As nursing home operators across the country work to implement a staff vaccination mandate that many feel singles out the industry, those that work in nursing homes are expressing resentment over how the sector continues to be regulated and scrutinized.

Rather than penalizing and pushing staff out of these facilities even further, Andi Clark, chief nursing officer for Consulate Health Care, would like to see a more proactive and realistic approach to federal regulations moving forward.

“If you’ve had surveys lately, and we have, I think they are pretty ferocious,” she said during a one-on-one conversation at the Skilled Nursing News RETHINK conference this week. “I think they are very unfair. I think they forget how hard we’re still working.”

Clark referenced a recent infection control survey that was done at one of the Consulate’s facilities in which a nurse wore her mask beneath her nose and the facility received what she felt was an unfair and unhelpful citation.

“I think the way they look at regulating us during this time, we understand it needs to be strict, we all want our nurses washing their hands, but I think that it is still a hostile situation,” she said. “I don’t think they’ve appreciated what our team has done.”

At the beginning of the pandemic, Clark was pleased with the way that surveyors worked with industry professionals more.

“I actually thought for a while, and maybe some of you did too, that surveyors were actually being our partners for a little while,” she said. “They were being kind, they were watching how hard our team worked.”

She felt that was more of a productive relationship, but it didn’t last for long.

She also expressed frustration over the regulations that have been put in place over the course of the pandemic.

“I think some of it was put out too quickly,” she said. “There were conflicting regulations between the Centers for Disease Control (CDC), health care, county health care partners, everybody had a different slant.”

When the COVID-19 pandemic started, Clark saw annuals and complaints drop completely and instead were replaced by infection control surveys.

Infection control surveys became the new norm, she explained.

“It’s almost like they thought, we’ve ignored you for a little while so we’re going to get back at this and I think for our teams in the building that’s a little hard to take,” she said. “I think the other thing around regulation that we are seeing more and more is that there’s no such thing as substantial compliance.”

The tension and hostility that she felt prior to the pandemic has come back in a big way.

“After a little reprieve, I was actually hopeful,” Clark said.

She complimented the Joint Commission’s surveys as more proactive, kinder and better to her staff — which helps the organization learn from its mistakes.

Clark said she wants to see the administration be more realistic about the way it regulates nursing homes moving forward.

“We don’t have that same kind of relationship with our regulators,” she said.