Nursing home funding falls woefully short
Saturday, May 5, 2007 11:40 PM PDT
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E-mail this articleThe 2007 Washington Legislature put some $30 million toward improving Medicaid reimbursement rates for nursing homes and other long-term care providers in the state. That's a fair chunk of change -- more, in fact, than the industry has seen in years. But it was just half of what nursing homes requested. And even that $60 million request would have raised reimbursement rates to no more than 80 percent of what it's costing nursing homes to care for a Medicaid patient.
It's the dilemma of an industry forced to play catch-up: A relatively generous appropriation from budget writers working with a large surplus leaves nursing homes in the state pretty much where they've been for more than a decade -- struggling to keep their doors open and provide the best care possible.
There have been too many lean years for this industry. Long-term care providers typically have been relegated to a second- or third-class status when it comes to allocating public health dollars. It's never made a much sense, given the increasingly critical role extended care plays in the health care system.
It makes less sense with each passing year. The state's population is rapidly graying. The oldest of the baby boom generation are nearing retirement, meaning the demand for long-term care can be expected to expand dramatically in just the next few years.
Will the nursing home beds be available to meet that higher demand here and in other parts of the state? It's hard to know. The accumulative effect of those many lean years has taken a considerable toll, particularly in this county, where there has been a dramatic shift from private-pay patients to patients relying on Medicare and Medicaid. Twenty years ago, about 80 percent of this area's nursing home patients were private-pay. Today, the mix of private- and public-pay patients is just the opposite, with state and federal dollars paying for about 80 percent of the patients in Cowlitz County facilities.
Several long-term care facilities in this area have been forced to close in recent years. Others that have mainly Medicaid patients continue to lose money. Even with the new $30 million legislative appropriation, the Evergreen Americana Health and Rehabilitation Center reportedly will lose $330,000 caring for its Medicaid patients over the next two years. Evergreen Park Royal Health and Rehabilitation Center expects to lose $185,000.
At some point, the Washington Legislature will have to do more to stop the bleeding. While generous by historical standards, the money appropriated this year is little more than a Band Aid.
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