Recently, the National Medical Security Administration issued the "Measures for the Designated Management of Long term Care Insurance Nursing Service Institutions (Trial)" (hereinafter referred to as the "Measures"), further clarifying the specific requirements for the designated management of long-term care service institutions. The Measures are based on the current situation of insufficient overall supply and urgent need for cultivation of long-term care service institutions, and implement point-to-point standardized management for designated institutions. Specific requirements have been put forward for specialized teams and service forces that are compatible with the legal personality of designated institutions providing long-term care services, as well as clear regulations on software and hardware equipment and corresponding management systems. After the release of the "Measures", it sparked a heated discussion among the public about the regulation of care institutions for disabled elderly people: what is the current development status of care institutions for disabled elderly people, what are the existing regulatory difficulties, and how to improve the system design that covers in-process and post event supervision, so as to promote the real release of the positive energy of "caring for the elderly" in care institutions for disabled elderly people? Deng Yong, director of the Health Rule of Law Research and Innovation Transformation Center at Beijing University of Traditional Chinese Medicine, has long been concerned about the care of disabled elderly people and has conducted in-depth research in care institutions in many places. In his view, strengthening the regulatory role of the government in the long-term care and elderly care system, and improving the coordination and cooperation mechanism among various departments are key to improving the quality of life of disabled elderly people. The following is his account: With the continuous deepening of aging in China, the number of elderly people who have lost their ability to take care of themselves due to aging, illness, or disability is also increasing. While the number of care institutions for disabled elderly people is increasing, disputes over elderly care accidents also occur from time to time. During my research, I came across a case where a semi disabled elderly person was admitted to a newly opened nursing home. However, the nursing home did not conduct a pre admission health assessment for the elderly person, nor did it ask for the elderly person's physical examination report from their family, so they proceeded with the check-in procedures for the elderly person. After a few months of living in a nursing home, the elderly can now use crutches for activities on their own under the careful care of nursing staff. One year later, the old man was able to take care of himself. Seeing such a situation, the nursing staff felt deeply relieved, and the family members were also filled with joy. Unexpectedly, one night after that, the old man suddenly felt uncomfortable and reported a stomachache. The night shift staff promptly notified the dean, and the dean and the on duty doctor rushed over immediately. After analysis and judgment, the elderly person may have a sudden myocardial infarction. The situation is urgent, the nursing home should quickly call the family members. However, the family members do not care because the elderly used to do this frequently. But the nursing home dared not take it lightly and quickly sent the elderly to the hospital. After examination, it was found that multiple ribs of the elderly person were actually fractured, and the hospital diagnosed them as old fractures. Due to a myocardial infarction, the elderly person passed away after 3 days of intensive care unit (ICU) rescue. The family found the nursing home and insisted that the elderly's fracture was caused by a collision in the nursing home. They demanded an explanation and demanded compensation from the nursing home. The nursing home believes that the situation of the elderly in the nursing home is clearly recorded in the surveillance video, and there has been no occurrence of rib fractures. And the hospital examination showed that the fracture belongs to an old fracture, indicating that it occurred very early and the elderly person was already unable to move around and take care of themselves when they moved in. Due to significant differences in opinions between the two parties, the family has taken the nursing home to court, demanding compensation of over 600000 yuan for medical expenses, death compensation, funeral expenses, and emotional distress. Later, the court ruled that the nursing home should compensate 60500 yuan. The court believes that although there is no evidence to show that the fracture of the elderly occurred in a nursing home, the nursing home did not conduct a pre admission health assessment of the elderly in accordance with relevant national regulations and mandatory safety standards, which is a certain fault. Therefore, it should bear certain responsibilities and compensate the elderly's family for certain economic losses. In addition, as a professional institution providing elderly care services, nursing homes have failed to fully consider factors such as the age, physical condition, and mobility of service recipients and fulfill their duty of care. Therefore, it can be concluded that nursing homes have made mistakes in fulfilling the contract. We have encountered many similar disputes during our research process. At present, the proportion of disabled elderly people among adopted elderly people in various elderly care institutions across the country has significantly increased. However, in reality, the proportion of disabled elderly people who can receive care from nursing homes or other institutions is not high. Overall, care institutions for disabled elderly in China are far from meeting market demand, and there are problems such as a lack of professional personnel, a decreasing proportion of young caregivers, and weak regulation. As a nursing institution for disabled elderly people, it is currently mainly regulated by departmental regulations such as the "Management Measures for Nursing Institutions" and the "Administrative Inspection Measures for Nursing Institutions". The supervision of care institutions for disabled elderly people in China lacks normative documents at the level of laws and regulations, and the effectiveness of departmental rules is limited after all. At the same time, existing documents do not provide clearer regulations for the care institutions for disabled elderly people, which is a special type of elderly care institution. Disabled elderly individuals with weakened physical and cognitive functions are more prone to care accidents in institutional care, thus requiring stricter supervision. In addition to lax supervision, there is also a problem of unclear regulatory responsibilities. The "Administrative Inspection Measures for Elderly Care Institutions" stipulate that "the civil affairs department of the people's government at or above the county level is responsible for guiding, supervising, and managing elderly care institutions. Other relevant departments shall supervise elderly care institutions in accordance with their respective responsibilities." "Elderly care institutions shall carry out service activities in accordance with laws, regulations, and mandatory standards such as construction, fire protection, food safety, medical and health, and special equipment." The "Administrative Inspection Measures for Elderly Care Institutions" stipulate that "registered elderly care institutions shall be subject to administrative inspection by the civil affairs department handling the registration. Unregistered elderly