As a provider of long-term care for more than three decades, I’ve seen that care evolve in our state from being provided almost exclusively by nursing homes to being available in a variety of home and community-based settings.
In fact, I’m part of that evolution. Not only do I own and work in a nursing home that’s provided skilled nursing care in Lacey for 41 years, but I operate a licensed boarding home providing assisted living across the street. I’ve even reduced my number of nursing home beds. The goal is to allow residents to age in place. Either lighter or more intensive care is available.
That goal is imperiled by Medicaid cuts before the Legislature. While nursing home reimbursement is based upon both cost and exacting criteria, making it easier to quantify a chronic funding shortfall, payments in the home and community-based settings are more arbitrarily set based upon whatever budget circumstances confront the Legislature.
A recent study showed individual providers leaving home care in our state, for example, had an average final hourly wage of $10.36 per hour. The study found the former workers, upon employment outside long-term care, saw an average $4.53 per hour spike in wages.
To provide long-term care is a labor of love, with no expectation of wealth. But is it unreasonable for caregivers to expect state Medicaid payments will at least afford living wages and benefits?
With rates for around-the-clock care, meals and housing in boarding homes as low as $47.06 a day, the 2 percent Medicaid cut the Legislature is contemplating would shave almost a daily dollar off the lowest payments. It would be hard to find any motel for that rate.
The total $3.4 million cut over a single year will act as a further disincentive for boarding home providers to offer Medicaid care where they can avoid it, which would be a shame for a state looking for cost-effective care options. And it piles on to previous cuts, including a brutal 7 percent cut that ran from April through June 2011.
Nor do I believe the state can find appropriate placements for all 60 Western State Hospital patients it seeks to discharge into the community to try to capture a savings of $4.3 million.
These are patients with dementia, traumatic brain injuries or other organic brain disorders who would not be appropriate for placement among the largely geriatric population of the average nursing home. Frequently these disabilities require intense staffing due to behavioral issues.
We’re on a fatal trajectory as our society ages. In the interest of my caregivers, residents and patients, I’m among care providers willing to partner with legislators to find a way forward from this point, even if that includes revenue increases that might affect me.
We must have that revenue conversation before it’s too late to turn back from a path of budgetary neglect and conflict with other funding needs like education.
Craig LeVee is the owner and administrator of Lacey’s Roo-Lan Health Care Center and The Lodges.
Read more here: http://www.thenewstribune.com/2012/03/22/2077382/legislatures-budget-cuts-threaten.html#storylink=cpy#storylink=cpy