Health care group ready to work with legislature

Subsequently, it was reported that the unanticipated surplus may be needed to account for overspending by some state departments. When state Finance Director Helio Melo asked why the departments hadn’t met their targeted budgets, he was told that some anticipated savings were unrealistic. At the Department of Corrections, for example, an across-the-board dictate to save money on personnel was apparently overly ambitious. Richard Licht, the director of the Department of Adminis-tration, explained that the personnel savings concept doesn’t work with departments such as corrections that are staffed 24 hours a day, seven days a week.
  As the chair of the state’s largest association of skilled nursing and rehabilitation centers, the irony of that comment didn’t go unnoticed by me. Skilled nursing facilities are no stranger to 24-hour-a-day, seven-day-a-week staffing. Round-the-clock monitoring and medical services are part of the job, yet in our world, overspending is not an option unless you’re prepared to go out of business. Providers must pay for their costs up front and get reimbursed after the care is rendered. 
  More than 80 percent of skilled nursing care is reimbursed by Medicaid and Medicare (primarily Medicaid), leaving provi-ders almost wholly dependent on government funding. For years, we’ve made our case to policy-makers that the 24/7 care needed by our residents requires adequate staffing, which in turn requires adequate resources, yet it seems abundantly clear that we are forced to play by different rules. 
  Despite the rising costs associated with wages, benefits, insurance, taxes, utilities and food, skilled nursing centers are routinely under funded. Eljay LLC recently released a study that shows that Rhode Island’s Medicaid system shorts skilled nursing centers by almost $15 per patient per day. Medicare used to be the safety net for such precarious funding, but massive cuts in that program are eroding the buffer. Also, anticipated changes in the Medicaid and Medicare payment systems promise to place many of our centers dangerously close to operating in the red.
  An Associated Press article recently noted that during 2009 and 2010, increases in government spending on health care were the lowest in 51 years. That leveling of health care spending comes at a time when the aging demographic that needs critical long-term care services is growing.
  It was reported that the $4 million variance from September was a result of adjustments reflecting amounts due back to the state from managed-care organizations providing services to Medi-caid recipients. You would think it reasonable then that those funds go back toward the care of Medicaid recipients, not to correct the overspending of state departments.
  Fortunately, our lawmakers have shown that they understand the needs of Rhode Island’s elders and have proven themselves willing to support those needs, even in times of budgetary strain. We look forward to working with them this year to ensure that Rhode Island nursing home residents are provided with the funding needed to support full and meaningful lives.
 
Joan M. Woods is chair of the Rhode Island Health Care Association (RIHCA), a nonprofit association for the state’s skilled nursing facilities, and executive administrator of the Genesis HealthCare Grand Islan-der Center in Middletown. Contact her at (401) 849-7100 or joan.woods@-genesishcc.com.