A DEPARTMENT of Human Resources official said, it was reported in the newspaper the other day, that the District's inability to provide for its aged poor is a crisis that "gets worse by the day." Few know this better than the Little Sisters of the Poor, the group of women who run St. Joseph's home for the elderly in Northwest Washington. At the moment, the Sisters, along with several others involved in nursing home care (whether public, private non-profit or private commercial operations) are trying to ease a pressure they see as part of the crisis: the District's regulations for nursing homes. The fear is that the regulations impose so many excessively burden-some standards that the costs and bother of meeting them have come to interfere with nursing care rather than strengthening it.
As enacted in June 1974, the Health Care Facilities Regulations were a response to abuses that had persisted for years in some of the city's nursing homes. As shocking as the abuses may have been, many people have been persuaded that the regulations - which are more stringent than the federal ones - need to be reviewed. One regulation, for example; demands that "nursing personnel shall observe in the record that patients are served diets as prescribed." Is that what staff time should be devoted to - at breakfast, lunch and dinner, writing down the details of each patient's diet? Wouldn't it be enough to record any dietary problems, and let it go with that? Other regulations call for telephones and televisions in every bedroom, doors in the bedrooms that are "lockable from the inside or the outside by the patient," and one room for toilet-training in each nursing unit of eight patients. On the last, the HEW standards call for one such room per unit, with nothing stated about the number of patients per unit.
Having lived with the regulations, Sister Marie Candide of St. Joseph's argues persuasively that the paperwork alone is crushing, and never mind the added operating costs. At a time when many nursing homes are leaving the city and when the shortage of beds is critical - especially for the elderly poor - it has to be asked: How many of the regulations actually relate to safety and health care and how many superfluous?
Hearings have been scheduled for March 1 by Polly Shackleton before the city council's Committee on Human Resources and Aging. A second look at the regulations is obviously needed, with some sense of the priorities of hard-pressed staff members and the real needs of the patients uppermost in mind.