Skilled nursing operators pondering when things would get back to normal need no longer wonder. In many ways, you’re already there — unfortunately.
There have been numerous signs that any accrued sympathy for the most vulnerable environments during the global healthcare crisis has been draining.
It’s not hard to find stories of providers being sued or accused of lapses in care during the pandemic. And there have long been warnings that the flow of extra relief cash from government coffers will be choked off all too soon.
Then came April’s announcement that Centers for Medicare & Medicaid Services is proposing a 1.3% Medicare Part A pay increase for next year. That $444 million raise is nothing to sneeze at, but it’s also several hundred mil shy of what providers usually are left to sprinkle over their communities.
On top of that, regulators also proposed an array of other possibly ominous provisions in the fiscal 2022 rule. True, CMS noted that this coronavirus bug seems to have set everything off kilter, so the agency didn’t immediately make any Patient-Driven Payment Model cutbacks.
But it made it pretty clear they’ll be coming. The agency pointed out its supposed payment-neutral system had overpaid by about 5% — or $1.7 billion. Some were hoping that any clawback might not occur until fiscal 2023 but that’s apparently not the case now.
At least CMS is asking for opinions on how budget amputations should take place. Comments expected by June 7, with no guarantees they’ll be heeded. The main intrigue is just how quick and blunt the instrument will be to carve the so-called fat from the program.
It’s almost as if some are acting like the industry had a broken arm that has healed after spending 14 months in a cast.
We haven’t touched on the projected value-based purchasing losses in the coming year and other belt-tightening proposals tucked into the many-pronged payment rule. Oh yes, there’s also that little matter of being scrutinized over worker COVID-19 vaccination rates. That’s also going to start Oct. 1, barring miraculous developments. Nor have we touched on the rolling back of certain waivers that were created because of the pandemic.
So, worries about funding, increased regulatory oversight and potential legal pressures? A sense that worse may be yet to come? Yes, it does sound indeed like things are getting back to normal.
