Now things are going to get interesting. That’s about the only way a third-party observer can sum up the “What’s next?” phase of presidential politics when it comes to long-term care.
The vague “interesting” label comes into play because no one really knows what an Obama administration is going to mean for you and your colleagues. As always, there is that odd LTC juxtaposition of business leaders, who traditionally lean toward less regulation and lower taxes, rooting for higher Medicaid spending.
But our current scenario goes far beyond that.
With Democrats in the White House for the first time in eight years and control of both chambers of Congress, one has to believe a more liberal agenda will not only be pushed but also passed over the next four years. Or at least the next two years. 
True to Americans’ overriding sense of buyer’s remorse upon exiting the polling booth, you can count on a Republican upsurge during mid-term elections in two years.
But nonetheless, things are liable to get harder before they get easier. The rising fear of union growth during a labor-friendly Obama administration is palpable.
And a ghastly economy that hasn’t bottomed out yet means Medicaid funding is going to enter its totally unfair double-whammy stage (more people in need but less in Uncle Sam’s piggy bank to pay for them). 
And doctors, still threatening to simply zip up their black bags and go home if they don’t get the payment increases they demand each year, are going to end up costing you Medicare dollars in the long run. Long-term care advocates in Washington are shocked it hasn’t happened yet.
Make no mistake: For as bad as the polls tell us the second Bush White House has been for the country, nursing home operators have done pretty well by it. 
Yet even the Bush folks are getting in on the tougher-guy act. Almost as if intended to be a going away “present” to nursing home operators, Bush’s man at the Centers for Medicare & Medicaid Services, Kerry Weems, is bound and determined to leave his mark with a new “five star” facility rating system before he is told to start acting like an administrator someplace else.
Hopefully you’ll at least be in the middle of the pack when the ratings come out later this month.
With a new star in the White House, you’re going to need all the help you can get.