James M. Berklan

Depending on how you like to interpret the news, nursing home operators are either facing some of the worst of times, or they’ve been infused with new life.

First comes news that the Medicare trust fund is doing … well, if not great then at least pretty swell. That’s thanks to Affordable Care Act cuts that look good to the public. Yet providers rightly point out that “savings to the fund” often simply mean trims to their reimbursements.

They seem to have something there. It’s not just paranoia at play. This year, even federal regulators and policy makers recognized providers’ needs, so they recommended a net 2% increase to Medicare skilled nursing reimbursements. That $750 million infusion to take place is not chicken feed, as the American Health Care Association’s speedy “thank you” illustrated.

AHCA President and CEO Mark Parkinson called the announcement “welcome news.” It’s not often you catch the chief executive of a trade group such as AHCA expressing more than anxiety or persecution.

Which brings us to the most recent gut twister. The AHCA press release came out about it on Tuesday, warning that impending doom is on the way. Well, sort of.

“Medicare Actuaries: Two-thirds of all Skilled Nursing Centers will be in the Red by 2040” the release blared. “Trust fund experts predict Medicare reimbursements will fall below Medicaid” it continued in panting tones.

The only problem is key hedging phrases or words were left out of the anxiety-laden document. Extrapolations like these are good for many things. Chronicling the future usually isn’t one of them.

“Absent other changes,” (emphasis added) two-thirds of skilled nursing facilities would be looking at negative margins by 2040, AHCA warned. That’s a big “if” to gloss over.

Let’s just say it’s safe to assume that in 26 years’ time, things will change. They always do. It’s the nature of politics and public policy. It’s also what lobbyists are hired to help make happen.

James M. Berklan is McKnight’s Editor. Follow him @LTCEditorsDesk on Twitter.