become famous by manufacturing conflict about the dumbest and pettiest things imaginable.

I've made it a point of focus at my facilities to review all 35 of the Resident Rights F-Tags with my staff. I believe that you should too. Not just because it is the right thing to do, but because the window of resident rights shifted the last couple of years but the rules and regulations have not changed. Surveyors know this. They are looking for those violations because they know they turned a blind eye that last couple of years. They also know that you did too. They ignored resident rights violations because their boss told them to do so. We are going to see a major resurgence of citations on resident rights in the coming year. I'd like to go on record now with this prognostication. If i'm wrong, i hope its because we returned to being educators and advocates of resident rights rather than the continued and willful neglect of resident rights. Only time will tell.

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