Nursing home facilities finances on shaky ground
Clarion Careage offers legislative forum MondayBy LINDSEY MUTCHLER Messenger staff writer
CLARION - As a result of budget cuts, 38 Iowa nursing home facilities are in the process of closing.
Clarion Careage is not one of them.
However, the assisted living facility felt the financial status of nursing facilities was important to address as health care legislation is debated in the Senate, and Gov. Chet Culver's 10 percent across-the-board budget cuts take effect Tuesday.
"There is no long-term care in Medicare reform right now," said Cindy Baddeloo, deputy director of both Iowa Health Care Association and Iowa Center for Assisted Living. "The message we're getting is that the bill is too big and there are other issues to focus on right now, like insurance."
But as the Baby Boomer generation ages, the problem of long-term care will need attention from lawmakers.
"I'm interested in your comment that 38 facilities are closing," said Rachel Richardson, administrator of Clarion Careage. "Where will the baby boomers go? It tears at the moral fiber of what Iowa prides itself on, which is caring for one another."
It's a question no one at the meeting could answer and is a heavy one as facilities will see no monetary increases from the federal government for services over the next 10 years, Baddeloo said.
However, the question did fuel discussion of solutions.
"We've been in discussion with the Department of Human Services regarding rules we could possibly suspend a year or two to provide cost savings," said Iowa Sen. Rich Olive, D-Story City. "One problem with that is many of the regulations are federal regulations, and if we drop those, we lose federal support."
Another area discussed was inspections, Olive said.
"There are some facilities undergoing seven or eight inspections a year," Olive said. "There's no sense in not trying to coordinate those inspections to some degree."
Reimbursement rates were also an area in question. While Iowa boasts some of the best care in the nation at some of the lowest rates, it also has one of the lowest reimbursement rates at $121.34 per patient per day while neighboring states receive upwards of $170.
"For every person on Medicaid, a facility loses $31 a day," Baddeloo said. "When 40 percent of the people in your facility or more are on Medicaid, it's not very sustainable."
According to Baddeloo, every facility submits its costs, and based on those cost reports and the acuity, or care, level of the residents, the government decides how much can be spent on nursing homes. But no one could say exactly how the federal government arrives at those rates.
With these lower reimbursement rates, care facilities are struggling with budgets.
"It's going to be very tough next year to make a budget we can live with and maintain the quality of care," said Joe Sherman of Crestview Senior Living in Webster City. "We need some help, senator."
Olive said the Senate intends to revisit Gov. Culver's 10 percent budget cuts to see if they can be adjusted for public safety, public education and health and human services.
"Medicaid cuts are affecting hospitals as well," Olive said. "They're going through the same process. We understand the problems and we're dealing with the shortfall of revenue to keep essential services going until we're out of this nasty recession."
Contact Lindsey Mutchler at (515) 573-2141 or lindsey@messengernews.net
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12-01-09 10:44 AM
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With the 17% real decline in the 1930-40 cohort vs that of 1920-30, there was bound to be a decline in patient numbers since that first cohort is just coming into maximum need of nursing home care. It will therefore be increasingly difficult to fill vacancies for some time so people need to be careful where buy-ins are required. It's not all a result of current economic conditions, but this govt action will, as is so often the case, exacerbate financial difficulties of nursing homes and extended care facilities.
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