For those of you already a bit frustrated or even disgusted with the hullabaloo surrounding the proposed nursing home staffing minimum rule, look out. It’s about to get even uglier.
To confirm your worst fears, the combatants are starting to resort to that repugnant four-letter word. Yes … math.
Except for the obvious professionals who have to use numbers and calculations in their daily chores, it seems many, if not most, people would rather speak in public in their underwear than deal with them. Journalists, with rare exception, are in that boat.
I have to humbly admit, however, I am not a part of that crowd. I’ll typically head into that fire, while others are running the other way. Try to slip by me a non-factual rate calculation or a tortured percentage change, and I’ll send you back to your abacus.
But I’m thinking things might be different with this staffing rule debate.
I came to this conclusion after a major statistics tit-for-tat this week between providers and consumer advocates.
On Tuesday, the American Health Care Association / National Center for Assisted Living released a study it commissioned that left one wondering how the heck our crazy federal government could throw an apparently drowning swimmer a few more cinder blocks to carry. (Find our most extensive coverage here and here.)
The math just doesn’t add up, as AHCA/NCAL President and CEO Mark Parkinson and colleagues persuasively explained. Surely the public, lawmakers and even the dastardly off-base regulators who proposed this mandate would see the light, right?
But then almost on cue, a digit-rich rebuttal came Wednesday from the Long Term Care Community Coalition, both barrels blazing. It pulled out the ol’ “cost of a cup of coffee” appeal for taking care of patients. (“Aren’t our residents worth a dollar a day?”)
But it also trotted out an impressive script of numbers that would seem to paint compliance with the staffing proposal as, oh, so doable. Like so many an X (formerly Twitter) thread, it leaves no doubt in current believers’ minds. Frankly, it also could look plausible to many a casual reader.
(OK, other than the this absurd statement: “The fact is that facilities with less than 24-hour RN staffing do not need to hire a bunch of RNs. They can simply shift from LPNs to RNs to bridge the hours needed to cover the gap.” Nurse accrediting bodies might call that a severe head-scratcher, along with the executive boards who would have to start paying filet mignon prices for ground beef — no disrespect to LPNs or ground beef intended. Financial implications are the only goal of that analogy.)
In brief, it’s turning into an “our” numbers vs. “their” numbers type of fight. And if you haven’t noticed, I haven’t even brought up the government’s own calculations, which, of course, are different from everyone else’s.
I would be derelict of duty at this point if I didn’t bring up the never-out-of-date Mark Twain observation that there are three kinds of lies: “Lies, damn lies and statistics.”
This is neither an endorsement of the consumer group’s numbers nor an outright repudiation of them. I haven’t called in the mathletes yet to parse them.
But let this calculated dustup be fair warning to providers who understandably see things through their own lenses. Tunnel vision is not a safe way to stay focused. Especially when the stakes are so high and math is in the air. With more than a month left in the rule’s comment period, the hot spots are going to multiply.
And you can count on that.
James M. Berklan is McKnight’s Executive Editor.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.