Skilled nursing gets hammered, again, in Congressional hearings, but they avoid the biggest problem: lack of funding.

So, did you think I was going to talk about the impeachment hearings? No way. That would be too easy. I’m talking about hearings on the cost of caring for the elderly.

Of course, a few of the people testifying had very little positive to say of nursing facilities and the quality of care. But what struck me as odd was that there was not one representative of the skilled nursing industry there. You would think that a large chain CEO might have been invited, or perhaps Mark Parkinson of the American Health Care Association. Maybe they were, but I kind of doubt it.

Could care in many skilled nursing facilities be better? Of course. Could skilled nursing attract better caregivers if wages were higher. Of course. Will Congress and states allocate more funds to nursing facilities to accomplish this? Of course not. The argument has been that investors are taking all the money out of the facilities that should be going towards care. This is only partially true. The reality is that Medicaid reimbursement in most states has not kept up with rising costs, and Medicare rates and lengths of stay have been dropping.

You want five-star dining? You are going to pay for it. You want five-star care in SNFs? It will cost you. The problem is that most people, and the government, can’t or don’t want to pay for it. A recent report from CliftonLarsonAllen in Massachusetts said that one in four nursing homes in the state are at risk of closing. Unfortunately, it is a story we are hearing more often across the country. And no one really benefits.