Existing and new obstacles to the construction and innovation of the nursing home sector are expected to eliminate the best need (CON) of certain state providers, but higher tariffs will impose challenges Therefore, it is felt all over the country. road.
The fraud law generally requires providers to provide specific permissions from the government before building skilled nursing facilities, hospitals and other care sites. And amid these fraud laws, US President Donald Trump's tariffs are expected to be around 25% for goods from Canada and Mexico, and 10% for goods from China, and nursing homes are expected to be It brings another hurdle to overcome.
“This is going to create another hurdle…and new developments are needed. Steve Laforte, Corporate Affairs and General Counsel at Cascadia Healthcare, told Skilled Nursing News. “More beds are It is necessary, more access is needed, and increasing construction costs will not help us. There is a need for ways to reach a wide range of solutions for the limited sector of the economy.”
Therefore, between CON laws and tariffs, nursing home operators are likely to exacerbate access issues despite increased closures, increasing demand amidst a lack of staffing, and Cut their work for them.
In August, the American Healthcare Association and the National Assistance Center (AHCA/NCAL) reported that at least 774 nursing homes have been closed since 2020, stoking away 28,421 residents. Approximately 20% of nursing homes closed their units, wings, or floors due to labor shortages.
Based in Idaho, Cascadia operates 58 facilities in five western states, including Washington.
Washington was notoriously difficult to build a new nursing home. That is, until the state has also brought about dozens of closures, due to the confluence of interest rates, covid and labor shortages, Lafort said.
Now, despite the law itself still exists, it's much easier to get scams in Washington, but he says operators still need to fight the bulging labor and material costs. I did. And it doesn't take into account potential tariffs.
Pros and cons of fraud
According to the National Health Policy, 35 states have CON laws, but about 12 states have completely abolished the CON program.
The latest to join the bid is West Virginia. State lawmakers are considering repealing demand law certificates, with some experts explaining that they cannot limit access to healthcare, increase costs and improve quality.
Other state leaders say the CON Act is still experiencing a shortage of staffing needs in rural areas like West Virginia, as nursing homes and other fraud settings still experience staffing shortages. It claims to provide a “balanced methodology.”
Building new facilities will improve access, but some argue that there may not be enough workers to operate them. Others, on the other hand, argue that new facilities will threaten the existence of old facilities, even if workers are available.
Marc Zimmert, CEO of Zimmet Healthcare Services Group, said the disadvantages are in place to maintain an equal playing field for all nursing homes in the state. For example, new facilities may have private rooms and spa-like amenities to attract more Medicare admissions, but Medicare fees are fixed and out-of-pockets are universal. There is no difference in price between customers and payers. .
The older facility will lose Medicare hospitalizations, Zimmert said.
“The argument for allowing new facilities is based on the usual economic theory that competition reduces prices and improves quality,” Zimmet said. “Skilled nursing does not follow the usual economic principles. Prices are established by payers and quality is theoretically supported by state surveyors.”
Is it the right time to abolish fraud?
Nevertheless, many states believe that fraud laws violate the rights of business owners.
The first Trump administration called on individual states to eliminate fraud laws. In 2018, then secretaries of the Department of Health, Human Services, Treasury and Labor Division accused the state of curbing healthcare innovations through Con.
“It fits ideologically into their philosophy. From an industry perspective, CON's law is anachronistic,” says Lafort. “I didn't live through healthcare time when many (the laws of fraud) were implemented. I think there was a reasonable policy basis, but generally, definitely after the acute phase. The rationale was hampered because of the care of the
West Virginia Governor Patrick Morrissey has campaigned on the abolition of CON, and conservative free market groups have been lobbying for the abolition of CON for the past few years. Last year, the delegation's Health and Personnel Committee recommended that a House bill be passed that eliminates CON requirements for all health services except hospice, but it was not featured at the time.
With so many leaders considering the issue at interim meetings, including the Joint Standing Committee on Health, the fight over CON will be a major one at the 2025 legislative meeting in the state, if not nationwide. It's obviously going to be a topic.
And, law aside, new construction faces many challenges.
Even non-con artists like Idaho still have a process that makes building difficult, Lafoy said. Cascadia was unable to obtain an initial state investigation, which was protected for 18 months in one build, and was converted to a multi-million dollar transport cost until the building was up and running.
The wait “will put the project underwater forever,” Lafoy said. “We were able to knock down in 60 days through lobbying and made it viable.”
Encouraging construction costs reimbursements to the refund rate could help new construction take off, Lafoy said.
“I think it's a shame that we don't know how to separate the most needy industries and the most needy people, like seniors and affordable housing,” Laforte said.
