Marty Stempniak, Staff Writer

Both nursing home and resident advocates will be eagerly watching Wednesday, as the powerful Senate Finance Committee launches an investigation into cases of abuse that have occurred at facilities in recent months.

I’ll be watching, too, and covering the hearing for McKnight’s, but I am more curious to see when one of these senators is going to climb onto his or her soapbox and get a little indignant about one of the root causes that’s spelling problems for so many SNFs.

To rewind things a little bit, last week, Sen. Charles Grassley (R-IA), the Finance Committee chairman, announced that he’s placing nursing homes squarely in his crosshairs. The senior senator has been a longtime nursing watchdog, and the source of his most recent ire seems to be the dehydration death of an Iowa nursing home resident last year, along with the notorious recent sexual assault of a disabled woman at a Phoenix long-term care facility.

“These outcomes are unacceptable,” Grassley wrote in a letter to CMS last fall, laying the groundwork for this hearing.

And who wouldn’t agree? What’s recently transpired at Hacienda HealthCare in Arizona (the sexual assault, resulting in a surprised pregnancy) and at the Wanaque Center for Nursing and Rehabilitation in New Jersey (where 11 children died from a viral outbreak last year) is absolutely horrifying. These outcomes are most definitely unacceptable, and deserve nothing but the most intense scrutiny from Capitol Hill.

My gripe is where is the righteous indignation from politicians when it comes actually giving nursing homes adequate payment to employ a full complement of staffers and, even more basically, keep their lights on and doors open? As we detail this morning, there’s been a wave of nursing home closures across rural America, in states such as Maine and South Dakota. Meager Medicaid funding, coupled with dwindling populations and scarce talent, have led to thousands of SNF beds disappearing. And that has subsequently forced frail nursing home residents with few options into facilities that are many miles away from friends and family.

It just kind of strikes me as odd that over the past year, and actually earlier, leaders like Grassley and Sen. Ron Wyden (D-OR) — whose hearts seem to be in the right place — continually harp on the industry and the mistakes it’s made, without doing much acknowledging the massive challenges it’s facing or how those are exacerbating patient safety and staffing challenges.

One recent report found that the average nursing home lost about 4 cents per patient day in 2017, down from earning  almost $4 a few years prior. As commenters on our last Grassley article pointed out, providers in some states haven’t had a Medicaid increase in years, and elected officials can’t expect to be served a filet mignon when they’re forcing businesses to operate on macaroni-and-cheese budgets, as one reader put it.

In politicians’ defense, yes, there certainly might be some bad apple operators out there who are pocketing profits in the same vein as some pharmacy industry counterparts. And I understand that family members of the abused are the ones who vote in elections, and who they’ve been elected to protect.

But I gather that the lion’s share of you are in this space for the right reasons and are frustrated when your bold intentions aren’t lining up with your financial allotments. At some point, it seems that more politicians are going to have to start trying to better understand why they keep getting a plate of cold macaroni, rather than continually harping: Where’s my steak?

Follow Staff Writer Marty Stempniak @MStempniak.