Why Regulations Aren’t Enough

It’s no surprise that nursing homes are heavily regulated—practically everything we do falls under government scrutiny. However, you might be surprised to learn how those regulations are potentially limiting the care your loved one receives.

In this article, we will explain how your loved one may be missing out on the best care and what we do at The Maplewood to overcome this industry-wide problem.

To understand the problem we need to take a moment and talk about the regulations that apply to nursing homes in Rochester, NY and across the country.


Back when Ronald Regan was president, there was a drive to improve the quality of care provided by nursing homes. Congress passed the Omnibus Budget Reconciliation Act of 1987, better known as OBRA-87. OBRA-87 dealt with a host of national issues at the time, but a significant part of that act was devoted to the establishment of federal regulations for nursing homes.

OBRA-87 was a great step forward in dealing with what had become a problem—nursing homes that did not have the best interests of their residents at heart. It’s sad, but many homes had been allowed to provide substandard care up to this point. OBRA-87 aimed to resolve that issue.

It’s been over 30 years since OBRA-87 became law. Today most states have adopted it as their standard and bad actors are being held more accountable. Even so, there are two problems with these regulations that result in nursing home residents not getting the best care.

Paradigms Matter

The first problem is OBRA-87’s age, and more specifically, the paradigm it creates.

We know so much more about nutrition and how it contributes to health. Physical therapy has become more effective, giving seniors more mobility and stability. Medicine has made great strides forward with new treatments, new technologies, and new drugs. Our nation’s overall approach to healthcare has undergone tremendous changes, as has the way we deliver care to those in need. Even the way we approach healthcare facilities is changing with new layouts, new functions, and new features all designed to provide better care.

Of course, updates have been made to OBRA-87 in an effort to keep pace with the fast-changing healthcare landscape. The problem isn’t so much with the details of OBRA-87, but rather with its paradigm, which is rooted in a decades-old understanding of medical care.

This results in nursing homes that are stuck in an old paradigm with many of the advances made in healthcare and lifestyle passing by. These homes could be implementing new technologies and new ways to deliver better clinical care but are hesitant to do so for fear of falling afoul of regulations made for a different time.

Unfortunately, it’s the residents that miss out on opportunities to experience better care and a better life.

When the Minimum Becomes the Goal

The second issue has to do with the nature of all regulations, regardless of industry. In short, regulations are not designed to describe ideal care. Rather, they identify what is minimally acceptable. That’s the nature of regulations. They are put in place to eliminate bad care, and to do so they define what is good enough to not be considered unacceptable.

To make this work, government agencies must aggressively monitor, test, and grade nursing homes against regulations, heavily penalizing homes that don’t measure up.

Because there is so much focus on regulations, organizations tend to treat them as the goal and not the minimum. They manage their staff against regulations, design their work to meet regulations, and deliver their care based on what’s defined in the regulations. What was meant to be the minimum has become the standard.

We believe that it’s not right to take the focus off of what really matters, which is the wellbeing of your loved one. Don’t get us wrong. We understand how important regulations are in protecting some of the most vulnerable people in our society. We just take issue with people receiving care designed to meet the government’s basic minimums.

Our Purpose is Our Solution

We can’t change outdated regulations or the tendency of organizations to focus on just meeting the minimum. Instead, we’ve created our own solution. We live, hire, and work according to our purpose—our “why”.

Our people—from our administrator to our cleaning staff—get out of bed every morning to provide the best life possible for our residents.

We work hard every day to deliver something special, something distinctly different. We’re inspired by helping each one of our residents enjoy their life to its fullest. That means going well above and beyond what the regulations require: spacious and private living quarters, fresh home-cooked made-to-order meals, engaging spaces to visit with a loved one over a cup of coffee or a cold beer, peaceful and uncluttered hallways, and caregivers that are consistent and respectful.

If you want to find a nursing home that can provide the best life possible for your loved one, dig deeper than details like how well a home meets regulations. Uncover a nursing home’s purpose; their “why”. If you live in the Rochester area, be sure to come and tour The Maplewood. See for yourself what distinctly different looks like.