Nursing home advocates gearing up for election, 'high-risk' lame duck session

The American Health Care Association will remain “incredibly vigilant” in advocating for providers' interests in the nation's capital through the upcoming election and lame duck session, officials shared on Tuesday.

“When we talk about lame duck, it doesn't mean that nothing's going to happen,” Clifton J. Porter II, senior vice president for government affairs at AHCA, told attendees at the group's legislative update. “Frankly, the duck ain't that lame. It's a fairly high-risk period of time for us.”

Porter highlighted AHCA's recent legislative successes, including avoiding payment cuts, receiving a “clean” payment rule and working on scoring, or determining the economic impact, of its payment reform proposal. In the coming months, the group plans to turn its focus to the election, as well as fighting a recently proposed value-based purchasing act that Porter called a “non-starter.”

“This bill is bad for us at the end of the day,” he said, criticizing the bill's currently proposed 5% withhold percentage. “A cut by any other name is still a cut.”

Porter believes the group's fight against the bill will prevail “because we're right.”

Laying out potential scenarios for the post-election legislative landscape, Porter said that a “Republicans-win-everything” scenario could put Medicaid pay at risk, but also less executive regulation. A “Democrats-win-everything” scenario, meanwhile, could preserve Medicaid and bring a “slightly lightened” regulatory environment.

Other highlights from Tuesday's AHCA sessions included:

• A call from the group's legislative staff for providers to form relationships with their local members of Congress. Research shows that the majority of lawmakers say 10 online comments or tweets from constituents can be enough to sway their opinion on an issue or co-sponsor a bill.

• At a session on employment law Tuesday, Robert C. Castle, a partner at Fox Rothschild LLP in Minneapolis, said employee speech is often protected in the realm of social media — though only to a point.

"If an employee posted on Facebook that they work at Mary Meadows and said the residents are dying due to malnutrition or bedsores, that is not going to be protected." On the other hand, complaining about wages is "clearly protected."

Where protection around speech becomes murky is when an employee posts something such as, "We don't give good care because we aren't paying enough.”

"Those issues need to be carefully parsed," Castle said.