Proposed cut threatens care

Rhode Island’s General Assembly will soon vote on a $6.4 million cut to Rhode Island’s 83 skilled Medicaid-certified nursing and rehabilitation facilities. Though nursing home residents and their caregivers will feel the effects of the total loss, the state will only realize roughly $3 million of that in savings. The remainder would be lost in federal matching funds.
  The following facts put those numbers in context. According to the 2010 census, Rhode Island ranks first in the nation with respect to the percentage of its citizens that are over the age of 85, an age group that increased an incredible 28 percent from 2000 to 2010.  That group is the primary consumer of skilled nursing care. Those demographics speak to the 24-hour care critically needed by many of our eldest citizens. In recent years, the two main payment sources for nursing home care – Medicaid and Medicare – have been under attack.  
  In Rhode Island, the state’s Medicaid-certified nursing homes have lost more than $34 million in funding in the past five years. In fact, the Medicaid population, which totals about 66 percent of all nursing home residents, continues to be under reimbursed for their actual cost of care by almost $15 per person per day. Medicare funding, the program that once acted as a safety net by helping providers compensate for Medicaid’s shortfalls, has also seen substantial cuts in recent years. All of that is occurring while the needs of nursing home residents are becoming increasingly complex.
  Added to the threat of the $6.4 million cut is the fact that the Rhode Island Department of Human Services is developing a new reimbursement system for nursing homes scheduled to take effect July 1. Again, despite the fact that nursing home residents are more frail and sick than ever before, requiring many more nursing hours and resources, the new system is based on budget neutrality. In other words, providers that are already absorbing a loss on the care of roughly two-thirds of their patients can look forward to no relief in the form of more funds – funds that are desperately needed to compensate for the additional costs required by the intensive medical needs of today’s patients.
  To this point, Rhode Island skilled nursing centers have managed to lead the country in terms of quality care. However, if the $6.4 million cut is approved, it will hurt providers that have swallowed many years of funding reductions. The providers will have no choice but to decrease direct care staff. Consistent staffing is a hallmark of quality care, which suffers when family-like caregivers are let go.
  Please help spread the word to legislators that Rhode Island’s nursing home residents are relying on them to protect their quality of life. Adequate care requires adequate resources. Rhode Island’s skilled nursing providers want to give their patrons the quality care they deserve, but the power to do so lies in the hands of the General Assembly.
For more information on legislation impacting nursing home care or about skilled nursing and rehabilitative services, go online to www.rihca.com and click on the preserve nursing home funding tab.
 
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 Island-er Center in Middletown. Contact her at (401) 849-7100 or joan.woods@genesishcc.com.