Are we entering skilled care's Golden Age? The answer might surprise you.

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John O'Connor
John O'Connor

There's no doubt the skilled care sector faces its share of challenges. While there have been hardly any new facilities built in in recent years, occupancy levels remain myopic or worse. And the long-awaited Silver Tsunami (and unprecedented numbers of ADL-challenged and post-op seniors) won't reach shore for a few years.

Then there's the fact that barely a month goes by where we don't see another major player flirting with a death rattle. So you can bet that these and other concerns will be hot topics at this week's NIC meeting in Dallas.

Still, it's very possible historians may look back at 2018 as a kind of Golden Age for skilled care. No, I have not been drinking.

Let's not forget that Congress just gave operators a huge break by trimming corporate taxes. I asked a CPA friend who fills in the forms for businesses to help me wrap my head around the implications. His answer: for every $1 million in revenue, the new law trims Uncle Sam's share by $140,000. If that's not a windfall, what is?

Providers are also benefiting from one of the one of the most pro-business administrations and Congresses to come along in many a moon.

President Trump has been an ardent supporter of red-tape reduction since Day 1 in office.

Operators have benefited from this view in two big ways. One is that the introduction of new regulations has come to a virtual standstill. Another is that fines against operators found out of compliance have been trimmed or outright eliminated in many instances.

And now comes even more good news for operators. The Centers for Medicare & Medicaid Services Director of the Center for Clinical Standards and Quality Kate Goodrich just predicted this will be a major year for regulatory reform and burden reduction. Speaking at a CMS and Office of the National Coordinator for Health IT listening session, Goodrich added that there is much the agency can do to reduce provider burden via sub-regulatory guidance.

As one example, Goodrich touted the Patients Over Paperwork initiative. She said this effort alone will enhance the experience providers have with CMS while also improving resident care.

Melanie Combs-Dyer, director for the Center for Program Integrity at CMS, added the agency is working to streamline and simplify requirements, like local and national coverage determinations.

CMS also has a proposed rule under review at the White House Office of Management and Budget that would “reform Medicare regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on healthcare providers and suppliers.” It would accomplish this by revising conditions of participation and conditions for coverage.

If these developments are not music to your ears, you must be tone deaf.

So, yes, market conditions could be better. But any honest appraisal would have to also concede they could also be much worse. And in this business, that's not bad.

John O'Connor is McKnight's Editorial Director.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.