Ohio Health Care
Association: Taft Administration’s
Medicaid nursing home cuts hurt
Ohio seniors
COLUMBUS, Ohio, Jan. 7 /PRNewswire/
-- The following is being issued by Peter Van Runkle, President &
CEO, Ohio Health Care Association:
Ohioans want quality nursing home
care. They want to be confident that when they entrust their parents
or other loved ones to a nursing home, they are going to be well
cared for. Unfortunately for Ohio's seniors and their families,
Governor Taft wants to cut the Medicaid funding that supports
quality care in the state's long-term care facilities.
Ohio's Medicaid program pays for
the care of two-thirds of the state's nursing home residents. As a
result, Medicaid dollars dictate much of what happens in Ohio
nursing homes. The Taft Administration is proposing to cut Medicaid
funding for seniors in nursing homes by $90 million below current
levels, while increasing the rest of Medicaid by more than $500
million.
It is no mystery why Medicaid
spending for nursing home services goes up. Each year it costs
Ohio's nursing homes more to provide the quality care Ohioans
demand. Staff wages and benefits, workers' compensation charges,
liability insurance premiums, and other costs of care continue to
increase. Every year the patients entering Ohio's nursing facilities
are more acutely ill and, because of that, more expensive to care
for.
Seventy-five percent of the cost
of operating a nursing home is for nurses, nursing assistants, and
other health care workers, so the deep funding cuts the Governor
wants inevitably will result in staff layoffs and lower quality
care. Homes eventually will be put out of business, and their
residents will have to move. These things are happening in other
states where funding has been cut.
A recent analysis by the
accounting firm BDO Seidman found that the true cost of providing
quality care consistently exceeds Medicaid reimbursement rates.
Nationally, this under-funding amounted to at least $4.1 billion in
2001. According to the report, Ohio's Medicaid program under-funded
nursing home care that year by $7.65 a day, or $148 million a year.
Medicaid needs to pay its fair share, especially since the federal
government contributes 60 cents of every dollar Medicaid pays.
Ohio government figures show that
nursing homes are not the primary reason for Medicaid's increasing
drain on the state budget. During the past eight years, Medicaid
nursing home spending grew by 40%, but the rest of Medicaid
increased by more than 100%. Growth in the cost of drugs alone
exceeded 40% in just three years. Nursing homes are not the problem.
According to the Taft
Administration's own numbers, Ohio's nursing homes saved the state
budget more than $400 million over the past two years. Medicaid
rates for nursing homes were cut by 4% in 2003 and 6% in 2004. The
Governor has now proposed even deeper cuts. In a time of increasing
costs and workforce shortages, this cannot help but have a real
impact on nursing home staffing and on quality of care.
Ohio's long-term care providers
worked with two recent study groups that looked at Medicaid
expenditures and nursing facility reimbursement: the Commission to
Reform Medicaid and the Nursing Facility Reimbursement Study
Council, chaired by State Representative Shawn Webster.
Representative Webster's Council has been working to reform the
nursing home payment formula in a way that promotes efficiency in
operations and supports ever-increasing standards of quality, while
ensuring a reasonable return for the investment and risk providers
undertake.
Representative Webster's work will
save the state money by slowing growth in nursing home spending.
Part of his solution is to create incentives for Ohioans to take
personal responsibility for their long-term care by purchasing
insurance policies when they are young enough to afford them. This
not only reduces future Medicaid costs, but also gives the
policy-holder more control over how and where their own long-term
care needs are met. The Study Council's carefully crafted approach
is in striking contrast to the Governor's proposal to
indiscriminately slash dollars intended to care for our elderly,
disabled, and convalescent.
Governor Taft says nursing homes
are caring for fewer people than in the past. The reality is that
more people are using nursing homes than ever before, they just are
not staying as long. According to Miami University's Scripps
Gerontology Center, Ohio's nursing homes admit more than twice as
many patients now than they did in 1992. Many of these patients come
for short stays for recuperation, at far less cost than if they had
stayed in the hospital.
The Governor also wants to have
total control over the Medicaid budget, and over the nursing home
reimbursement system. There are two important reasons why nursing
home reimbursement requirements are set in state law. First, this
arrangement ensures the stability and predictability of the system
and the care it funds. Second, no other segment of health care is as
reliant on state and federal dollars to support quality care. The
proper forum for funding decisions affecting tens of thousands of
Ohioans is in the General Assembly. The legislature can hear the
arguments of both sides and draw a reasonable balance between the
needs of seniors and the demands of the state budget.
The Governor suggests that if Ohio
spends enough money on home care for seniors and people with
disabilities, the state can cut funding for nursing home care. The
members of the Ohio Health Care Association have long supported the
concept that seniors, people with disabilities, and their families
should be able to choose the most appropriate type of care for their
needs. Many more options are available today than just ten years
ago, even for those who cannot pay their own way.
But the fact remains that families
turn to nursing homes when other options no longer work. At some
point, it becomes too difficult to keep a loved one at home. Ohio's
families need to know that when that time comes, the nursing home
will be there, and it will have enough staff and other resources to
provide good care.
OHCA will keep working with the
Ohio General Assembly and the Taft Administration to solve the
problems resulting from reduced state tax revenues and growing
Medicaid rolls. We must, however, keep fighting to assure Ohio's
seniors, disabled, and their families that the quality of their
long-term care will not be threatened by funding cuts.