MedPAC's message to nursing homes: No soup for you!

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John O'Connor
John O'Connor

Whenever MedPAC releases payment recommendations affecting skilled care, I'm reminded of the Soup Nazi.

As “Seinfeld” viewers may recall, he would punish customers who had offended his sensibilities by screaming, “No soup for you!”

It would appear the skilled care sector has also been doing a terrific job of offending the sensibilities of MedPAC's advisors.  You could count the number of times panelists voted for funding increases since 2009 on one hand. Actually you wouldn't need a hand, as the answer is zero.

For nearly all of its nearly two-decade existence, the commission has consistently voted to reject Medicare payment increases for long-term care operators. This, despite the well-known fact that Medicare was often the only chance operators had to compensate for clearly inadequate Medicaid funding.

When pressed on the matter, commission members would invariably reply that Medicaid is not their concern, only Medicare. Which sounds a bit like parents protesting that they need only raise their male offspring.

MedPAC's  latest soup-free suggestion arrived this month. In finalized recommendations, its advisors honored earlier proposal to reject SNF market basket updates for 2018 and 2019. Shocking, right?

Fortunately, cooler heads have generally prevailed in Congress, where the funding amounts are actually determined. That's right: Congress is the group acting like the responsible adults here.

In the “Seinfeld” episode, the Soup Nazi eventually closed his restaurant and moved on.  With a little luck, perhaps the new administration and a GOP –controlled Congress can make sure MedPAC realizes a similar fate.

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.