60 Seconds with... Thomas Scully Former CMS Administrator

'Found' funds earn a rebuke

Q: What's your frustration with nursing homes?

A: The nursing home guys I worked with for years, they talk about Medicare, Medicare, Medicare. But the Medicare rates are pretty healthy. And people on Capitol Hill and MedPAC and the administration see 20% or 25% margins and they say, ‘You're overpaid in Medicare.' Nursing homes lose a ton of money on Medicaid, which I spent a lot of time at CMS talking about. 

Q: What can be done?

A: Nursing homes need to educate people a little more about Medicaid. They get hammered on Medicaid, and they just go back to the Hill and say, ‘Pay us more in Medicare.' 

Q: What's wrong with that? 

A: Well, most people in Congress and the administration don't understand the overall big picture. They say ‘You're doing great in Medicare.' So I think it's a matter of more and more education for people in Washington on how bad Medicaid is.

Q: But there really are no quick fixes, are there? 

A: No. The fact is, governors have big fiscal problems. They have more mandates every day saying cover more, and their budgets aren't in great shape. What are they going to do?