Interview with Brendan Williams, President - New Hampshire Health Care Association
Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Brendan Williams, President and CEO of the New Hampshire Healthcare Association (NHHCA), in the AHCA Provider Lounge. Brendan discusses the staff crisis facing skilled nursing homes. Not only does Brendan strive to make caregiving an attractive profession to the current generation, he argues that "we can't have people getting poor for taking care of the poor." (Audio transcription below).
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Kris Mastrangelo: Good Afternoon. It’s Kris Mastrangelo with the Provider Lounge. We are here at the American Health Care Association Annual Convention. Today we have Brendan Williams from New Hampshire Health Care Association.
Brendan Williams: Thank you Kris.
Kris: First off, I have to tell you that I love your updates. You write the best narrative and give such great information. You distill and synthesize for the readers. Tell us a little bit about what’s happening in New Hampshire and what keeps you up at night.
Brendan: Well I think the staffing crisis right now keeps me up at night. We really have a read-hot service economy and New Hampshire has a three percent unemployment rate, which is great for the economy as a whole, but challenging when it comes to recruiting and retaining caregivers. The Medicaid rate has only gone up four and a half percent over the last seven years and when you think about the fact that providers had to give pay increases over that time, you can imagine how squeezed they are when it comes to finding caregivers and keeping them. So, we’re really challenged right now.
Kris: And coupled with the fact that the Requirements of Participation are putting a higher expectation on training and competencies that is going to absolutely impact the operations as well.
Brendan: Unfortunately it feels like the floggings will continue until morale improves. Unfortunately, the federal government has been really unmindful of the work of long-term care providers. Most people in CMS tend to come from the hospital industry or they come from the insurance industry and they don’t really understand long-term care so it’s a challenge for us. I know that the intentions are good in terms of a lot of these requirements but it’s just an additional burden for all providers.
Kris: Agreed. The intentions are good and I think that as I spoke earlier that when we have these requirements and the proposed rule identifies that the complexities of the patients have increased. How can one expect higher standards without reimbursing the providers for that? It threads right into this conversation.
Brendan: Well and a lot of these discussions about quality sort of seem like admissions against interest…in the sense that it’s as if providers are not already providing good quality. And in New Hampshire we’re second in the nation when it comes to having the fewest health deficiencies so we think we’re already doing a good job. You know obviously, we’d always like to improve but the idea that this could be driven by federal regulation not really the case – particularly if there’s no funding accompanying that.
Kris: Excellent and the facilities are beautiful and they are absolutely well-run. It’s amazing. It’s beautiful environmentally as well. One more comment, what about the integration of the five-star with the quality measures. How are your providers receiving that? Are they managing it along or do they have any issues with the five-star.
Brendan: Well I think they fear that all of this is a bit arbitrary. You know sort of like what is going on in schools these days where you’re just teaching to the test, right, and there’s so much more to the quality that a long-term care facility provides than just these sort of arbitrary measures and I hope people aren’t fooled into thinking that that’s all there is. I really hope they take the time to check out facilities and get to understand the caregivers and the type of care that’s being provided not just rely upon these arbitrary measures.
Kris: Agreed. One hundred percent. I’m a major patient advocate although I like the reimbursement aspect of it and the regulatory and I do believe, in my years in hundreds and hundreds of nursing homes, that the services provided are underestimated and I didn’t realize that the governmental makeup was of non-skilled experienced individuals that does put a different spin on it for me.
Brendan: Actually, it’s been tough for us because you know those wanting to go into long-term care are already spending so much time training and if they have a better option in the service sector somewhere, are they really going to put in that effort in order to become a licensed nurse’s aide. We need to make caregiving attractive to this current generation and we can’t have people getting poor for taking care of the poor and that really is what happens in Medicaid facilities unfortunately.
Kris: It’s a great quote. We can’t have people getting poor, taking care of the poor. That’s going to be the tagline for this one. Thanks so much for coming.