Well, we certainly can’t say the Centers for Medicare & Medicaid Services always misses with its promises.
Sure, there’s that little ol’ first-ever federal nursing home staffing mandate thing that’s an overdue cliffhanger. You know, the story of the year … whenever details are released. (See last week’s finger pointing column.)
But then this week, the agency made good on its promise of tightening the screws on facility owners, especially multi-facility involved owners and stakeholders. As is usually the case, it seems like a few bad apples have compelled regulators to make things tougher on everyone.
Per the news we broke Wednesday, the feds have really pulled back the curtain on nursing facility owners and related parties. They’re now posting all sorts of ownership and intertangled relationship information on the Care Compare website.
Seems all those movies you might have seen about complex corporate webs and cynical “behind the scenes” players nefariously pulling levers for only their own benefit were also seen by CMS honchos. So now everything is all out in the bright light for everyone to see — or at least that’s regulators’ hope.
On top of that, they’ve tied performance scores to each ownership entity. We’re talking inspection reports, quality indicators, staffing levels and much more. If your favorite Major League Baseball team has a lousy batting average, you can find out about it in various places. Well, now the same is true for facility owners/operators and their multiple facility affiliations.
Sports fans for years have gone round and round arguing the merits of Jerry Reinsdorf owning both the Chicago Bulls and the Chicago White Sox, to further the sports analogy theme. (There are many other business moguls who also own multiple franchises, and roundly get roasted or toasted, depending on their individual successes.)
I can tell you in Reinsdorf’s case, the complaints have been loudest when his teams have had lousy records, underperformed or lacked investment by management. But complaints when Michael Jordan and the Bulls were winning six NBA championships, or the 2005 White Sox won the World Series? Not so loud. In fact, virtually non-existent.
Producing a winner, or at least a respectably performing product, seems to be the elixir to quell malcontents. Why wouldn’t the same dynamic be in play with nursing home operators — especially when they’re benefitting so mightily from taxpayer money?
Providers make good points
That’s not to say providers don’t have a few valid bones to pick with what’s been unveiled so far. Consumers will need more context in some instances. For example, ownership groups are identified by how many Special Focus Facilities or candidates they have, as well as how many facilities have been hit with an “abuse icon.” But the results page does not appear to explain what those designations mean. Somehow this isn’t totally shocking. Re-consult the “abuse icon” coverage in deeper detail to learn how tone deaf CMS can be.
The agency must take every effort to make Care Compare information easily understood because, as one provider advocate rightly pointed out, website visitors are bring differing levels of comprehension with them. And, also true to her words, different audiences use federal nursing home sites in different ways.
Providers also make a good point about how CMS — the powerful overseer-funder of the sector — needs to give both sides of that hyphenated label sufficient attention. Most often lacking is the funding side, any provider will tell you.
But skilled nursing lobbyists veer off track when they intimate that owners’ commitment cannot be discerned via performance scorecards. The most basic sports fan will quickly point that out facility owners can, and should be able to, make clear their commitment to delivering decent outcomes. Where there’s a will, there’s a way, is how most would put it.
So there’s a call now to let the sun shine on executive leadership and show some not so bad results. In long-term care, a least one doesn’t have to be a world champion to keep the naysayers at bay. You just have to put a good team on the field, keep the beer cold and make a reasonable attempt to send people home happy.
It really doesn’t get much more complicated than that. Winning teams make people forget about flaws or other bumps in the road. Many solid providers already do it every day, in every corner of the country.
And so the expectations now go for all nursing homes in this new era of ownership transparency. Game on. While many will be absorbed in discovering the losers, let’s also not forget to revel in the winners.
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.
