John O'Connor
John O’Connor

Well, the Centers for Medicare & Medicaid Services dropped one shoe earlier this week. The agency announced a 3.7% Medicare Part A payment increase.

That certainly came as welcome news for many skilled nursing providers, as it means a higher-than-anticipated market basket increase.

“Funding goes hand in hand with quality care. The proposed payment rule acknowledges this critical reality,” Ruth Katz, senior vice president of policy for LeadingAge, told my colleague Kim Marselas. 

But as anyone who has been paying attention will tell you, there’s still another shoe to be dropped: an imminent staffing requirement. And if you think it will just affect nursing homes — that senior living won’t be affected — the Pennsylvania Health Care Association would like to have a word.

It’s not clear why the promised sanction was held back from this week’s announcement. More than likely, CMS is still trying to work out some staffing-related kinks. After all, the mandate promises to be a real game changer.

For now, operators are stuck in a “just wait until your father gets home” kind of purgatorial state. They know all too well that what’s coming will hurt, they just don’t know how much. Either way, there will be pain.

And the timing could hardly be worse. 

Operators have just endured more than two years of COVID-19, which has been one of the greatest job disincentive programs ever created for long-term care.

Hiring and keeping capable workers is a major challenge in the best of times. And what operators have experienced lately is anything but.

So, facilities that can’t find enough workers are going to be forced to meet quotas? To say the logic here is a bit odd would be an extreme understatement. It’s as if a law school refused to accept students until they passed the bar exam.

Regardless, the rule is coming. While much about it still remains a mystery, one thing is for certain: Providers are not going to like it.

John O’Connor is editorial director for McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News, which focuses on skilled nursing, and McKnight’s Home Care. Read more of his columns here.

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