The industry needs to be very proactive about this issue. It is a real and legitimate threat.

By Steve Moran

Recently, we published an article titled “Will This Be the Day the Feds Destroyed Assisted Living?” I was pretty proud of it because I got the jump on every other senior living publication. The very next day Senior Housing News published an article about the report in which they had quotes from LeadingAge, AHCA, and Argentum with all three saying in effect, “This is no big deal.”

I confess to being baffled and wondered if I was in fact OVERREACTING.

Then Came NIC

The Tuesday morning opening general session at the NIC Spring (2018) investment conference was titled “Trends in Healthcare Payment and Delivery Reform”.  The speakers’ group included:

  • Niall Brennan, President of the Health Care Cost Institute
  • Adaeze Enekwechi, VP for Policy, Strategy, and Analytics of McDermott+Consulting
  • Kristin Welsh, Founding Partner, Welsh Rose, LLC
  • Dan Mendelson, President, Avalere Health

These are all folks who are or were Washington insiders. They to a person think the senior living industry, meaning very specifically assisted living will…

  1. Get federal regulation sooner or later

  2. Should take the lead in pushing for regulation

The Thinking

I want to start by saying they are not the first people I have heard suggest we need federal regulation. There are some insiders who believe we need it because it would provide more consistency. But here is how the panel’s logic goes:

  1. As assisted living becomes increasingly medical, the need for regulation will increase.

  2. Assisted living provides a uniquely positive way to provide care to frail seniors at a cost that is lower than skilled nursing and quality that is higher than skilled nursing.

  3. It is inevitable that some big disaster will hit that will result in a public, media, and or politically motivated imperative to regulate.

  4. If the industry does take the lead in becoming federally regulated they will be more likely to make sure the regulation is light rather than heavy.

Keep Your Heads Down

Is it inevitable? I don’t think so, I hope not. The problem is that no agency ever says, “You know, we already have enough regulation” or “Hey, let’s spend this year reducing the regulatory burden on those we regulate.” Even if it starts light, it won’t stay that way.

Regulation will also mean increased costs and increased staffing needs at a time when those areas are of great concern for every operator.   

The Solution

I don’t have a specific solution, but I do believe the industry needs to be very proactive about the issue and see it as a real and legitimate threat. It is part of the reason why we should be saying “That’s Not Us” whenever we see operators that are not doing the kind of care they should be doing.

So what do you think? Would you favor federal regulation? Do I have this wrong?