February 4, 2013

Chronic underfunding means short staffing for Maine nursing homes

By Susan M. Cover scover@mainetoday.com
State House Bureau

(Continued from page 1)

click image to enlarge

Sara Sylvester, right, administrator at the Oak Grove Center in Waterville, speaks with employee Betty Bayley in a rehabilitation unit on Thursday. Sylvester said that the facility is concerned about funding shortfalls that could impact staffing.

Staff photo by David Leaming

click image to enlarge

Betsy Stevens reads a book in the dining room on Friday at Heritage Rehabilitation & Nursing Center in Winthrop.

Staff photo by Joe Phelan

In recent weeks, Gov. Paul LePage has touted his intention to pay back hospitals $186 million owed in Medicaid payments. Nursing homes aren't seeking to recoup any debt, but they need the state to update its formula so it comes closer to keeping pace with expenses moving forward, Erb said.

A lack of MaineCare funds, which is the state's version of Medicaid, hits nursing homes particularly hard because 73 percent of their operating funds come from MaineCare.

And while the facilities traditionally have passed some of those expenses on to private-pay residents -- the average private-pay rate is 40 percent higher than MaineCare -- that pool of money has dried up in recent years, Sylvester said.

"Private pay doesn't help anymore," she said. "It doesn't make up the difference."

At Oak Grove, 51 of the 90 residents are MaineCare-eligible. Even those who saved money to pay for their long-term care find that it doesn't take long to spend down the money and end up on MaineCare, she said.

Statewide, nursing homes employ nearly 10,000 people full-time, according to the health care association. Erb said many of the nursing homes are in fragile financial condition, and he pointed to the closure last year of a Washington County nursing home as the first sign that many are in trouble.

The Atlantic Rehabilitation and Nursing Center in Calais closed in June, citing financial problems. Erb said 90 percent of the residents were on MaineCare, a percentage higher than normal, but not unusual, for a rural facility. The parent company of the Calais facility has said it intends to build a nursing home in Ellsworth, which is 93 miles from Calais.

Without increased state funding, Erb said more and more nursing homes are at risk. He's also concerned about the possibility that Medicare -- the federal health care program for those 65 and over -- will be cut further at the federal level.

That will eat into the amount of money that now is paid to nursing homes that provide temporary rehabilitation services.

"Over the next two years, I would expect we would see closures, reducing access in rural areas; and then distance becomes an issue," he said.


Susan Cover -- 621-5643

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