August 30, 2013

St. Joseph's renovating to get fewer MaineCare users

The Portland diocese says the care facility it sponsors needs more private payers to stay financially healthy – bad news for some facing discharge.

By Kelley Bouchard
Staff Writer

PORTLAND – The Roman Catholic Diocese of Portland acknowledged Thursday that the assisted-living unit at St. Joseph's Rehabilitation & Residence will be renovated to attract more private-pay residents and help offset the cost of residents covered by MaineCare.

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The Roman Catholic Diocese of Portland acknowledged Thursday that the assisted-living unit at St. Joseph's Rehabilitation & Residence will be renovated to attract more private-pay residents and help offset the cost of residents covered by MaineCare.

Gordon Chibroski / Staff Photographer

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The diocese finally responded to mounting criticism of the way 34 residents of the unit – 28 of them MaineCare recipients – are being discharged to make way for a $750,000 to $1 million renovation, without the promise of being allowed to return.

David Twomey, chief financial officer for the diocese and Bishop Richard Malone's delegate on St. Joseph's board of directors, said it's uncertain whether St. Joseph's will accept MaineCare residents when the renovated unit opens in 2014.

Twomey said the 40-year-old unit that St. Joseph's now operates is unattractive to many people because it has an outdated layout of 24 mostly two-bed rooms, with two rooms sharing each bathroom.

The renovated unit will have private rooms with private bathrooms.

"Will there be more private-pay residents? I would say yes," Twomey said when pressed for an answer. "If we're going to need a higher percentage of private-pay (residents to cover the cost of renovating and operating the upgraded unit), that's something we'll have to consider."

St. Joseph's is a private corporation sponsored by the diocese and operated by a board of directors appointed by the bishop. It's managed by Catholic Health East and Trinity Health, a national nonprofit organization that formed when the two groups merged in May.

Twomey said the church remains dedicated to helping people in need, but if St. Joseph's isn't run "soundly" and doesn't get the "proper balance" of MaineCare residents and private-pay residents, "we're not going to be able to help any portion of the poor."

Twomey noted that four staff members have been assigned to help the 34 residents find safe and appropriate places to live, as required by law. He also said that St. Joseph's will continue to have MaineCare residents in its skilled-nursing unit, which isn't being renovated.

As of Aug. 1, 76 of the 106 residents (71 percent) in the skilled-nursing unit were covered by MaineCare, the state's form of Medicaid, according to the Office of MaineCare Services in the Department of Health and Human Services.

Eighty-two percent of St. Joseph's assisted-living residents are MaineCare recipients -- just above the statewide average of 80 percent, according to the Maine Health Care Association, which represents about 200 long-term care facilities.

St. Joseph's monthly MaineCare reimbursement is now $2,580 per person, according to association spokesman Rick Erb. Residents also contribute most of their Social Security benefits, which range from $500 to $1,000 per month.

Meanwhile, St. Joseph's and other assisted-living facilities charge residents who pay for themselves $6,500 or more per month, depending on services and amenities. Some facilities shift the unreimbursed cost of MaineCare residents to those private-pay residents, who wind up spending down their personal assets and ending up on MaineCare quicker, Erb said.

Despite such cost-shifting, Maine lawmakers have increased MaineCare reimbursement rates for assisted living only once in the last eight years -- a 1 percent increase for fiscal 2011-12, Erb said.

The MaineCare funding gap has forced many facilities to put off much-needed renovations for years, Erb said.

There's a 92 percent occupancy rate for the 4,232 beds in assisted-living facilities that accept MaineCare. Given such demand, many of the 34 residents who will be discharged from St. Joseph's face a significant challenge in finding other places to live by the targeted Oct. 1 deadline.

Paul Gagne of Portland is one of several family members of St. Joseph's residents who contacted the Portland Press Herald to express disappointment and anger over the way the facility has handled the discharge process since it was announced Aug. 19 and 20.

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