Life is too short to constantly fixate on the negative, even if others do. As a result, I generally prefer to look for silver linings. 

Or, as one frequently disgruntled sister-in-law puts it, I look too much for the good in people. Really. (No, she’s not a facility surveyor, just an avid Notre Dame football fan. Draw your own conclusions.)

Above all, I crave candor. Stop beating around the bush and tell it like it is, for better or worse.

That’s what made one particular exchange during the McKnight’s executive Power Panel discussion I moderated Wednesday compel me to bolt upright in my chair. 

While many, if not most, long-term care stakeholders appropriately point to positive signs as we head toward the dissolution of the public health emergency, one notably did not Wednesday. That’s because Patrick McCormick’s speciality is the financial perspective of the business of long-term care.

While he agreed with the other three outstanding panelists that care and quality issues give the industry “a lot to be proud of,” the Plante Moran partner also said he believes, “We still have a lot of pain” headed our way. Put another way, his level of optimism was a 4 on a scale of 1 to 10.

Ironically, this should be a reason for providers to feel gratified. The last thing an operator needs now is to be glad-handed.

The reasons for McCormick’s caution are sound. Among them: a slow recovery across service lines and inflation buffeting everything, including higher wages. “A lot of disruption” in the revenue cycle is what he forecasts.

In addition, payers are slower and managed care is seems to be scrutinizing every single charge more.

On top of that, there are increased documentation demands as we exit the pandemic. In many ways, there’s more regulatory pressure now than over the last three years.

“There will be more oversight, and that’s going to add to the disruption,” he summarized.

You’re darn right it will.

But hardly an ogre, McCormick also acknowledged that conditions vary among regions. Some providers have waiting lists for residents while others are struggling to fill 60% of their beds and meet payroll.

He absolutely nailed it with a statement that was affirmed by nearly every speaker at Wednesday’s event (still available in archive for 12 months, incidentally). “I don’t think you can cut your way to profitability. You are going to have to have growth,” he intoned to a corps of nodding heads.

Whether it’s new technology or programs, something has to capture an operator’s fancy and desire to grow. The status quo should never be good enough, and that is perhaps true now more than any other time in history.

In McCormick’s view, that means providers are going to have to become more stringent again about some of the basics. That includes creating, and collecting, the right documentation from the start, and pursuing every appropriate possible channel of reimbursement.

It also includes keeping the big heart providers are known for when dealing with residents and their family members — but not forgetting “this is a business at the end of the day.”

There does, after all, need to be some silver in the silver linings for there to be happiness in the end.

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.