Funding cuts threaten nursing homes; Medicaid already cut

Legislative cuts in Medicaid funding would “let our seniors down,” says the administrator of the Marianna Health and Rehabilitative Center, Jonnie Cloud.

Speaking about proposed state budget cuts this week, Cloud said she understands that the state must spend less, because state revenues are down, but it would be a shame to regress in the area of senior citizens’ health care.

“These cuts to nursing homes would put an undue hardship on not only our facility but on every other skilled nursing home in the state,” Cloud said.

This week both the Senate Health and Human Services Appropriations Committee and the House Healthcare Council introduced their 2008-09 budgets. The Senate reduced nursing home funding $163 million and the House reduced funding $278 million.

This could severely impact nursing homes like the one the City of Marianna owns, which maintains a 98 percent occupancy of its 180 beds.
Cloud said that 87 percent of the occupants are Medicaid recipients and action of the Legislature last year reduced Medicaid reimbursement.

Reimbursement comes twice a year, in January and July, and usually goes up a bit. When it came in January of this year, however, it was $69,000 less than the previous year, according to Cloud.

“That’s substantial there,” she said.

Now she’s wondering what else the Legislature might do. Final decisions on the budget are expected next week.

The local administrator reviewed advances for nursing homes in the state and how legislative budget cuts could affect those advances.

“Florida legislators approved landmark elder-care facility reform legislation in 2001 that mandated increased minimum staffing requirements, tougher regulation and quality improvement, and risk management programs,” she said. “Since then, nursing home quality has steadily improved. Now, Medicaid funding cuts threaten this progress and the vulnerable elderly who have nowhere else to go.

“Today, Florida’s nursing home staffing standards are one of the highest in the nation. The Florida Legislature has funded these required staffing increases, but the new Medicaid rates effective Jan. 1, 2008, cut funding by an annualized $75 million, eliminating the funding received for the Jan. 1, 2007 mandatory nurse and certified nurses’ aide staffing increases,” she said.

“We urge the legislators to restore the $75 million in funding cut Jan. 1, 2008, so that Florida’s nursing homes can pay for the additional nurses and CNA staff that law now requires,” she said.

She said that according to the Web site of “Our Florida Promise”  – which is the Florida Health Care Association’s advocate organization for adequate nursing home funding – as a result of the 2001 legislation, fully 87 percent of Florida nursing home patients and 84 percent of their families now describe their nursing home as “excellent or “good.”

The Office of the State Long Term Care Ombudsman reports that fewer nursing home complaints were received and investigated over the past several years, she said.

“Care has improved because funding has improved. (Now) Governor Crist has proposed eliminating $192 million in inflation-related increases for 2008-09,” Cloud said. “The last time funding was cut this drastically, approximately one-fourth of the nursing homes in Florida filed for bankruptcy and nearly two dozen closed their doors permanently, sending their vulnerable elderly patients elsewhere.”

This also puts jobs in the picture. The Marianna nursing home employs 200.

If more cuts come, Cloud said, “We’d have to take a hard look at our services.”

The first place to look, she said, would be non-emergency transportation – to doctors’ offices, stores and restaurants. She said the nursing home is proud it doesn’t charge for that and she’d hate to see it go.