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Will This Be the Day the Feds Destroyed Assisted Living

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By Steve Moran

I sent my dog out to get the newspaper and opened the front section to find an article that was sourced to the New York Times: “Feds find gaps in scrutiny of assisted-living facilities.” (The title is that of the Sacramento Bee.) The New York Times on their site titled it “U.S. Pays Millions for ‘Assisted Living’, but what does it get?”

Sometime on February 4, 2018 the GAO will issue a report on oversight of assisted living communities that receive federal dollars through the Medicaid waiver program. The crux of the article is that federal and state governments are spending $10 billion a year ($30,000 per resident) on 330,000 residents who live in assisted living communities, but there is inadequate data on how well those residents are being cared for.

Report Not Yet Out

At the time I am writing this the report has not been released, but this article suggests the New York Times got an advanced copy so it may turn out to be better than it appears to be . . . but don’t bet on that.  

There is one line that seems alarming (I assume the intent of the line):

The problem, of course, is that there is no context for this statement; most glaringly, not even what year it is talking about.

The Underlying Problem

The underlying problem/frustration with what appears to be the theme of this report is that more oversight and, more specifically, more federal oversight will mean residents will get services and be better protected. Yet all one has to do is look at the massive, senseless, contradictory, burdensome federal regulations nursing homes must deal with to see that:

  • There are still stories of horrific abuse in nursing homes that appear in national or local news outlets every single day

  • Those regulations make the cost of care massively higher

  • Worst of all because of those regulations, nursing homes spend most of their time trying to serve the regulations, not residents

Our Messaging

We need to be doing all we can to tell our story better. There are 5 obvious areas that all of the various trade groups should join forces to be telling:

  1. When abuse happens we should condemn the abuse and the operators. Yesterday there was a story about a drone pilot that flew in the restricted flight area of the Las Vegas airport. Every single drone advocacy group came out saying “Figure out who did it and prosecute them.” I am not sure I have ever seen that kind of strong response from our industry.

  2. We need to talk about what regulations are doing to the nursing home industry, how they hurt resident care and safety. Along those lines, we need to propose a new way of doing things. I know it is not easy, but it is the right thing to do.

  3. We need to talk about how much higher a quality of life these waiver residents have.  

  4. We need to talk about the additional $20 or $30 billion dollars that $10 billion dollar investment saves federal and state governments.

  5. We need to be telling feel-good stories. We need to talk about how we are helping hundreds of thousands of seniors live massively higher quality of lives.

These kinds of things can hurt us or serve as a call to make things better. I am hopeful that we will step up to the challenge of this great opportunity. 

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