Thursday, May 8, 2008

Minnesota Nursing Home Crisis Shameful

Hubert Humphrey said, "The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadows of life - the sick, the needy and the handicapped." We're not doing especially well for those in the dawn or the shadows of life, with school programs being cut across the state, the number of uninsured rising every year, health insurance and medical cost skyrocketing, and the injured veterans struggling with an often incompetent bureaucracy to receive the timely care and benefits they deserve.

However, we're failing miserably with those in or approaching the twilight of life! All across the state, newspapers and media outlets are covering the crisis facing our nursing homes. The May 3, The Star Tribune editorial indicated that a third of the state's nursing homes might be at risk for closure in the very near future. The Bemidji Pioneer stated that the nursing home industry is on the verge of collapse. The years of little or no increases in state reimbursements for qualified Medicaid residents in nursing homes are the crux of the crisis.

In 2007, a rural NE Minnesota Hospital and Nursing Home received state reimbursements of $129 per Medicaid resident per day, but the costs for the state mandated level of service to these residents had risen to $178 per resident per day. That amounted to a $1.5 million shortfall for 2007. 2008 will be even worse. Costs go up, revenues don't. Yes, there were 2% increases for nursing home reimbursements in 2005 and 2006, but those minimal increases were far short of the increased costs and they followed 2 years of funding freezes in 2003 and 2004.

These kinds of minimal increases that are dependent every two years on the current political will are shortsighted and only delay the inevitable. Unfortunately, the planning horizons for most politicians seldom exceed their term of office. The consequence of these politically expedient freezes and/or miniscule increases is that the nursing home industry is now so far behind, it may too late for many. Where will our parents go when they need 24-7 skilled nursing care?

The fundamental problem is with the rebasing formula for nursing homes. Rebasing is the state process of regularly recalculating the actual costs of service for hospitals and other state-funded services. Reimbursements are then adjusted accordingly. However, rebasing has not been done for Minnesota nursing homes since 1994!

Where will Governor Pawlenty and the other short-sighted politicians, who have balanced the state budget on the backs of our elderly, be when the baby boomer tsunami strikes? Their terms of office will be over and they will have moved on to bigger and better opportunities. They will not be here to explain the lack of adequate long-term care facilities or to answer for their shortsightedness.