This spring’s nursing home fun actually started Feb. 28, when the administration said it was going to push for the most sweeping industry reforms since OBRA ’87.
During the State of the Union address the next night, President Biden took aim at private-equity ownership within the field, while promising tougher Medicare standards. He also claimed care quality is declining as operators charge more.
“That ends on my watch,” he concluded.
Predictably, the sector responded with a few questions of its own. Questions like:
• If nursing home operators can’t hire enough people now, how will they hire more?
• Where is the money for these numerous new initiatives?
• How do massive fines help fiscally struggling facilities improve?
There were more questions, but you get the general idea.
To quote Yogi Berra, “It’s like déjà vu all over again.” Several variations of this kabuki dance have been playing out since President Johnson signed Medicare into law more than a half century ago. That landmark legislation created the long-term care system as it now functions.
Ideally, Medicare payment provisions would have covered more than a small fraction of actual nursing home caregiving costs. But several key lawmakers balked, fearing the economy might suffer. So providers suffered instead.
Now, are there bad actors in the industry who have played fast and loose with payment rules? Absolutely. In fact, we report on them all too often.
In my view, lawbreakers should be arrested and prosecuted. These characters give the industry a tarnished reputation. And they give critical policymakers and lawmakers ammo. Moreover, long-term care as it is delivered at more than a few facilities could be better.
But if the government is going to keep setting unrealistic expectations — such as demanding Ritz-like amenities while offering Motel 6-like payments — it should hardly be surprising when corners get cut. For as the saying goes, you get what you pay for.
It’s really not a difficult concept to understand. Except in Washington, apparently.