care institutions shall be subject to administrative inspection by the civil affairs department of the county-level people's government where the service site is located." In our research, we found that although the regulatory subject is relatively clear, its specific regulatory responsibilities, such as regulatory scope, evaluation standards, etc., still need to be improved. And multiple departments have regulatory responsibilities for care institutions for disabled elderly people, but there is a lack of coordination and cooperation among departments, resulting in unclear regulatory responsibilities and inconsistent regulatory standards. In addition, there is also a problem of insufficient regulatory strength. At present, the relevant regulatory policies are not perfect enough, and the actual implementation of the regulatory policies that have been introduced is also insufficient. We have noticed that some regulatory authorities have failed to timely detect, stop, and punish disabled elderly care institutions that operate in violation of regulations, resulting in damage to the legitimate rights and interests of some elderly people. This is also related to China's regulatory and law enforcement measures. At present, the supervision of care institutions for disabled elderly in China mainly adopts administrative supervision methods, and there are problems such as insufficient law enforcement personnel in current administrative supervision. Therefore, more social entities need to participate and strengthen the regulatory team. Although the "Management Measures for Elderly Care Institutions" stipulate that "elderly care institutions should publicize the charging standards and basis for various service projects in a prominent position and accept social supervision", in practice, social forces lack proactive motivation to participate in supervision and practical ways to participate. Through field research, we have put forward several suggestions for improving the supervision of care institutions for disabled elderly people: firstly, special regulations should be made for the supervision of care institutions for disabled elderly people. Disabled elderly people are more special compared to ordinary elderly people. They have lost their ability to take care of themselves and require more professional and meticulous care, with higher requirements for nursing institutions. Therefore, it is necessary to formulate a specialized "Management Measures for Care Institutions for Disabled Elderly", or to make special provisions for care institutions for disabled elderly in the "Management Measures for Elderly Care Institutions", improve the supervision system and credit punishment mechanism for care institutions for disabled elderly, and implement credit punishment for relevant entities' illegal and irregular behaviors in accordance with laws and regulations. We need to clarify the regulatory responsibilities of the regulatory body. Establish the civil affairs departments of the people's governments at or above the county level as the main regulatory bodies to lead regulatory work; Administrative departments such as construction, fire protection, food safety, medical and health, and special equipment shall conduct auxiliary supervision in accordance with laws and regulations. Clarify the regulatory boundaries of each entity, establish regulatory standards such as service quality standards and evaluation systems for care institutions for disabled elderly people, and establish a multi departmental coordination and cooperation mechanism to achieve effective coordination of regulatory responsibilities. In addition, it is necessary to establish a regulatory system for care institutions for disabled elderly people, and build a long-term mechanism that combines daily and long-term supervision. Administrative law enforcement should increase regulatory efforts to ensure that care institutions for disabled elderly people operate legally. In regulatory activities, attention should be paid to whether buildings, fire safety, food safety, etc. comply with legal standards, and whether care institutions engage in illegal fundraising, abuse of disabled elderly people, and other illegal activities. Relevant departments can develop a list of random inspection items for care services for disabled elderly people, and based on regulatory characteristics and needs, formulate and improve inspection work rules, making regulations on inspection proportion and frequency, inspection methods, inspection content, inspection procedures, and other matters; Coordinate the establishment of a list of inspection objects and a list of law enforcement inspection personnel. Establish a sound coordination and cooperation mechanism among various departments to achieve interconnection of illegal clues, exchange of regulatory standards, and mutual recognition of handling results. The civil affairs department shall immediately urge the institution to take measures to eliminate safety hazards in areas such as construction, fire safety, and food in the care institutions for disabled elderly people during supervision and inspection, and inform relevant departments in writing; For those with prominent safety hazards or urgent situations that require immediate disposal, the service institution shall be ordered to suspend operations for rectification or take emergency measures for disposal in accordance with the law, and relevant departments shall be notified to handle them on site; For those who should take administrative compulsory measures or administrative compulsory execution, the department with corresponding law enforcement authority should be notified or an application should be made to the people's court for handling in accordance with the law. Establish a new regulatory mechanism based on "double random, one open" supervision as the basic means, supplemented by key supervision, and based on credit supervision. At the same time, industry organizations in the field of care services for disabled elderly people should actively promote the industry credit commitment system, improve industry self-discipline regulations, regulate member production and business behavior, strengthen member credit management, and promote the construction of industry self-discipline system; Develop industry professional ethics standards, regulate the professional behavior of practitioners, and actively coordinate and resolve disputes over care and elderly care services for disabled elderly people. Intensify the disclosure of information in the field of care services for disabled elderly people, establish a service quality information disclosure list system, and urge service institutions to proactively disclose their basic information, rules and regulations, service projects, fee standards, and other matters through written notifications, setting up public bulletin boards in prominent locations, etc., to facilitate public supervision channels. Optimize the process of handling service complaints and reports, and achieve "civil affairs leading and centralized responsibility". During the survey, some grassroots cadres said that the happiness of a society depends on whether the elderly are happy or not. The care of disabled elderly people tests the precision of modern social governance and reflects the warmth of society. I believe this is also the sentiment of disabled elderly people. To meet the health service needs of this group, we need to start from the fundamental point, strengthen the regulatory role of the government in the long-term care and elderly care system, improve the coordination and cooperation mechanism among various departments, thereby improving the quality of life of disabled elderly people and supporting the development of China's long-term care service industry. (New Society)