John O’Connor

Well, Sen. Joe Manchin (D-Big Coal) is at it again.

In December, the hard-to-believe-he’s-a-Democrat from West Virginia torpedoed his colleagues’ $1.8 trillion Build Back Better plan. It was a measure that would have provided billions of dollars in additional funding support to long-term care operators, by the way.

Thursday, he threw down the gauntlet again, insisting talks regarding future spending proposals within his own party would need to start “from scratch.”

“We’re going to start with a clean sheet of paper and start over,” Manchin said to a group of reporters.

While it’s theoretically possible Manchin is both a bad faith actor and a lackey for the coal industry, it’s probably best not to entertain such dark thoughts. Instead, let’s just assume he’s being sincere when he says he simply cannot condone wasteful spending.

To honor that concern, here’s my clean sheet of paper suggestion for improving staffing and care in long-term care today: Give each 5-star nursing home a $10,000 bonus each year, courtesy of Uncle Sam.

Now, such largesse would probably require a few qualifiers. Such as:

1) The money could only go to front-line caregiving staff.

2) The funds could go to a single employee, or divided among several recipients (10 max).

3) The Director of Nursing would select each recipient.

4) The DON and employees related to the facility owner or management would be ineligible.

So John, aren’t you basically suggesting a plan that helps the proverbial rich get richer?

Yes, and here’s why:

First, experience has shown there is really no point in trying to cajole 1- or 2-star facilities into making quality Job One. It’s simply not in their DNA. In case you haven’t noticed, many of the industry’s backbenchers have been compliance challenged for years, if not decades.

Second, this plan would also give 3- and 4-star facilities a real incentive to up their game.

Third, it’s the kind of carrot that would appeal to both prospects and existing staffers. A chance at $10 large? For someone making $12 an hour, that kind of bonus can look mighty tempting.

Fourth, it’s actually a pretty economical solution. At least, by Washington standards. There are roughly 3,500 qualified facilities nationwide. Multiply that by $10,000 and the cost for this program is a relative pittance: $35 million. Maybe we should up the bonus to $20,000?

What we have here is a bargain-basement program that will address care and staffing challenges. Plus it poses absolutely no threat to the coal industry. Not that this last point would in any way influence Manchin’s vote, of course.

John O’Connor is Editorial Director for McKnight’s.