Does Regulatory Misery Love Company?
Between the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA), HVACR contractors might feel as if they are facing a one-two regulatory punch. Especially on the refrigeration side, new regulations roll out of both DOE and EPA regularly enough to keep things — shall we say — interesting. Even more interesting is that the regs sometimes appear to be at odds with each other: the DOE increases energy-efficiency standards while, at the same time, the EPA proposes to phase out some of the most efficient refrigerants.
However, before we in HVACR start feeling too sorry for ourselves and crying in our beers, let’s remember that every industry deals with some regulation — in some cases much more than we do.
For example, my wife works in the long-term care industry, and I can tell you that nursing homes and assisted living facilities face a crushing weight of regulations. And, rightfully so, you say. We probably all have relatives, friends, or loved ones in one of the various long-term care settings, and we all want safeguards and standards in place to ensure that they’re well-looked after. But, just as in our industry, the regulations can be onerous.
I asked my better half to describe some of the regulations her industry faces. There are so many that she was able to rattle off the following with very little effort.
First of all, nursing homes (skilled nursing facilities in the parlance of the industry) are regulated at the federal level. The government controls a big piece of the reimbursement, and it monitors everything, right down to staffing levels. I don’t believe there are any government regs that mandate to HVACR companies how much (or if) they’ll get paid, or how many people they must employ.
The government offers a website, Nursing Home Compare, to help consumers choose a nursing home. The U.S. government’s Centers for Medicare and Medicaid Services recently changed the rating system to factor in the off-label use of antipsychotic medications for residents with dementia, as well as other changes (including some related to staffing). The result is that nursing homes could be performing exactly the same as they were last year but still get a lower rating.
Here is the link because, let’s face it, as much as we complain about regulations, if you’re looking into nursing homes for mom, you want to know how well she is likely to be taken care of. Government regulations? We don’t like them in our industry, but this is mom we’re talking about here . . .
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Here’s another: In 2014, a public/private collaboration announced new goals of reducing the use of off-label use of antipsychotic drugs in skilled nursing facility residents with dementia by 25 percent by the end of 2015 and by 30 percent by the end of 2016; both percentages are in relation to a baseline rate from the fourth quarter of 2011. In a report earlier this year, the Government Accountability Office proposed expanding antipsychotic med cuts to assisted living and home health care.
Sure, overuse of antipsychotic meds is bad, but nursing homes also must minimize the use of physical restraints. So, now, you have people who are unrestrained and not on meds, walking around a facility possibly posing a physical risk to other residents or staff. Not ideal.
Assisted living is regulated at the state level. Here are some recent happenings:
· Florida: An assisted living community will be fined $500 if it does not conduct a background check on a hired job applicant. Also: If a professional performing a fire safety, electrical, or other type of inspection notices any activity that would not be healthy for residents, he or she is required to report it to the state’s abuse hotline. Yikes! How would you like that level of oversight?
· Texas: New legislation changed an existing law under which a new assisted living community could not accept more than three residents between its first required state inspection and a follow-up inspection (and significant time could pass between inspections). Such a facility could have been built to accommodate 100 or more residents and yet had to sit almost idle while awaiting a second inspection.
California: The state’s Department of Social Services has proposed legislation to phase in increased frequency of inspections and to tighten the oversight of the state’s assisted living communities. Inspections would occur at least once every three years beginning in 2017, at least once every two years beginning in 2018, and annually in 2019.
And this was just an “off the top of the head,” tip of the iceberg of some of the regs faced by long-term care providers. Now, consider that some states don’t even require licensure for HVACR contractors.
I don’t know if thinking that someone has it worse makes you feel any better about the regulatory challenges that the HVACR industry faces. But, maybe it should. So, dry your eyes and deal with our industry’s regulations with a smile, knowing that you’re not alone: everyone faces regulations to some degree. Plus, nobody likes a warm, salty beer.