State budget plan threatens elder care

    People receiving services in Rhode Island’s nursing homes have already felt the loss of $30 million in Medicaid funding over the past five years. An additional $13 million cut would drastically affect the quality and accessibility of nursing home services.
    To compound the situation, the proposed funding cut comes at a time when the entire Medicaid reimbursement system for nursing home care is being revamped and no one is sure what the outcome will look like. We do know that the state intends to save money by paring down the Medicaid program, pointing to the fact that Medicaid expenses are rising by 7.6 percent per year.
    However, generally unstated is that spending for nursing home care, which accounts for a portion of the Medicaid budget, has risen by only 2.1 percent per year. Actual expenses have risen at a much higher rate and skilled nursing providers have been forced to realize a shortfall for the difference. Given that nearly 70 percent of nursing home patients rely on Medicaid to pay for their care, continued shortfalls have created significant hardships for providers attempting to offer quality care. Nonetheless it seems like nursing home care is always a popular target for the budget cutters.
    As a result of these losses, staff layoffs have become more common. Anyone involved in the delivery of health care services to the elderly knows that consistency and continuity of staff is a key driver of quality. Adequate staffing dictates whether a resident receives services in an institutionalized setting that provides little more than basic services or a setting that promotes well-being and quality of life.  After a lifetime of contributions to society, our citizens in nursing homes deserve the latter.
    Approximately 9,000 elderly and chronically ill Rhode Islanders receive care in our state’s nursing homes. They rely on those centers to provide 24-hour skilled care to manage chronic, medically complex illnesses or rehabilitate them following an accident or illness. Many need 24-hour attention due to dementia. In general, nursing home patients are not candidates for other types of care. Assisted living and community-based home care services have become the alternative for those with minimal care needs and nursing homes have admirably filled the void for the health care needs of the most acutely ill, frail and dependent citizens. Unfortunately, a perpetual cycle of funding cuts is threatening the care on which they must rely.
    Please contact your legislator about the governor’s proposed cuts to nursing home care.  For more information, or to learn how you can make your voice heard, visit rihca.com.

    Joan M. Woods is chair of the Rhode Island Health Care Association (RIHCA), a nonprofit association comprised of about two-thirds of the state’s skilled nursing and rehabilitation facilities. She is also executive administrator of the Genesis HealthCare Grand Islander Center in Middletown. She can be reached at (401) 849-7100 or joan.woods@genesishcc.com.