Over and over again, a crowd of nursing home executives, staff and residents chanted a message they hoped would carry all the way to the Florida legislature: “People, not profits; people, not profits.”
The congregation of mostly elderly men and women at River Garden Hebrew Home on Friday hoisted their protest signs, angry and upset and wanting to be heard. Why, they wanted to know, were high-quality nursing homes across the state facing a crippling loss in funding, while others — almost all low-quality, for-profit entities — could see windfall profits?
To that crowd of approximately 300, the answer reeked of greed and corporate interests.
More than $7 million in funding could be diverted from nursing homes within Northeast Florida under a new Medicaid prospective payment system currently being proposed in the Florida Senate budget.
As it is now, nursing homes are reimbursed for the amount of money they spend on care, up to a certain point. The proposed Florida Health Care Association Medicaid Reimbursement Plan, however, would distribute money upfront and without any requirement on how it is spent.
“This plan is full of so much pork not a Jewish home anywhere can say this is kosher,” said Martin Goetz, CEO of River Garden Senior Services.
John Capes, executive director of Moosehaven nursing home, agreed: “This is the transfer of money from [nursing homes] who are willing to spend on care to those who want to put money in their back pocket.”
Of the 52 nursing homes in the Northeast Florida area, 22 of them will lose money under the prospective payment plan.
Duval County will be hit the hardest — 11 of its 30 homes will lose approximately $3.5 million.
Behind Duval, Putnam and St. Johns counties stand to lose the largest amount of Medicaid funding. St. Johns nursing homes, 80 percent of which will be impacted, could lose $1.1 million, while a single nursing home in Putnam will lose $1.6 million. The county has only three homes.
Funding for St. Catherine Laboure Manor in Jacksonville will be cut by $1.3 million, while River Garden will see a $187,581 decline in Medicaid funding.
Capes says Moosehaven’s loss of about $152,000 is equivalent to four staff members — and he doesn’t believe that’s an uncommon figure among nursing homes.
“Everybody knows the answer to quality is staffing,” Capes said. Most quality health-care providers staff well above the state minimum requirement for personnel, he added. This funding cut means a direct loss in staffing capabilities.
While this new plan would shift money from higher-rated nursing homes to lower-rated nursing homes, that does not mean money would flow from rich communities to poor communities. In fact, more than 50 percent of River Garden’s residents rely on Medicaid, said Randy Kammer, vice president of the nursing home’s board.
For Evelyn Peck, the potential loss in profits seems very real.
Her husband lived at River Garden for nearly five years, and she currently works as a volunteer in the home’s not-for-profit gift center. All proceeds earned there, she added, return to the nursing home.
“When you come here, this is family,” she said. “If you run out of money, they don’t say, oh, we aren’t going to keep you. Everybody is loved, and everybody is cared for.”
With the funding cut, she believes this may not be the case. Karen, Backilman, former president of the River Region Auxiliary, sees the loss in terms of River Garden residents.
“I think it is going to impact everyone,” she said. “No one knows who here is on Medicaid and who isn’t. So, if they cut funding, who will get less care? Everyone.”
River Garden staff, as well as representatives from other nursing homes, asked residents to contact their local lawmakers and demand the proposal be removed from the Senate budget.
The proposal hasn’t drawn a lot of attention, said Jim Richman, chief operating officer of River Garden Senior Services, because it’s budget neutral and doesn’t require a bill to be implemented. It simply shifts around the $3.5 billion allocated to Medicaid reimbursement for nursing homes — moving that money from some nursing homes to others.
The proposal has no match in the House of Representatives. However, the House could still decide to adopt the plan statewide — or the House could force the proposal to be shelved for future study and development. No public hearing has been held to address the plan or its long-term effects. However, many believe this, if passed, could impact the quality of care for Florida seniors for years to come.
“This is not about today, this is about the future,” Goetz said. “Some of us have been told that we will like what will come next even less … We have an opportunity to get this right, and we must not blow it.”