When historians look back on the 21st century, many lessons will be learned. Among them, the importance of maintaining a good reputation and image.

Exhibit A could be the nation’s nursing home sector.

It would be crass to suggest the first proposed federal nursing home staffing mandate is anything but an attempt to improve care. It would be equally naive to maintain that’s all it is.

In brief, old people can make good politics. (If not necessarily good politicians, as chagrined Americans have made clear to presidential pollsters time after time this year).

In brief, old people vote, and so do their adult children. Trying to make them happy is vital. It’s a force not quite as powerful as the economy but when it comes to swaying voter sentiment, seniors’ health and care is not nothing.

And that’s where the staffing mandate, operators and politics collide. Remember that the first mention of the staffing mandate did not come from the Centers for Medicare & Medicaid Services, within the administration, but rather directly from the White House in a memo. That was the day before President Biden made critical mention of nursing homes in the first of two successive State of the Union addresses.

So as the race tightens in the coming months, you can rest assured that taking care of seniors is going to be a solid theme of Biden’s re-election campaign. This is not necessarily a bad thing. Seniors should be taken care of properly.

But the fact is Biden will have a new weapon in his tool belt: a finalized staffing mandate that no other president before him has had the moxie to try.

And if a nursing home group follows through with plans to sue to stop the rule, guess who’s liable to look bad? Not the guy looking for votes come November.

It will be nursing home operators, who run organizations where people die every year, and will, unfortunately, into eternity. 

‘Bad’ pub 

It’s an image and reputation problem — regardless of the merit of any arguments about them — that seems impossible to polish to an acceptable level.

Mainstream media will always be able to cherry-pick stories about bad players in the sector. A blitz of published stories that came out after the proposed staffing rule was issued Sept. 1 reminded everyone of that abundantly well.

Similar waves can be expected whenever the final staffing rule is issued. That could be any moment, based on recent movement within the administration hierarchy. In fact, both sides — representing aggrieved consumer and worker interests, and fearful providers — will no doubt have their cases heavily pleaded in the court of public opinion whenever the final rule drops.

History tells us that a public image battle usually does not turn out well for nursing home operators. 

And to put it in simple math terms, there are millions more votes to be found in addressing, even stoking, the fears of the voting public than worrying about the voters who work at keeping more than a million nursing patients safe each year.

I predict the final staffing mandate will be issued soon, take a hardened position against providers … and come roaring back as a point of discussion on the campaign trail. It’s almost a no-brainer in that regard.

Any lawsuit to attempt to block the effort, or legislation aimed at sidetracking, likely would not have much effect after the ballots are cast Nov. 5 anyway. And even if something should happen to halt or derail the mandate before then, well, the current resident at 1600 Pennsylvania Avenue can still tell the 62 million voters over the age of 65 that, hey, at least I tried to have your backs.

Another reason the staffing mandate is liable to play even larger as a political football: Even if a mandate is issued soon, its main provisions wouldn’t kick in for another couple of years. The wave of additional facility bankruptcies and further shrinkage of access wouldn’t be felt by the voting public until, you guessed it, well after Election Day.

James M. Berklan is McKnight’s Long-Term Care News’ Executive Editor. Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.