Category Archives: Long Term Care and Nursing Homes

The Accelerating Scale of the Legislate-Regulate-Spend-and-Repeat Cycle Has Broken Government

by James C. Sherlock

Virginians – the state and individual citizens – have received over $81 billion in COVID-related federal funding. That comes to $9,507 for every man, woman and child in the Commonwealth.  Big money. 

That was Virginia’s share of $5.3 trillion in federal spending just on the pandemic (so far). A trillion dollars is a million million dollars. A thousand billion dollars.

For comparison, GDP was about $21 trillion in 2020  It is projected to total just short of $23 trillion this year.  The national debt is $29 trillion and growing. A little over $86,000 for every American. That figure does not include the $5 trillion in additional spending pending in the Congress.

Every day we spend $1 billion on interest with interest on the 10-year treasuries at 1.18% today. The Congressional budget office predicts 3.6% before 2027. Do the math. That is $3 billion a day — well over a trillion dollars a year — in interest. 

Relax. If you thought I was about to launch off on a discussion of drunken sailors, writing checks that our grandkids will have to make good, and the fact that inflation will drive interest payments ever upward, be reassured I am not.

This is about the demonstrated inability of many government agencies at every level to regulate, administer, oversee, spend and repeat with anything approaching efficiency or effectiveness.  Continue reading

The Business and Politics of Senior Care in Virginia

by James C. Sherlock

We write here often about senior care, the companies that provide it and the politics around that business.

It is useful to understand the continuum of care to make sure we also understand the different financial situations which companies in different parts of that industry find themselves and the way they are overseen and paid in Virginia.

The larger corporations that offer these services often offer both facility and in-home care.

The basic descriptions below are offered for considering the business interests and therefore the lobbying efforts of the companies that provide the services. They are not meant for personal counseling. Continue reading

The Real Nursing Home Scandal in Virginia

Canterbury Rehabilitation and Healthcare Richmond

by James C. Sherlock

Mike Martz has written three excellent columns that have appeared in the Richmond Times Dispatch starting March 19.  Headline of one: “Virginia tries to move ahead of national ‘reform agenda’ for nursing homes.”

The gist of it was that a couple of national nursing home industry organizations have taken advantage of the public consciousness of the COVID tragedies to produce a “reform agenda” centered around significantly higher Medicaid payments.

Unreported so far is that they also want weaker inspections. More about that below.

We all applaud any attempt to “improve operating standards for nursing homes, initiatives to boost the facilities’ workforce, and efforts to give residents more privacy and protect them from poor-performing nursing homes” as Martz wrote. Who could oppose that?

The financials of nursing homes lead me to agree that higher Medicaid payments will be required to accomplish those goals. But the higher payments need to be accompanied by better oversight to make sure that the money brings the desired outcomes.  Continue reading