State legislation being discussed that could restore funding

Nursing homes and other residential care facilities in the Show-Me State are dealing with reduced budgets following a cut to Medicaid rates in August 2017 — resulting in cutbacks in certain areas to ensure their finances remain balanced.

Representatives from Beth Haven Retirement Community, Willow Care Center, Levering Regional Health Care Center and Maple Lawn Nursing Home have joined together to lobby in Jefferson City and host town halls in Hannibal to emphasize how funding shortfalls have negatively impacted each center’s ability to provide care for residents. The Medicaid rate cut shrank budgets at each facility — Willow Care Center witnessed a reduction since August of between $79,000 and $80,000, and Beth Haven saw a decrease of about $120,000. Area nursing homes have made difficult decisions as a result, but they remain hopeful that future legislation can turn the situation around.

At Willow Care, Administrator Greg Sandidge said that the smaller budget meant that transportation services and some comprehensive services for residents had to be scaled back, and maintenance issues are being closely observed.

“We’ve also had to live within our means, like most people do when you have a reduction in your revenue,” he said. “We did not pass that along to our customers.”

Beth Haven Retirement Community CEO Paul Ewert echoed Sandidge’s focus on providing the best care possible for residents, pointing out that staff members are more closely prioritizing building maintenance issues, too. The funding gap also means that employees did not receive a wage increase as they had in years past, and residents who don’t receive Medicaid are paying a higher cost for their care. About 60 percent of Beth Haven residents are Medicaid recipients; at Willow Care Center, about 65 percent of residents receive the funding.

“So everybody who has Medicaid, they pay their required Social Security amount and the state picks up the rest,” Beth Haven Retirement Center CEO Paul Ewert said. “And of that rest, the state government only pays $15 a day… whereas across the river in Illinois, the rate is much higher.”

As a result, nursing homes like Beth Haven are dealing with a daily financial shortfall.

“At Beth Haven we are underpaid on a daily basis — I think it’s close to $20 a day — compared to our cost by what Medicaid pays us,” Ewert said. “So while [taxpayers] are getting a bargain, the state is not paying their fair share.”

Despite the challenges each facility faces, administrators and legislators are hopeful that pending legislation could reverse the current trend. Ewert said the Missouri Hose of Representatives and the Senate each have proposals on how to restore Medicaid funding or a portion of it.

“We’re now going to our Senators and trying to encourage them, and going to the House and trying to encourage them to go the Senate’s version of the bill, because it’s about three times more money for us in making up this difference,” he said. “The House version does not restore the full funding cut that we took last year.”

Nate Walker (R-Kirksville) and Rep. Lindell Shumake (R-Hannibal) are among elected officials who support increasing Medicaid rates to help provide residents in nursing homes and other facilities with the care they need. Shumake said that Senate Bill 818 — which was referred to the House Budget Committee on March 29 — would raise Medicaid rates by using current cost figures to determine reimbursement levels. The current reimbursement rates are based on 2004 calculations, and Shumake said he feels that needs to change to more accurately reflect the needs at each facility.

“I think it’s high time to do that,” he said, pointing out that the current situation could cause more people to be hospitalized instead of receiving the care they need at their nursing home.

Representatives voted on Thursday to host a conference between the Budget Committees for the House and the Senate to come to a consensus on topics including Medicaid rates.

Ewert and Sandidge agreed about the importance of community members making their voices heard with their elected officials.

“Really, the legislators have the power to turn this around by restoring funding to our line item,” Sandidge said. “The state of Missouri spends more on their prisoners than they do on their elderly.”

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Medicaid cuts bring financial hardship to residential care centers