Regardless of how long we need to wait after Election Day until we know the results, they will have “enormous implications on everything, including long-term care,” American Health Care Association / National Center for Assisted-Living President and CEO Mark Parkinson told those listening to LTC Properties’ third-quarter earnings call on Friday. He was a guest speaker at the event.

Parkinson knows a thing or two about government, having served in the Kansas House of Representatives and Senate and as governor of the Sunflower State before assuming his role with AHCA/NCAL, which represents 4,000 assisted living buildings and 10,500 skilled nursing facilities. And he has walked in the shoes of providers, having built, developed, owned and operated assisted living communities and skilled nursing facilities with his wife, Stacy, before taking on those government roles. And he brings perspective of having been a member of both of the country’s major political parties, too.

So what are the enormous implications Parkinson sees?


One involves coronavirus-related relief for assisted living and skilled nursing operators.

Although the outcome of the election won’t affect whether another stimulus bill will be passed and signed into law — Parkinson said he agrees with conventional wisdom, which suggests “a 100% chance” that the future has in store more relief — the election could affect the timing and amount of aid, he said.

“If Republicans retain one part of the apparatus, whether it’s the presidency or the Senate, the stimulus bill is very likely to be of the size that was being discussed when the discussions fell apart this week, somewhere around $1.8 trillion to $2.2 trillion,” Parkinson said Friday. “And of that, significant additional funds will be added to the CARES Act funding that will then be available for both skilled nursing and assisted living.”

If Democrats win the presidency and control over both chambers of Congress, however, then Congress may wait until a new president takes office in January to pass a new stimulus bill, he said. But the amount in the legislation will be higher, Parkinson predicted.

“Whenever there is a stimulus bill, if the Democrats take over, it will be larger than the $1.8 trillion to $2.2 trillion. It’ll be more like the $3 trillion bill that they passed back in August, and that may just be the beginning,” he said. “They are clearly wanting to spend significant amounts of money to stimulate the economy [and] to fight COVID.”

Liability protections

Coronavirus-related liability protection is another area that could be affected by the election results, Parkinson said, adding that two schools of thought exist on the subject. 

“As long as the Republicans maintain one part of the federal apparatus, whether it’s the presidency or the Senate …I think that the Republicans will continue to maintain that any future stimulus bill needs to have the kind of liability protection that all healthcare providers need to function going forward.”

On the other hand, he said, “If there is a Democratic sweep next Tuesday, there is the possibility that this liability discussion will be set aside,” although “the other school of thought is that if the Democrats sweep everything, they have an understanding that for the economy to move forward, there’s got to be some kind of liability protection.”

If Democrats win big in the election, Parkinson said, it could be that a smaller stimulus bill will be passed during the lame duck session and will contain liability protections, followed by the passage of a larger stimulus bill in January or February.

Federal regulation

Another big question for assisted living, regardless of who wins the presidency or Senate and House races, Parkinson said, is whether the industry’s request for federal help with coronavirus-related expenses will lead to federal regulation.

“It’s a very good question, and it’s a question that I think the boards of all of the assisted living associations asked themselves prior to making the decision to lobby for the funds,” he said. “Ultimately, the decision was made that the need for the funds outweighed any risk of potential additional regulation.”

Although Democrats generally are more interested in regulation than are Republicans, Parkinson said, even if Democrats sweep national contests, “full-blown regulation of assisted living that looks anywhere near like what skilled nursing is regulated under is unlikely. I don’t think that that will occur.”

Instead, he said, discussions most likely would focus on topics such as whether states should require assisted living communities to have stockpiles of personal protective equipment or infection control programs.

Testing and vaccination

What else does Parkinson think the future holds?

He predicts “robust testing” and “a clear understanding in long-term care buildings who has COVID and who doesn’t” over the next few months. Test accuracy and pricing already are improving, and long-term care is being prioritized for the tests, Parkinson said.

“And then, hopefully, we will get into the vaccine phase, and we’ll get people vaccinated,” he said.

If a COVID-19 vaccine is approved by the end of the year, Parkinson said, “there is a possibility that all of our residents and all of our staff will be vaccinated in January and in February and it will create this wonderful time that I’m certainly looking forward to, where we would be able to say to people that the safest place in the country for an older person right now is in one of the long-term care facilities that are out there.”

But “as all of this is going, we’ll continue to receive the funding that we need from the state and federal level to keep our heads above water,” he said.

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