President Obama has made another recess appointment—this one with big implications for long-term care.

The president appointed Don Berwick administrator of the Centers for Medicare & Medicaid Services on Wednesday. A recess appointment means that the nominee is not subject to Senate approval.

Obama made the appointment because of the Senate’s delay in holding nomination hearings on Berwick. Since so much of healthcare reform is tied up with Medicare and Medicaid, Obama wants a new person at the top as soon as possible.

Berwick has been a controversial pick because of his work with the British healthcare system and a statement about rationing. Republicans have come out fiercely against him. Healthcare groups largely have stood up for him.

Many in healthcare are greeting this appointment with outright praise.

“Dr. Berwick is the right person for this era of health transformation based on defined quality outcomes and new ways of serving the needs of America’s seniors,” American Association of Homes and Services for the Aging President and CEO Larry Minnix said Wednesday in a statement.

They also must be breathing some relief. There has not been a permanent CMS administrator since 2006.

Implementing healthcare reform is important. It’s also about time that CMS got around to resolving some burning regulatory concerns. Fixing nursing homes’ Five-Star Quality Rating System is just one of them.