James M. Berklan

When the kids run in from the playground complaining about the “big bully,” visions of the Incredible Hulk romp in at least some imaginations.

When an adult investigates, however, often a snort and a shake of the head ensues. Bully? It’s just some bold sixth-grade punk. Step aside, junior, and leave the others alone or serious punishment is in your future.

In other words, when stuff hits the fan, it’s often all a matter of perspective. That’s the pickle nursing homes find themselves in today.

Are they being given a chance to do well or are they simply getting (undeserved) preferential treatment?

Thanks to a damning New York Times report that was published on Christmas Eve and Day, a brushfire of smokey publicity is engulfing providers. Some of it, however, involves smoke and mirrors.

Where providers say they are simply getting relief from resource-draining fines and over regulation, others believe it’s scoundrels conducting bad care in order to pocket federal reimbursements. While regretful rogues exist in any profession, getting rich via shoddy care doesn’t have a lot of legs as a long-term business plan.

Overall, the NYT article calls it a “victory for [the nursing home] industry” because of the Trump administration’s general push for lighter regulation.

One bone of contention is that some Phase 2 regulations in the voluminous Requirements of Participation will not be penalized for 18 months. Left out, however, is the perspective that providers have not fought the imposition of requirements as much as the sheer volume of them coming all at once.

The penalties will be imposed, but everyone first needs to come to grips with the terms and parameters of the new rules. Added education during this interim “breaking-in” phase will put future offenders more firmly on the spot. It is not as if longstanding rulebooks are being torn up or that existing rules are going away.

It seems that nursing home advocates’ biggest sin might have been requesting a little breathing room. The American Health Care Association was quickly mentioned as highly influential in both the New York Times and this subsequent “I-Team” report from a New York TV station. 

The reports seemed to accuse AHCA lobbyists as being too good at their job. As proof, the NYT (and therefore others) brought up the administration’s elimination of a prohibition of mandatory arbitration clauses in admissions contracts earlier in 2017.

The bigger harm is when mainstream media conflate actions concerning regulatory decisions in non-related areas. Sprinkle in a provider or two that truly fouled up with sad outcomes, and a big messy picture of the entire profession is left on the canvas.

What it comes down to is nursing homes are again spiking in national fame — some might say infamy — because of a set of circumstances that were mashed into a trend story to fill a year-end news space.

It’s an old trick, and a heck of a way to start the new year.

Follow Editor James M. Berklan @JimBerklan.