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Published October 28, 2009, 12:00 AM

Health care reform could cut North Dakota nursing home payments

The financial cord supporting North Dakota nursing homes could become more frayed if legislation that would trim up to $75 million over 10 years passes Congress, industry representatives said Tuesday.

By: Patrick Springer, INFORUM

The financial cord supporting North Dakota nursing homes could become more frayed if legislation that would trim up to $75 million over 10 years passes Congress, industry representatives said Tuesday.

The funding cuts, in legislative proposals pending in the U.S. Senate and House, would exacerbate Medicare cuts of at least $22.3 million just starting to hit nursing homes in North Dakota, according to figures highlighted Tuesday by nursing home industry representatives.

Because 70 percent of nursing home budgets involve staffing, funding cuts would further strain the ability of providers to remain open or care for their residents, said Shelly Peterson, president of the North Dakota Long Term Care Association.

The proposed funding cuts to nursing homes are part of health care reform legislation pending in Congress.

But a spokesman for the Centers for Medicare and Medicaid said it is too early in the legislative process for the funding picture to be clear.

“It’s very speculative,” said Michael Fierberg of the CMS Denver regional office. “Nobody really knows what’s going to be in the final bill. Therefore, at this point, there’s really no comment we could make.”

Rhonda Richards, a senior AARP legislative representative in Washington, said the organization, which represents seniors, will oppose any legislation that harms beneficiaries, deteriorates quality of care, or deprives seniors of the option to receive care at home.

In the health reform debate, funding for long-term care centers has been overshadowed by headline issues, including the clash over a public health insurance option, said Bruce Yarwood, president of the American Health Care Association.

Over time, the financial pressures will heighten as baby boomers age, he said, adding, “That population is going to have a high demand for services.”

The funding squeeze is especially dire for rural nursing homes, which are having problems attracting and keeping staff, said Gregory Salwei, administrator of the Wishek Home for the Aged in Wishek, N.D.

“We are very concerned out here in rural North Dakota as to what the impacts may be,” he said.

The nursing home in Wishek has a staff of about 120 who care for 70 residents. The oldest caregivers on staff are in their upper 70s, Salwei said.

Earlier this year, the nursing home in Steele, N.D. was forced to close because it was unable to provide adequate staffing, Peterson said.

The center moved to Mandan, and the Steele community now is trying to reopen the facility as an assisted living home or basic care center, she said. More closures are likely, Peterson added, as the staffing crunch continues in rural areas.

Revenues are tied to federal and state payments as well as private rates set by the state, she added, so government holds the funding keys.

Fortunately, Peterson said, North Dakota legislators increased state funding, allowing an 80-cent-an-hour pay increase to help attract and keep staff.

Still, North Dakota’s 84 long-term care centers have an average operating margin of 1.9 percent, or $46,000 per year. “So we have very thin margins,” Peterson said.

“I think the whole long-term care system is threatened,” she said.


Readers can reach Forum reporter Patrick Springer at (701) 241-5522

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