Daily Editors' Notes

Nursing home operators get a little respect

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor

Attitude determines altitude. You make your breaks. People are about as happy as they make their minds up to be. They're all somewhat overused yet admirable sayings people live by. Nursing home operators might want to remember them. Otherwise, it's easy to miss that providers aren't always getting hammered by authorities or officials.

Take, for example, a couple of quite disparate news items during the past week that at first blush might not have seemed like such big deals if you skimmed a bit too quickly.

First, consider an item about a quiet final rule issued out of Washington. The Centers for Medicare & Medicaid Services wants it known that — get this — providers can, in fact, be a resident's agent when enrolling him or her to receive Medicaid benefits. One of the lesser publicized aspects of the Affordable Care Act, this commonsense provision puts head and heart together. It also more closely aligns federal policy with state policies and practices.

There was not unanimous agreement in releasing the final rule. A comment period produced numerous dissenters, most of them not keen about putting providers in charge of something so personal for residents. As if providers aren't already trusted to get up close and personal with other things in their residents' lives. More transparency needed? Please.

Given the opportunity to side with skeptics and cast more aspersions on nursing home operators, however, regulators chose (this time at least) to give operators some credit.

Then there's a courts item that gives everybody the chance to tsk, tsk and shake their heads sadly about quality of care delivered in nursing homes. Everyone knows nursing homes get pounded in the courts and, subsequently, news reports. 

Well, not 100% of the time, as it turns out.

Take, for example, the judge who recently decided he would stick by his guns and not pile on an exposed and vulnerable provider. In a case tried in Arkansas, a jury attempted to disregard the judge's instructions and tried to punish a provider excessively for allegedly poor delivery of care.

True, the jury decided against the provider, but the judge knocked down its emotion-driven award from an original $5.2 million to $1 million. Judge Mike Maggio cut the original award by 81% because he found that the plaintiff's counsel wrongly "inflamed the jury's passion and prejudice." The original award "shocked the conscience of the court," Maggio wrote.

A conscientious defense, or at a minimum a bit of sticking up for, nursing home operators' interests. Not once, but twice. It's worth pausing a moment to digest and savor. 

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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