John O'Connor

Ignore the white noise over whether Hillary or The Donald will be a worse choice. There’s a sleeper issue in the November elections, and it just might have a major impact on your long-term care organization.

I’m referring to this: Regardless of who wins, we will likely see a new boss running things at the Centers for Medicare & Medicaid Services. As in, the organization that determines the rules for skilled care facilities and how generous Medicare payments will be.

It’s an open secret that Andy Slavitt, who is the current boss at CMS, will be seeking other options after November. And who could blame him? If it seems like CMS is constantly in “pardon our dust”mode, it’s because that has been the case for quite some time. Right now, the organization is replacing the Meaningful Use program with a more flexible option for medical records. CMS is also in the middle of a multi-tiered project to improve skilled care quality and accountability. There are also notable internal efforts underway to better monitor submitted invoices.

Regardless of who Slavitt’s successor turns out to be, these and other initiatives will continue.

As this piece is being written in mid-August, Hillary Clinton holds a commanding lead in most voter polls. There is also speculation that Democrats might retake the Senate.

Leaving the Senate outcome alone for a moment, let’s consider what a Clinton victory would likely deliver. In a nutshell: the usual Democrat-backed initiatives. As an operator, that will likely mean a continued push for more regulatory oversight. Should Democrats become the majority party in the Senate, the next boss at CMS probably would not need to worry about “acting” being on her or his business card.

If Donald Trump wins, it’s evident that pushing more regulations on the skilled care sector would probably not be very high on his to-do list.

We can debate the relative merits of each candidate until the proverbial cows come home. And as tempting as that might be, there is a better way to think about the election: what’s in it for you.

As an operator, what’s in it for you is this: A Democratic administration would push to tighten rules, A Republican White House would try to loosen them.

Yes, this may be one of the wackiest election seasons in memory. But at least from a regulatory perspective, what happens afterward should hardly be a surprise.