Nursing homes push back on cuts
By PAUL FEELY
New Hampshire Union Leader
CONCORD — Health care administrators and nursing home owners in New Hampshire plan to ask state legislators to take action to prevent a proposed $7 million reduction in Medicaid reimbursement rates.
The reduction was unveiled by Health and Human Services Commissioner Nick Toumpas before the Legislative Fiscal Committee on Jan. 23 to help address a $58 million shortfall in the department’s budget. The shortfall is due to a federal change making more low-income children eligible for Medicaid, a settlement over the state’s mental health system and start-up costs associated with the Medicaid expansion program.
Senate Finance Committee Chairman Jeanie Forrester, R-Meredith, and representatives from nursing homes across the state were slated to discuss the effect the reduction would have on New Hampshire nursing homes at a news conference Monday, but the event was canceled due to the impending storm. Organizers plan to reschedule.
In 2013, state legislators voted to approve a set spending level for DHHS, including an amount appropriated to nursing homes to cover the cost of care provided to residents covered by Medicaid. Last July, the previous year’s budget overage was slated to be carried over into the current fiscal year to offset the Medicaid reimbursement rate, which is already below the cost of providing care, according to John Poirier, president and CEO of the NH Health Care Association.
Poirier said the carryover is mandated by a footnote in the budget, but this year when nursing homes received their Jan. 1 reimbursement rates, the funds were not included in their rates.
“This rate-setting formula is designated by law. When setting their budgets, DHHS states that there is not enough money available to pay the rates calculated using this law and they reduce nursing home rates by almost 30 percent to create a rate that they can ‘afford’,” Poirier said. “Now, DHHS is telling the legislature that there are excess funds available from the nursing home reimbursement line item that can be used elsewhere. Both of these statements can’t be true.”
According to Poirier, reductions could range from $30,000 to $40,000 for smaller nursing homes, to as much as $500,000 for the largest ones.
“We do not have the option of ceasing to provide care to these residents, as this is morally and legally unacceptable,” said Patricia Ramsey, owner of The Edgewood Centre in Portsmouth. “I do not understand how Governor Hassan, Commissioner Toumpas, and DHHS can make this decision to take away money from the residents, among the frailest and most impoverished in the state, and the people who care for them. Not only are we required by regulation to provide exceptional care to our residents — our residents and their families expect and deserve exceptional care. How can we continue providing this quality care when we are continuously underpaid for providing it?”
“There are four nursing homes in my district, three county homes and one private one,” Senate Finance Chairman Forrester said. “I believe they will face around $700,000 in reductions in Medicaid funds because of the governor’s cuts, the largest being to the Grafton County nursing home at about $277,000.”
Forrester said she filed a late bill last week that would amend the state’s 2014-15 operating budget regarding transferring funds for nursing home services.
“I think that would put a stop to this,” Forrester said. “There seems to be support for it, from others I’ve spoken with.”
Brian Newman, executive director of the Courville at Manchester nursing home, said his facility faces an estimated $65,000 reduction in Medicaid funds.
“To be honest with you, at this point we’re not sure what we’re going to do,” he said. “We’re probably looking at staff cuts or wage reductions, looking at lower quality food services or a reduction in benefits. We’re not sure what we’ll end up doing, except hoping the governor changes her mind.”
“These funds were promised in a budget signed by the governor, and one quite frankly she has taken a lot of credit for,” Forrester said. “This is not about Republicans and Democrats. This is about keeping a promise.”
If you have any questions, please let us know. Again, we will keep you update on this immportant matter.
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