by William J. Beerman, Sr.
Here’s an example showing that elections do matter, and so does access to power.
On June 12, 2017, the American Health Care Association (AHCA), which is an association of operators of 13,000 nursing homes and other facilities for the elderly, issued a news release about their leaders meeting with President Trump’s then-new Secretary of Health and Human Services, Tom Price.
The AHCA’s news release about its meeting with Price said:
“AHCA members discussed with Secretary Price the need for responsible regulation that supports and incentivizes quality improvement. Recent regulatory changes impose both redundant and unnecessary stipulations on providers and are not focused on improving care at the bedside. AHCA members specifically noted that some of the practices detailed in the Requirements of Participation, which the Centers for Medicare & Medicaid Services (CMS) issued last October, interfere with person-centered care and day-to-day operations.”
On July 7, 2017, less than a month after the AHCA met with Secretary Price, CMS, an arm of HHS that oversees nursing homes at the federal level, released a memorandum intended to lessen fines levied against nursing homes that have not complied with health and safety standards. CMS followed up with memos on October 27 and November 24 that reduced civil monetary penalties and delayed for 18 months enforcement of regulations in the Requirements of Participation that were set to take effect just days after the November 24 memo.
I mentioned the Price-AHCA meeting in my book, “Mary Regina’s nursing home,” along with the fact that Price, a former congressman, had received almost a half million dollars in congressional campaign contributions from the health sector, and that Price, also a physician, wanted to limit legal options available to aggrieved health care patients.
AHCA and National Center for Assisted Living (NCAL) President and CEO Mark Parkinson is no lightweight stranger to politics. He is the former governor of Kansas and served as lieutenant governor under former Kansas Governor Kathleen Sebelius, who actually became HHS secretary herself under President Obama. Parkinson is also the developer of 10 elder care facilities.
In a letter released February 20, 2018, 11 Democrat U.S. senators and one independent senator wrote to new HHS Secretary Alex Azar and to Seema Verma, administrator of CMS, explicitly criticizing CMS over the three CMS memoranda from July, October, and November 2017, and characterizing the memoranda as “a string of actions…that will inevitably weaken the safety of our nation’s nursing homes and put patients, many of whom are elderly and wholly reliant on this care, at greater risk.”
The letter from the senators said: “It is abundantly clear that when health and safety are compromised, when errors occur, or in the worst cases, when patients are harmed, there must be a wide range of strong enforcement actions available….That is why we are so alarmed that CMS seems intent on rolling back or delaying enforcement of regulations that are meant to keep nursing homes safe for the patients they serve.
“We will not and cannot accept CMS’ actions that fail to keep nursing homes held to the highest possible standards when it comes to patient care and safety, and we urge CMS to reconsider these policies immediately.”
The letter was signed by Senators Richard Blumenthal (D-CN), Amy Klobuchar (D-MN), Robert P. Casey, Jr. (D-PA), Elizabeth Warren (D-MA), Catherine Cortez Masto (D-NV), Tina Smith (D-MN), Bernard Sanders (I-VT), Kirsten Gillibrand (D-NY), Jack Reed (D-RI), Edward J. Markey (D-MA), Cory A. Booker (D-NJ), and Sherrod Brown (D-OH).
Support for nursing home residents is not a strictly partisan issue. The 11 Democrats who signed the letter are among 47 Democrats in the 100-member Senate. For example, the two Democrat senators from my state of New Mexico were not among the signers. In a case where Republicans demonstrated that nursing home patients are not exclusively a Democrat concern, in Minnesota, a group of Republican state senators led by Karin Housley held a press conference to “demand accountability, transparency, and immediate attention” to state nursing home oversight failures in Minnesota. Their protests led to the resignation of the state health commissioner in December 2017.
The AHCA seems to have demonstrated it can be successful with the current administration in opposing regulations it disagrees with. The organization also contends that Medicaid payments fall about $25 per patient-day or $7 billion a year short of what is needed to meet standards of nursing home care. If what AHCA says is true, then Congress should remedy the funding problem.
But if Congress accepts the AHCA argument and provides more money, the appropriation law should include safeguards such as effective oversight to ensure that the additional money is spent on improving patient care and that it does not generate unreasonable profits for the operators.
I delayed publishing this article and sent it to the AHCA and HHS to give them an opportunity to comment. The AHCA replied that it had nothing to add, but HHS did not respond.