Short-Term Relief Does Not Correct Nursing Home or Medicaid Home Care

The illness and death that covid-19 brought to the elderly brought historic opportunities to the United States Rethink how care is provided and paid. Still, many in the care industry, and even many defenders of the elderly and young people with disabilities, are lobbying for short-term corrections rather than actual reforms.

Nursing homes and nursing homes are looking for government remedies and federal protections against lawsuits from people and staff infected with coronaviruses on the premises. They have already received something like that Liability protection from at least 26 states..

Many advocates for the elderly are equally short-term focused. They are Temporary increase in federal share of Medicaid paying for home and community-based care.. This strengthened federal consensus is also far less than resolving the underlying financial challenges and delivery flaws of Medicaid’s long-term service and support.

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Quick fix

However, nursing homes do not need help. Or, you don’t need any more short-term assistance to provide Medicaid’s long-term service and support.

But this successful support leaves our broken healthcare system virtually unchanged. It will surround structural defects for months, or perhaps a year. But we still have the same problem. The United States spends enormous money on providing the wrong care to seniors in the wrong place. And older people and their families hate it.

Nursing home remedies can be even worse. Poorly designed, they effectively reward facilities for covid-19 failures and discourage reform.

Nursing homes have already received approximately $7 billion from the federal government with direct assistance, and billions more in advanced Medicare and Medicaid payments, as well as payroll protection programs (PPP) and low-interest loans. Received through a wide range of business relief programs. The Trump administration has promised an additional $5 billion in cash assistance and new rapid testing equipment.

But the industry wants Congress to give a green light Another $100 billion cash aid The following stimulus bills provide health care providers with a significant amount for nursing homes and nursing homes.

Don’t be surprised

The question is not surprising. Many providers face serious financial problems. On the cost front, they face high costs and high labor costs due to covid-19 related testing and personal protective equipment (PPE). At the same time, earnings are being hit. Nursing homes suffer from beneficial acute rehabilitation and other loss of care for patients recovering from surgery and stroke. Residents who may be in long-term care are reluctant to move in. Nursing homes and continuing care communities face many of the same problems, but some are slowly starting to recover after a devastating spring.

The industry’s main lobbying groups, the American Healthcare Association (AHCA) and the National Living Support Center (NCAL), Survey of special elderly nursing home operators According to reports, 55% of facilities are currently operating at loss, and 40% believe they cannot continue to operate for more than 6 months with their current margins, and nearly three-quarters cannot survive a year. These results are consistent with a nursing home lending expert, who personally predicts that covid-19 will shut down about half of all current businesses.

Genesis Healthcare Inc., one of the largest nursing home companies nationwide Warned investor On August 10, it was discovered that cash flow constraints “substantially questioned our ability to continue as a going concern”.

Moral hazard

Short-term financial relief may keep some facilities above water for some time. But even after the covid-19 pandemic is eased, the facility still faces high labor costs (even before the pandemic, a severe labor shortage pushed up wages). They still bear the capital cost of reconfiguring the interior space to reduce the spread of future viral infections. For example, often two or even four unrelated residents need to abandon the arrangement to share a room.

At the same time, the demand for care both post-acute and long-term is unlikely to return to pre-covid-19 levels. Improvements in technology, Medicare and Medicaid payment changes, and the growth of managed care will move patients from nursing homes to home-based alternatives.

In the case of liability protection, it gets even worse. Indeed, it has the potential to reduce short-term legal costs and keep providers affordable insurance. However, government remedies and liability protection are classic examples of moral hazard. If you think someone else will pay for your mistake, you will continue to make mistakes.

In this case, poorly designed assistance only prevents operators from making the necessary changes to staffing, care protocols, and design. As a result, more consumers will be driven off, and regulations may be tightened.

However, the elderly are not alone with myopia. Supporters of the elderly are also aiming for too low a goal. For example, the National Council on Aging Temporary increase in federal funding Medicaid home care and community-based care. AARP doesn’t go that far: that Legal response to covid-19 It seems to be primarily focused on supporting more funding for testing at PPE and nursing homes, as well as facility oversight.

These defenders for providers and consumers need to know better. Short-term modifications do nothing to repair the shattered system of the nation’s care of people with the need for long-term care.