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 New Congress Brings Change, Offers Chance to Tell Provider Story

In an interview with Provider, Mark Parkinson, president and chief executive officer of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), describes how the split government and influx of new members of Congress will offer new opportunities and challenges for the long term and post-acute care (LT/PAC) profession.

The changing of the guard in the House to Democratic control will likely lead to gridlock on major legislation this year and headed into the presidential election year of 2020, and leave the regulatory activity at the Centers for Medicare & Medicaid Services as the main center of attention for LT/PAC advocates, he says.

But, Parkinson notes that Congress will remain a focal point for possible oversight hearings and other activity as the profession weights how a Democratic House, Republican Senate, and Republican administration will affect LT/PAC priorities in the next two years.

“Each party advocates for things that help us, and each party advocates for things that hurt us,” he says. “Democrats are good on Medicaid, and the fact they have control of the House now means that the Medicaid risk we faced in 2017 is something we are not going to face. There is not going to be a big bill to create per capita caps or block grants.”

On the flip side, Parkinson says, the Democrats can offer challenges on oversight and tort issues.

“Now that they have taken control of the House and have a bigger voice in the Senate, we are going to face more oversight, and it is very possible in the next couple of years that there could be hearings, particularly on the House side, on issues like staffing, adverse outcomes, and any time there is a negative isolated case like the evacuation problem in Florida,” he says.

While hearings may make for concern on some level, Parkinson is confident that the skilled nursing sector can more than hold its own when it comes to educating lawmakers on the quality of care residents are receiving.

“We have a very good story to tell. Our data are compelling in showing the national improvements that have been made in quality,” he says. “So, any time there is a hearing being held on an unreasonable topic, we will fight against that. In general, however, if there are hearings about how a nursing home is doing and we are given a chance to testify and the witness list is fair, we think we can do quite well and might be able to use it as a platform to explain the progress we have made.”

Parkinson says to improve quality in even a single nursing facility is hard, but to do so around the country as providers have achieved in recent years, it is even more remarkable.

“If you look at the data, and the numbers are the numbers, on a whole bunch of quality measures we improved across the country. But, we have gotten almost no credit for it,” he says. “There are very few stories that ever say, this isolated thing happened in Florida, but you have to keep in mind that hundreds of thousands of people were safely sheltered in place and oh by the way the sector is getting better on return to home and patient satisfaction, etc. It is just not out there.”

To get that story told in a more aggressive manner, Parkinson says AHCA/NCAL is increasing its efforts this year to build a so-called “army” of providers via a new social media initiative that can work to spread the positive news on quality issues.

Beyond the work advocating on issues and policies in Washington, D.C., he says with so many new members of Congress starting work, it is also important for providers to get these legislators into their buildings.

“There are a lot of stereotypes about what we do that go away when that happens,” Parkinson says. “They see the great care our members provide and also how old and frail our residents are, which deflates the myth that we have all of these people living in our buildings that could be living at home, which is just insane.”

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