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Lawmakers finally discussing nursing home funding challenges, but now they need to act

The Atlantic Rehabilitation and Nursing Center closed in 2012. A number of other nursing homes in Maine are facing financial pressure from a gap between MaineCare reimbursement rates and operating costs.
Courtesy of Tom Walsh
The Atlantic Rehabilitation and Nursing Center closed in 2012. A number of other nursing homes in Maine are facing financial pressure from a gap between MaineCare reimbursement rates and operating costs.
Posted Jan. 29, 2014, at 12:59 p.m.

There has been much discussion in the Maine media and at the State House in Augusta of our state’s unique demographic challenge. Maine has the highest median age of any state, and this is a critical issue for people of all ages in Maine who will shape the financial future of our state and the lives of thousands of families. The impact is particularly significant in our rural communities where the elderly make up an even larger segment of the population.

At Mt. Heights Health Care Facility in Patten, we care for 25 Maine elders with a variety of illnesses and diagnoses. These are our neighbors, friends and relatives with significant health issues who can no longer live independently.

Despite the complexity of their care, we see beyond the illness and diagnosis to care for the whole person. Like many of the state’s nursing homes, our home acts as an informal community center and one of the major anchors for families in the region. Our philosophy is, “our home is your home.” Families are welcome to visit loved ones day or night.

Unfortunately, our nursing home and peers around the state are facing extremely serious operating challenges because of state funding decisions over the past decade. Like any operation, our homes have incurred increasing costs every year in employee salaries and benefits, electricity and heating expenses, and all other purchased goods we use. Despite the growing expense, the state has barely increased the reimbursement rate we are paid for residents who are on MaineCare in more than a decade.

As this funding gap has grown over time, nursing homes have had to bear its impact while continuing to provide top-quality care for Maine’s elderly. As our budgets have tightened, it’s getting harder for those of us who manage homes to make the numbers work and continue the level of operations that our residents need and deserve and our families have come to expect. This also affects private payers who fund their own care. They end up shouldering elevated costs because MaineCare isn’t covering its share of our home’s expenses. The private pay rate in Maine is 50 percent higher than what the state pays.

The funding gap presents a major problem for nursing homes like ours as we try to make ends meet. About two-thirds of patients in Maine nursing homes rely on MaineCare to finance their care; in our facility, 80 percent rely on this coverage. With such a large proportion of residents relying on the state, the decision to underfund nursing home care has a huge impact on the way we run our operations and whether our home remains viable.

In 2012, one home in Calais had to make the difficult decision to close, requiring residents and their families to make significant lifestyle changes. With limited beds across the state, these families have had to travel from their communities to find new homes for their loved ones. In Calais, the closure left a hole in Washington County and likely forced families to consider options in Hancock, Penobscot and Aroostook counties.

In rural Maine communities, when a nursing home closes, there won’t be another option right down the street. In most cases, the next nearest opening is going to be a significant drive away. Closure creates an enormous disruption for residents, making it harder for family members to make those visits that are the highlight of their loved one’s day or week. The weather this winter highlights how difficult it can be for these families to see their loved ones when they’re contemplating long drives on icy roads.

Luckily, our leaders in Augusta have begun the process to address this problem — just in the nick of time. A legislative commission recently released a report that included policy recommendations to close the MaineCare funding gap in the coming year and ensure that modest cost-of-living increases prevent it from growing again.

Even better, it explicitly calls for special help for the rural Maine nursing homes like ours that are caring for a high percentage of MaineCare residents. Collectively, our homes create a strong network of coverage across the state. It is a vital part of our health care system that has largely been ignored for a decade.

The state can no longer ignore that we need this help. More homes may soon have to close under the financial pressure that the funding gap creates. If our lawmakers act quickly to implement the report’s recommendations, they will have taken a great stride in securing care for rural Maine’s elderly. On behalf of all Maine nursing homes, I urge them to do so.

Beth Martin is administrator of Mt. Heights Health Care Facility in Patten.

 

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