The Opening Session at the American Health Care Association Convention in Las Vegas was a mix of overflowing enthusiasm and reasonable concern about reimbursement issues. It appears that the 11.1% CMS cut has not caused undo concern in the Nursing Home Industry because everyone understands that it resulted in a windfall profit the prior year. That being said, there is very real and legitimate concern about reimbursement in future years. Here is the gist of the concerns:

  • The critics of Long Term Care do not really understand what the industry does, particularly with respect to skilled nursing. The quote of the day was: “Our critics don’t know what we d0.”
  •  There is a perception that long term care is just a huge money pit and provides little value to society. There is a belief that long term care/senior housing is simply human warehousing, holding the almost dead until the end comes and doing it in an inhumane fashion; and, finally, that these terrible warehouses are run by people who only care about the money.
  • There is a lack of appreciation for the fact that long term care communities provide jobs for hundreds of thousands of people, many of whom come from the lowest economic levels of the country, and that, without these communities, the unemployment problem would be much worse.
  •  There is a lack of understanding that staff in care facilities work hard to make the last days of our most frail seniors as comfortable and pain free as possible. That it is often a long term care staff member who holds the hand of a senior as they take their last breaths.
  • They pointed out that, when the Obama Health Care plan was being crafted and debated, virtually every segment of the health care industry had a seat at the table (hospitals, physicians, drug companies, durable medical manufacturers) except long term care.

This analysis of how long term care and senior housing is perceived is right on the money. What I didn’t like was the plan to address these issues. There are a series of short videos that have been made to portray long term care “as it really is.” There are smiling seniors and well-dressed, well-spoken, uniformed care givers . . . see for yourselves . . .

I only wish this were an accurate picture. Some active retirement communities, and even some assisted living communities and perhaps a few skilled nursing facilities do look like this. But most skilled nursing communities and SSI based assisted living communities do not.

Don’t get me wrong, I believe that most skilled nursing communities are doing the best they can with the resources they have. The residents have complex needs that must be managed which is not an easy task. These “feel good” videos actually make the industry look worse, not better.

I would bet that most corporate nursing home executives, administrators and care givers hope and pray they will not have to live out their last days in the facilities they own, operate and work in. (If your facility or facilities are great don’t beat me up: you know what I am talking about.)

The problem is that when you paint a false picture and people then visit a more typical community they are shocked. They have no idea that these buildings, these care teams, are doing the best they can with what the government is willing to pay.

I wish that these videos would paint a more realistic picture of what senior housing/long term care is like. Sure, talk about the dedicated professionals (because this is true) but tell the story of how challenging it is, how close to the edge many communities run because they do not get adequate funding. Then lobby for more reasonable reimbursement and more flexibility in the regulations.

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