Two respondents expressed a desire for more outcome based measures of quality.
The types of things needed to really assure quality, such as performance based outcomes, would be better put into the Medicaid provider contracts than in licensing and regulatory requirements.
The regulations are getting too prescriptive. Oregon started with a resident centered program because the state wanted people to direct their own care. Now it's getting towards a more prescriptive model. The cause could have been a bad situation prompting media coverage. I prefer the more outcome based regulations--though I don't always know the best outcomes.