Last spring, the Maine Legislature established the Commission to Study Long-term Care Facilities to address increasing concerns about the chronic underfunding and long-term viability of Maine’s nursing homes. The commission was directed to examine three critical areas: reimbursement issues, staffing requirements and access issues (particularly in rural areas).
I served as a member of this commission and in our work it became apparent very early in the hearings that a decade of underfunding nursing homes had taken its toll. It had resulted in a cost shift which left private-pay residents covering the unmet cost of MaineCare residents and a financial crisis which threatened the homes’ ability to provide high quality care – or even to remain open.
Over the past decade, the reimbursement rate through MaineCare has barely changed, while the cost of providing care has continued to grow. As a result, nursing homes are faced with a growing gap between what it costs to care for residents and the amount they receive from MaineCare to provide these services. At this point, the cumulative gap for homes around the state over the past five years amounts to more than $120 million.
GAP AFFECTS HOMES, WORKERS, RESIDENTS
This gap has significant effects on nursing homes, their employees and residents. Residents who pay for their own care are bearing the burden as a result of cost shifting to make up for the loss in state dollars. Employees have been subject to wage freezes and increases in their share of benefit costs. Many homes have postponed necessary infrastructure improvements. All of these can be attributed to the state not paying its fair share.
Why is this important for every Maine family?
Financial instability is a problem for nursing homes, but it can also have a devastating impact on the growing number of Maine families who rely on their services. Maine’s population is the oldest in the nation. Between 2010 and 2030, the number of Maine residents over age 75 will double, which makes it more important to maintain our nursing homes.
These facilities and their employees also provide an enormous economic impact. Maine nursing homes serve as economic engines in communities around the state and provide hundreds of good-paying health care jobs – often in regions that desperately need them. In many Maine communities, they are one of the most essential employers.
Given how important nursing homes are to our state, their financial problems are serious, and they are urgent.
Several commission members had experienced the devastating effects when Atlantic Rehabilitation and Nursing Center in Calais closed in June 2012. The disruption was felt throughout the community. Ninety-two employees of the facility lost their jobs, residents suffered through the disruption of locating nursing facility services outside of Calais and families and friends faced increased travel to spend time with their loved ones.
Faced with this nursing home closure and the threat of similar closures in other homes around the state, the Legislature correctly saw that it needed to take action, and it has through the commission.
THREE KEY RECOMMENDATIONS
As was recently reported, the commission has completed its work and issued its final report to the Legislature on a number of findings that go a long way toward preventing future closures. Within the report, there are three key recommendations which are very encouraging for the future of nursing home care in Maine.
First, the commission calls for the state to increase the MaineCare reimbursement rate to account for increased cost of care. Second, it re-establishes cost of living adjustments to make sure this problem doesn’t happen again. And, third, it provides supplemental reimbursement for facilities with higher-than-average percentages of their residents relying on MaineCare.
These recommendations are an important first step. By increasing funding to cover nursing home costs, the state would be taking decisive action to erase the huge liability of a fragile nursing home system. If things don’t change, it is not a question of “if” the system will fail, but how quickly.
By covering the cost of the MaineCare residents it is responsible for, the state can quickly stabilize nursing home finances and guarantee that the network will remain in place, that jobs will remain secure and that our state’s elderly will remain in their local communities.
– Special to the Telegram