Mark Parkinson headshot
AHCA / NCAL President and CEO Mark Parkinson
Mark Parkinson headshot
AHCA / NCAL President and CEO Mark Parkinson

If the nursing home system is going to attempt any kind of transformation post-pandemic, the sector must see an increase in Medicaid reimbursement rates, staff wages and facility accountability.

That’s according to speakers at a virtual roundtable discussion Thursday exploring the effects of COVID-19 on the long-term care industry. The webinar was hosted by the Solomon Center for Health Law and Policy at Yale Law School.

Amid a debate about the funding needs of the sector, American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson called for industry advocates to come together and acknowledge that nursing homes are struggling under the current payment system.

“There are some people that are making a little bit of money, but there’s a bunch of people that aren’t making any money at all,” he said. “The largest provider in the space is Genesis Healthcare, whose stock was delisted last week, trading at 80 cents. This constant thought that somehow these nursing homes are making a ton of money and we don’t need to put money into the system is slowing down the fixes that need to be made. Until we actually increase the resources available and spend them in a smart way, nothing is going to change.”

Parkinson was joined on the panel by Shawn Bloom, president and CEO of the National PACE Association, David C. Grabowski, Ph.D., a professor of healthcare policy at Harvard Medical School and Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care. The Solomon Center’s Nina Kohn moderated the discussion.

Several panelists noted that along with an increase in funding, nursing homes also must become more transparent in how that money is spent.

“There are some facilities that are playing games with their accounting,” Grabowski said. “Those additional dollars need to be paired with accountability. If we’re going to give this industry something, we’re also going to ask something from them as well.” 

A revision of the nature of the current payment system also would help transform the skilled nursing sector, said Bloom, who added that the current payment model essentially brings more money in as individuals decline in health. 

“We’ve got to really think about building incentives into payment models that slow and reward reductions and decline,” he said. “We’re not going to reverse aging, but if we can incentivize providers to slow the rate of decline and somehow build that kind of incentive into payment models, I think it would change the nature of how we deliver care.”

Grabowski added that another fix to help make nursing homes safer and more effective for both long-term residents and short-stay patients going forward would be to increase wages and benefits for direct care staff.

“If we’re going to transform the system and recruit better staff and retain those staff, we need to pay them more,” he said.