Long-term care providers are being indoctrinated yet again to a harsh life lesson that goes something like this: He with the biggest stick usually wins. Sub in “deepest pockets” for “biggest stick” and you get the same result when it comes to policy battles.

Don’t be surprised that money can buy you happiness when it comes to lawmaking and rule promulgating. Being correct on an issue can fill a person with pride, but if that’s all you come to the game with, it doesn’t do as much for filling the win column.

What I’m referring to is recent bare-knuckles distribution of government healthcare funding.

For nursing home operators, it’s a perennial battle to get more Medicare (and Medicaid) dollars to provide care for some of the most frail and vulnerable people in our midst. Their caregiving doesn’t Uber anybody to the fountain of youth, but at least it typically adds quality to already lengthy lives.

For others looking to Uncle Sam for big funding, however, let’s just say it’s more like they’re picking pockets to put better seat covers on their Rolls Royce.

Take, for example, what Medicare Advantage and other dubious insurers have been accused of by no less than the Wall Street Journal. “Insurers pocketed $50 billion from Medicare for diseases no doctor treated” read the headline this week. Extra MA payments kicked in for situations that were described as “anatomically impossible.” 

That’s $50 billion — with a ‘B,’ mind you.

That could pay for, oh, say a decade’s worth of the nursing home staffing mandate, according to just about everybody’s cost estimates.

Moreover, it could buy a lot of time to grow the pipeline to attract and educate a whole bunch of registered nurses that are called for in the mandate but don’t yet exist in great enough numbers.

But don’t get giddy just yet. 

A group getting fat on excess government cash that rushes to give any of it back has yet to be founded. 

The huge insurer profits aren’t just left to gather dust in a vault in the boardroom, either. Some of these same companies devouring the marketplace — and so much of Uncle Sam’s largesse — are also funding “consumer” campaigns like the one aiming to keep the nursing home staffing mandate in place.

And while groups less capitalized than the nursing home lobby might bemoan the latter’s resources on hand, you can be sure that pile of dough is a comparatively paltry sum compared to what the insurers go to battle with. Nursing homes have seen the same when being compared to the hospital and physicians’ lobbies. And we haven’t even mentioned Big Pharma yet.

Money … stick? They’re figuratively the same when it comes to trying to sway policy.

Unfortunately, right now, nursing homes don’t have enough of either to win the big ones it really wants.

James M. Berklan is McKnight’s Long-Term Care News’ Executive Editor and a Best Commentary award winner in the 2024 Neal Awards, which are given annually for the nation’s best specialized business journalism.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.