Q: What’s your frustration with nursing homes?
A: The nursing home guys I worked with for years, they talk about Medicare, Medicare, Medicare. But the Medicare rates are pretty healthy. And people on Capitol Hill and MedPAC and the administration see 20% or 25% margins and they say, ‘You’re overpaid in Medicare.’ Nursing homes lose a ton of money on Medicaid, which I spent a lot of time at CMS talking about.
Q: What can be done?
A: Nursing homes need to educate people a little more about Medicaid. They get hammered on Medicaid, and they just go back to the Hill and say, ‘Pay us more in Medicare.’
Q: What’s wrong with that?
A: Well, most people in Congress and the administration don’t understand the overall big picture. They say ‘You’re doing great in Medicare.’ So I think it’s a matter of more and more education for people in Washington on how bad Medicaid is.
Q: But there really are no quick fixes, are there?
A: No. The fact is, governors have big fiscal problems. They have more mandates every day saying cover more, and their budgets aren’t in great shape. What are they going to do?