If you have sensed any of the skilled nursing leaders of note around you are displaying a blue-ish tint lately, it’s probably pretty simple to figure out why.
People who hold their breath for too long tend to assume a blue-ish hue. It’s typically a pit stop on the way to discontentment — or being disarmed. Providers themselves are clearly hoping for the “disarmed” end destination.
For about three weeks now, skilled nursing operators have been guarded. And way more tense than anyone would have expected (before 2020, at least) with a 3.7% Medicare Part A pay raise proposal on the table.
Yet that’s right where we are: Looking at a $1.2 billion infusion of Medicare funding for fiscal 2024. Yet no outright joy.
Providers and their advocates, they’re a sharp lot that way.
They’ve been smart enough to be gracious and give modest thanks in public places and general media since the unveiling of the fiscal 2024 SNF PPS proposed rule. Some have even done their happy dance — but in private, so as not to tip their hand to heavy-handed federal overseers, of course.
There’s been restrained satisfaction overall. That’s because 3.7% is a big number. But long-term care providers have been around long enough to suspect that when something good comes their way, a backhand is often soon to follow.
If you’re going to add more than a billion to your hope chest, in other words, many think it’s safe to assume some kind of new order or regulation is going to cost at least a billion and a nickel more.
That could very well be the case here. Providers have tucked away in the back of their mind that the White House’s promised nursing home staffing mandate is not going to be cheap. There’s no way it can be.
We’re supposed to find out “this spring” just what demands this first-ever federal staffing mandate will impose. It would be naive, even by federal red tape standards, to think some kind of federal funding bone won’t be tossed into the mix. It would be the least the Centers for Medicare & Medicaid Services could do, right? But then the agency will announce whether your nursing home will have to supply 4.1 nursing hours per patient day, or something more, or even less for that matter. Repeat: It ain’t going to be cheap to comply.
My advice is to enjoy the proposed Medicare boost, which is juiced to contend with the effects of inflation. It’s no free gift, as they say. But that number could have been a lot lower.
Then hope that the anxiety welling up in you somehow turns out as unjustified, and hopefully nothing more than well-practiced worry muscles.
True, there are pressures sure to mount about increased ownership transparency rules, Medicare Advantage payment battles, a dearth of staffing suppressing possible census gains, and more.
But hopefully someday soon the only remarkable blue you’ll be encountering will be the clear skies above. One can dream.
James M. Berklan is McKnight’s Executive Editor.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.
