Will the winner matter?

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John O'Connor
John O'Connor

Ignore the white noise over whether Hillary or The Donald would be a worse presidential choice. There's a sleeper issue in next month's elections, and it just might have a major impact on your long-term care organization.

I'm referring to this: No matter who wins, we will certainly see a new boss running things at the Centers for Medicare & Medicaid Services. As in, the organization that determines the rules for skilled care facilities and how generous Medicare payments will be.

It's an open secret that Andy Slavitt, who is the current boss at CMS, will be seeking other options once all the hanging chads are accounted for. And who could blame him? If it seems like CMS is constantly in “pardon our dust” mode, it's because that has been the case for quite some time. Regardless of who Slavitt's successor turns out to be, improvement initiatives will continue.

As this column is being written, Hillary Clinton and Donald Trump are neck-and-neck in the voter polls. There is also speculation that Democrats might retake the Senate. The GOP majority looks likely to hold in the House.

Leaving Congressional outcomes alone for a moment, let's consider what a Clinton victory would likely deliver. In a nutshell: the usual Democrat-backed initiatives. As an operator, that would likely mean a continued push for more regulatory oversight. The next CMS  boss probably would not need to worry about “acting” being on her or his business card.

If Trump wins, it's evident that pushing more regulations on skilled nursing would not be very high on his to-do list.

We could debate the relative merits of each candidate until the proverbial cows come home. And as tempting as that might be, there may be a better way to think about the election: What's in it for you?

As an operator, what's in it for you is this: A Democratic administration would push to tighten rules, a Republican White House would try to loosen them. I'm not recommending a candidate either way, but there's no debating which way the winning side will lean.

Yes, many people may be shocked by the outcome. Regardless, what happens afterward shouldn't come as a surprise.