For senior residing, a fragile balancing act

For senior residing, a fragile balancing act


James Balda, president and CEO of Argentum, is asking for a tweak in how assisted residing is funded. And by tweak, I imply enhance.

In a current letter to Robert F. Kennedy Jr., nominee for secretary of Well being and Human Companies, Balda sought larger Medicaid help for assisted residing communities. He argued they provide a more cost effective various to nursing residence care — and, in lots of circumstances, residence care — whereas enhancing residents’ high quality of life. Balda made the identical argument to President Trump final week.

That will all be true. However my, how the worm has turned.

For many years, the assisted residing business has rigorously positioned itself as distinct from conventional long-term care. It did this by emphasizing a residential, hospitality-driven expertise and particular person alternative moderately than a extremely regulated medical mannequin. The concierge-with-benefits moniker offered two distinct benefits:

  1. First, it advised potential residents (who might afford the hire) that the assisted residing expertise can be way more uplifting than what a nursing residence might provide.
  2. Second, it subtly reminded federal regulators to maintain their mitts off: Assisted residing is a lifestyle-driven choice, not a healthcare facility in want of policing by the Facilities for Medicare & Medicaid Companies.

The second premise hasn’t aged significantly nicely, nevertheless. In truth, immediately’s typical assisted residing resident seems to be an terrible lot just like the nursing residence resident of a decade in the past. Individuals are transferring into assisted residing communities later in life, bringing extra complicated care wants and a larger reliance on help. The traces that after clearly separated assisted residing from expert nursing have gotten more and more blurred.

Now, as assisted residing leaders push for a extra central position within the senior care continuum, a troublesome query arises: Can the sector entice federal funding with out inviting larger federal management? Discuss a balancing act.

That problem might intensify, given the doubtless pushback from lawmakers and expert nursing operators — a few of whom are questioning why the goose retains getting handled in a different way than the gander.

Assisted residing is presently regulated on the state degree, permitting for flexibility, innovation, and — critically — avoidance of these pesky federal mandates that outline expert nursing.

If assisted residing continues its push for a stronger position in long-term care, avoiding Washington’s oversight could also be an choice that’s more and more troublesome to defend.

John O’Connor is editorial director for McKnight’s Senior Dwelling 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.

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