Saying 'yes' to nursing homes and 'no' to healthcare reform

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[Photo: Sen. Pat Roberts (R-KS)]

Some of nursing homes' heartiest advocates on Capitol Hill are against the healthcare reform law. Three such lawmakers addressed members at the American Health Care Association's annual briefing in Washington, D.C.

They talked adamantly about the need to provide stable funding to nursing home providers and to improve regulations. They also spoke about their disapproval of the healthcare reform law.

“I didn't vote for the bill,” Rep. Zack Space (D-OH), a moderate Democrat, told the group. “I felt we weren't doing it properly. But I'll work to make it better.”

Rep. Space, Stephanie Herseth Sandlin (D-SD) and Pat Roberts (R-KS) addressed the group on Wednesday, the last day of the conference. None of them voted for the law. 

Both Sandlin and Roberts said they opposed the bill, in part, because it contained more than $500 billion in cuts to Medicare.

“I voted against the bill because the cuts under Medicare are unsustainable,” said Sandlin, a fiscal conservative, who along with Space, is a member of the Blue Dog group.

The only representative from South Dakota, Sandlin also took aim at the CLASS Act, which will create a long-term care disability insurance program. She talked about the potential problem of adverse selection and the possibility it will not be self-sustaining over 75 years.

“I'm concerned about the fiscal soundness of the program,” Sandlin said.

Roberts, meanwhile, said he is against the law's creation of the Independent Medicare Advisory Board, which is supposed to make payment decisions on Medicare similar to the current Medicare Payment Advisory Commission. The difference is it could have more power to make those decisions. Nursing homes last year were hit with a 1.1% cut in Medicare funding. Roberts fears the board will be able to make payment cuts without being effectively checked by Congress.

‘Five-Star' discontent

The lawmakers talked about other hot-button topics. Roberts said he opposes the Five-Star Quality Rating System in its current form.

It is “too simplistic and too opaque for consumers to use,” he said.

He criticized the bell-curve style of the system, which gives 20% of nursing homes one star, regardless of quality. That is troubling because nursing homes are working to improve their quality themselves, he said.

The three lawmakers also mentioned the problem of Medicaid shortfalls at nursing homes across the country.

All in all, these lawmakers conveyed their command of nursing home issues. Sandlin talked about working to include a mention in Medicare material that the federal program does not pay for long-term care. While this might seem like common knowledge, it isn't and it is commendable that this congresswoman knows it. She also chose to take action to inform older Americans.

But lest you think that only political moderates or conservatives are advocates of nursing homes, two other congressmen addressed the group—and both voted for the healthcare reform bill. These two were Rep. Kathy Castor (D-FL) and Rep. Sander Levin (D-MI).

Castor spoke to the group Wednesday about her bill, the Nursing Home Patient & Medicaid Assistance Act of 2010 (H.R. 5457), which would provide a short-term supplemental payment program for nursing facilities with large Medicaid populations. She and Space co-sponsored the bill. Levin talked briefly to the group Tuesday and expressed his pride that the healthcare reform bill passed.

Clearly, there are politicians of all stripes who believe they have a stake in helping long-term care facilities. But healthcare reform, without a question, continues to be a divisive subject.


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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.