By any reasonable standard, nursing homes just endured a pretty rough week .
The fun started Monday. That’s when the administration said it was going to push for the most sweeping industry reforms since OBRA ’87.
President Biden continued the theme Tuesday night. During his State of the Union address, he took aim at private-equity ownership within the field, while promising tougher Medicare standards for all. He also claimed care quality is declining as operators charge more.
“That ends on my watch,” he concluded.
Predictably, the sector responded with a few questions of its own. Questions like:
• If nursing home operators can’t hire enough people now, how are they going to hire more?
• Where is the money for these numerous new initiatives going to come from?
· How do massive fines help fiscally struggling facilities improve?
There were more questions as well, but you probably get the general idea.
To quote Yogi Berra, it’s like déjà vu all over again. Several variations of this kabuki dance have been playing out since President Johnson signed Medicare into law. That was more than a half century ago.
That landmark legislation was instrumental in creating the long-term care system as it now functions, both for better and worse.
Ideally, Medicare payment provisions would have covered more than a small fraction of actual nursing home caregiving costs. But several key lawmakers balked at paying the full freight, fearing the economy might suffer.
So public funding was slashed. And providers suffered instead.
Now are there bad actors in the industry who have played fast and loose with payment rules? Absolutely. In fact, we report on them all too often.
In my view, lawbreakers should be arrested and prosecuted. These characters give the industry a tarnished reputation. And they give critical policymakers and lawmakers plenty of ammo. Moreover, long-term care as it is delivered at more than a few facilities can and should be better.
But if the government is going to keep setting up unrealistic expectations — such as demanding Ritz-like amenities while offering Motel 6-like payments — it should hardly be surprising when corners get cut. For as the saying goes, you get what you pay for.
It’s really not a difficult concept to understand. Except in Washington, apparently.
John O’Connor is Editorial Director for McKnight’s.
