Financially, nursing homes are treading water. We appreciate the Medicare PPS adjustments you made in BIPA last year because these adjustments are providing some stability to our Medicare patients. You spoke eloquently a few short month's ago about the state of caregiving in this country, and your words have been appreciated by those hard working women who perform a very difficult and demanding job. All I can say is, how right you were. We are facing a staffing crisis of epidemic proportions in every part of the United States.
Recruitment is nearly impossible.
This crisis is compounded exponentially by a regulatory system that forces caregivers to focus an extraordinary amount of time on cumbersome paperwork and complex, confusing regulatory requirements. This burdensome system is having a negative impact on patient care by driving good providers out of the business. This system bears very little resemblance to what OBRA 87 envisioned. The current system is susceptible to political forces, and providers are caught in the crossfire. Clearly the incentive for inspectors is to cite more deficiencies.