Governor earmarks funds for SNFs in budget

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New Mexico Gov. Susana Martinez (R)
New Mexico Gov. Susana Martinez (R)

Governor earmarks funds for SNFs in budget

NEW MEXICO — Due partly to the average 11.1% reduction in Medicare payments to nursing homes that took effect in October, New Mexico Gov. Susana Martinez (R) is asking state legislators to approve her state budget, which earmarks $8 million for skilled nursing facilities.

Prior to Martinez's budget, officials from the New Mexico Health Care Association were pushing a plan that would have assessed a “bed tax,” or provider fee. Nursing homes would have had to pay a fee based on each facility's number of Medicaid beds. Roughly 64%, or 3,600, nursing home residents in New Mexico are Medicaid recipients.

“This is a targeted investment that will prevent the closure of nursing homes because of federal Medicare cuts, and it's certainly a better proposal than the imposition of a bed tax that others have proposed,” Martinez spokesman Scott Darnell told the Santa Fe New Mexican.

MIDWEST

Medicaid payments delays
ILLINOIS — Nursing homes in Illinois are feeling the strain of Medicaid payment delays of up to six months.
At the beginning of the fiscal year last June, Illinois Gov. Pat Quinn (D) made a deal with the state's long-term facilities, hospitals and other vendors, to delay Medicaid payments by six months rather than cut reimbursement rates by 6%. Under that deal, thus far, the state owes nursing homes $800 million.

And while industry groups say they received notice that the state was to reimburse facilities in January (for services rendered in July), there was no guarantee that monthly payments would follow, The State Register-Journal reported.

A proposed borrowing plan pitched by the governor has not caught on. Another plan in the works would allow private investors to “purchase” up to $2 billion in outstanding Medicaid bills, according to the paper. The investors then would be repaid at a later date, with interest. The state is working on an additional plan to relieve vendors that also are feeling the pinch.

Criminals hired for LTC
MINNESOTA — Minnesota has granted waivers for 15,000 people with criminal backgrounds seeking to work in the state's long-term care facilities, a new report finds.

Generally, criminal background checks weed out job seekers with prior criminal convictions. However, state law offers former criminals an appeals process that gives them a second chance, according to an investigation by the Star Tribune. This appeals process lets previous offenders work in a variety of care settings, including hospitals, assisted living facilities, group homes for the disabled and home care providers. Offenders range from those with misdemeanors to felonies, including robbery and forgery.

Public records show that Minnesota's Health Department approved 75% of more than 10,000 appeals. More than 5,000 waivers were issued to people seeking employment in nursing homes or home health agencies, the newspaper reported.

State regulators told the Star Tribune that they do not track how many waiver-seekers went on to work in long-term care facilities, nor do they track whether these individuals go on to commit new crimes. Federal regulators revealed in a 2011 report that as many as 92% of nursing homes nationwide have at least one staff member with a criminal conviction; roughly half of U.S. nursing homes have at least five employees with a past conviction.

SOUTHEAST

Class-action status lifted
FLORIDA — Thousands of institutionalized Medicaid recipients in Florida will not be able to move forward with a lawsuit after a federal judge removed its class-action status.

U.S. District Judge Robert Hinkle ruled recently in favor of the Medicaid patients who sued the state in 2008. But by removing the class action part of the suit, the ruling applies to one person rather than the 8,500 people estimated to be in a similar situation.

Seven original plaintiffs had sued the state in 2008, saying that as Medicaid recipients, they should be allowed to live in other settings. But five have died, and a sixth changed his mind, which led to Hinkle vacating the class-action status. He also cited changes to the state's Medicaid program that now gives more people the option to leave a nursing home.

Calls for a review panel
KENTUCKY — The Kentucky Association of Health Care Facilities, a long-term care advocacy group, has proposed forming a panel to review lawsuits against facilities. The group says a panel would prevent frivolous lawsuits. Opponents to the proposal, however, say it would make nursing homes less accountable for neglect and abuse.

The proposal floated by KAHCF calls for panels to comprise three physicians, chaired by a neutral attorney, who would not vote on the case. The party launching the complaint would be allowed to choose the first two panelists, who in turn would pick the third member. The panel's findings would be admissible in court, the Lexington Herald Leader reported.

Opponents to the proposal, which includes Kentuckians for Nursing Home Reform and a group that represents attorneys, claim the proposal is “blatantly unfair” to nursing home residents and would further serve to insulate the industry.

WEST

Medicaid cuts blocked
CALIFORNIA — A federal judge granted an injunction last month that stopped the state of California from implementing 10% reimbursement cuts to skilled nursing facilities operating within hospitals.

The 10% cuts, which U.S. District Judge Christina Snyder said violated the federal Medicaid Act, were a part of the state's 2011-2012 budget, which was signed into law last March by Gov. Jerry Brown (D). Snyder also granted a separate injunction that prevented cuts to pharmacies participating in California's Medicaid program. The California Hospital Association requested the injunction.

“The state's fiscal crisis does not outweigh the serious irreparable injury the plaintiffs would suffer absent the issuance of an injunction,” Snyder wrote.

A spokesman for California's Health Care Services Department told Bloomberg that his office is planning to appeal the decision.

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