Long-term care operators, meet Jan Brady

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John O'Connor
John O'Connor

“Marcia, Marcia, Marcia!”

Fans of the “Brady Bunch” TV show will instantly recognize Jan Brady's signature line. She tended to belt it out whenever older sister Marcia got a better deal. Which seemed to happen all the time.

Middle daughters around the world still relate to her exasperation. So too should long-term care operators. But instead of being jealous of an older sibling, this field's indignation might be better directed at nearby hospitals.

For like the proverbial Jan Bradys of the world, skilled care operators usually get the blame, while hospitals always seem to get a lucky bounce.

The most recent example of this maddening double standard appeared last week, when the Centers for Medicare & Medicaid Services released an updated plan for bundled payments.  While the plan may be new, it's anything but improved. Unless you're running a hospital.

The new model will effectively end the ability of SNFs to initiate episodes and take risks as a financial partner. Instead, such operators can participate only through financial partnerships with other providers (read hospitals). In other words, hospitals stand to reap huge windfalls, while nursing homes play the role of “the help.”

Not that this is the only screw job of recent vintage.

When regulators decided to reimburse providers for making much-needed technology investments, guess who qualified for funds? And guess who didn't?

Of course, the unfairness hardly extends to the rule makers. Many more people die in hospitals every year than skilled care settings. Hospitals are also the places you will find far more incidents of medication abuse, malpractice and lawsuits.

Yet nursing homes get to wear the “warehouses for the elderly” moniker, while hospitals are perceived as places where miracles happen?

But there's an important distinction to be made here. Jan Brady was being treated unfairly in a pretend world. For skilled care operators, the mounting slights are all too real.

“Marcia, Marcia, Marcia!” indeed.

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 Marty Stempniak.