CMS Administrator Chiquita Brooks-LaSure speaks while taking a tour of CVS
PORTLAND, ME – OCTOBER 14: CMS Administrator Chiquita Brooks-LaSure (right) speaks while taking a tour of CVS on Auburn St. in Portland Thursday, October 14, 2021. Credit: Portland Press Herald / Contributor/Getty Images

After initial dismay upon hearing the administration’s strategies for sweeping new nursing home reform plans last month, providers were more optimistic after meeting with Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure on Monday.

Leaders for four long-term care providers with primarily 5-star rated facilities met with Brooks-LaSure via video call and explained to her that “even using absolute best practices, it’s impossible to get workers right now.”

A series of meetings will ensue among staff members of CMS and the American Health Care Association, the latter’s leader said Tuesday.

“We’re very encouraged,” AHCA President and CEO Mark Parkinson told McKnight’s Long-Term Care News on Tuesday. “It was not just a check-the-box meeting on [Brooks-LaSure’s] part. We’re now scheduling follow-up meetings with staff to have conversations about how we can work together to really improve quality.”

Also on Tuesday, LeadingAge President and CEO Katie Smith Sloan said she and four of her members were also set to meet with the CMS administrator and Health and Human Services Secretary Xavier Becerra this week.

“I know these members will represent you well,” Sloan told members gathered in Washington, D.C. “Their stories will be powerful and convincing.” 

Parkinson emphasized the importance of providers presenting their case to the rulemakers. Proposed reforms encompass future staffing minimums, enhanced penalty ceilings, increased ownership transparency and much more.

“I think the administration did some due diligence but just not enough,” before announcing its planned reforms in a statement Feb. 28, he said. “They talked with certified nurses aides and they talked with residents, but they really need to talk to providers. That’s what we’re now offering them just so they can understand the whole challenge that we face.”

‘We remain hopeful’

Each of the AHCA-member providers described conditions at their respective businesses, which stretch from coast to coast and include much of the heartland, including many rural areas.

Providers taking part Monday were AHCA Board Chairman Phil Fogg Jr., president and CEO of Portland, OR-based Marquis Companies; Deb Fournier, chief operations officer for the Maine Veterans’ Homes; Nate Schema, president and CEO of the Good Samaritan Society; and Margarita Kechichian, executive director of the Ararat Nursing Facility in Mission Hills, CA. They also fielded questions from the CMS leader and her staff.

Fournier said she appreciated being able to share firsthand perspective on the current landscape. 

“The entire long-term care industry is challenged with operational factors, such as the lack of workforce supply. These challenges have the potential to risk limiting access to care for our nation’s seniors,” she told McKnight’s Tuesday  

“We remain hopeful that by working together with our industry partners and policymakers at both local and federal levels, we will be successful in gaining support to address these challenges.”

Schema told the CMS leader that over the last two years the Good Samaritan Society has made “historic investments” to support its staff while also providing high-quality care, but more help is needed. South Dakota-based Good Samaritan operates 156 skilled nursing facilities, many of them in rural settings.

“In the face of ongoing workforce challenges, increased operating costs and Medicaid reimbursements that do not keep up with the cost of care we provide, we’ve been forced to make difficult decisions about how and where we can provide services,” Schema noted to McKnight’s on Tuesday.

Fogg echoed their thoughts and said he’s looking forward to continued dialogue with CMS and HHS.

“It is critical that our public health officials hear from us and understand the challenges that are affecting our staff, residents, and families,” Fogg told McKnight’s

AHCA/NCAL earlier this month requested a sit-down with Biden, Brooks-LaSure, and Becerra so they could hear directly from providers on their quality efforts and workforce challenges.

“We really appreciate [Brooks-LaSure’s] recent comments on two fronts. First, she wants to hear from providers. We saw that [Monday]. That’s very important,” Parkinson explained.

He said it was also heartening that she recently stated that new staffing requirements would be paired with adequate funding.

“That really demonstrates her understanding of how important that is,” Parkinson said. “So those are two very encouraging things. We are not discouraged. We feel confident that the administration wants to do the right things, and that we’re going to be able to work with the administrator and secretary and be able to advance quality all at the same time without making it harder on providers.”