For many years, I’ve been predicting one thing no assisted residing operator needs to listen to: federal oversight of assisted residing will occur.
So, I used to be 100% unsurprised earlier this week when Senate lawmakers referred to as for precisely that — or not less than an exploration of whether or not extra is required.
Understandably, the assisted residing business is pushing again, because it all the time does, arguing that state-level regulation is “sturdy” and that new reporting necessities beneath the Medicaid Entry Rule ought to be given time to work. However let’s be trustworthy — these are stalling ways. Federal oversight just isn’t a query of if, however when.
Assisted residing is, at its core, a area that cares for the frail aged. Its residents are sometimes simply as medically weak as these in nursing properties, and in some circumstances, they want much more care. But, not like nursing properties, assisted residing communities stay beneath a patchwork of state laws that fluctuate dramatically in each rigor and enforcement.
The business’s let-us-be argument might need been extra persuasive when assisted residing was basically a private-pay choice. However that’s clearly not the case.
Roughly 17% of residents depend on Medicaid to pay for his or her care. And that quantity is simply rising as extra older adults depend on Medicaid to pay for his or her care.
Given this degree of federal help, the concept that assisted residing can stay a state-regulated business indefinitely is a troublesome promote. Furthermore, comparisons to nursing properties — federally regulated for many years — are exhausting to disregard, particularly now that so many assisted residing operators proudly name themselves healthcare suppliers.
Business teams just like the Nationwide Heart for Assisted Residing and Argentum argue that state oversight is adequate and that extra federal guidelines would restrict resident selection or discourage suppliers from accepting Medicaid altogether. They emphasize that satisfaction charges amongst residents are excessive.
What amazes me about this argument is how lengthy it has been efficient. However all good issues should finish. Nursing properties fought federal oversight, too. So did residence well being companies. So did hospitals. And but, regulation occurred. Why? As a result of public funding inevitably brings public accountability.
Sure, state oversight exists, however as previous experiences have proven, it’s inconsistent. The 2018 Authorities Accountability Workplace report already highlighted gaps in state Medicaid oversight.
Prefer it or not, federal oversight is coming. The actual problem ought to be whether or not the business needs to assist form these laws — or have them imposed within the wake of a disaster.
On the plus aspect, there is a chance right here for business leaders to be proactive — to work with policymakers on good, balanced oversight that ensures high quality care with out strangling innovation. And there’s a mannequin for that: business motion on the state degree.
Assisted residing operators could be clever to push for federal guidelines that enhance transparency, resident security and funding stability whereas sustaining the pliability that makes assisted residing a beautiful choice for older adults.
The worst strategy — in my opinion — is hoping federal regulation will be averted altogether. Historical past tells us that stance has a restricted shelf life. And by all indications, that expiration date could also be quick approaching.
John O’Connor is editorial director for McKnight’s Senior Residing and its sister media manufacturers, McKnight’s Lengthy-Time period Care Information, which focuses on expert nursing, and McKnight’s House Care. Learn extra of his columns right here.
