State News for December 2014
Rep. Frank Artiles (R-Miami)
Nursing home construction boom?
FLORIDA – A nursing home building boom may be on the horizon following the end of a 12-year moratorium.
State regulators are currently reviewing more than 130 applications for construction projects totaling more than $430 million. The projects, which include hospice facilities, would add 3,115 new beds to the state's long-term care community.
The moratorium ended in 2013 following implementation of the state's Medicaid long-term care managed care program. Later, a House-sponsored bill (HB 287) paved the way for new nursing homes in areas of the state where occupancy rates exceed 92%. Nearly two-thirds of the new beds are reportedly targeted for northeast and central Florida. A recently passed Senate-sponsored bill immunizes individuals from liability in negligence suits against facilities in which they invest.
The state will announce approved applications in February.
Hospital-LTC Medicaid pacts
INDIANA — More than two dozen publicly-owned hospitals throughout the state are taking advantage of a policy that allows them to acquire or partner with long-term care facilities to maximize federal Medicaid matching dollars, portions of which are being used to improve hospital operations and finance new construction.
Major Hospital, an aging 34-year-old facility, will use money from this type of relationship to cover about a third of the $89 million tab to build a new 300,000-square-foot, 56-bed hospital southeast of Indianapolis. Under the oft-used provision, government-owned hospitals typically take over the long-term care facilities and allow former owners to continue operating them.
Proponents say the partnerships allow public facilities like Major to improve their bond ratings and attain more attractive construction financing. They also say it empowers facilities to streamline and coordinate care and reduce readmission rates.
About 345 nursing home licenses in the state are currently held by hospitals under the partnerships arrangement, which generated about $313 million in additional funding in 2013, according to the state Department of Health.
LTC wages near poverty level
WISCONSIN — Nearly half of long-term care and home care providers pay employees at or near the minimum wage in a state where one in four workers now live in poverty, according to a new report by the Madison-based Center on Wisconsin Strategy and the Economic Policy Institute.
Poverty-level wages are particularly prevalent among the state's food, retail, residential and in-home health care businesses, according to the “Raise the Floor” report. Roughly 700,000 Wisconsin workers earned less than a living wage in 2013 to support a family of four or more, a benchmark of $11.36 per hour established at the federal level. Even more (about 66%) of the state's foodservice and retail workers are earning wages at or near the poverty level. Wisconsin's minimum wage is $7.25 per hour.
Gov. Scott Walker's (R) administration recently stopped an effort by a labor group to exploit a state law provision that would have raised the state's minimum wage.
Legionella guidelines out
PENNSYLVANIA — Allegheny County gets more than its share of Legionella cases — more than double state averages — prompting county health officials to implore long-term care facilities to take proactive measures to prevent infections.
Absent state and federal guidelines for preventing the spread of Legionella, a water-borne bacteria, the county health department has partnered with the Jewish Healthcare Foundation. They have developed 70-plus pages of guidelines to help facilities check for Legionella, develop routine testing measures, and implement methods to prevent or reduce the spread of bacteria. The bacteria are typically contracted by inhaling contaminated droplets from a water source like showers and fountains.
The frail elderly are particularly vulnerable to complications from so-called Legionnaires' disease, notably pneumonia. At least 52 cases of Legionella have been recorded in the county this year; six residents of the Veterans Affairs Pittsburgh Healthcare System died in 2011 and 2012 after a massive outbreak.
Plan to boost Medicaid pay
TEXAS — Much like some providers in Indiana, a Lone Star state hospital district is looking to partner with nursing homes to generate needed funding.
The Parker County Hospital District recently unanimously approved a plan to enter into such partnerships, which allow government-owned hospitals that join with nursing homes and other long-term care facilities to boost Medicaid reimbursement through increased federal matching dollars, and use portions of the increased funding to enhance care and improve facilities.
Under the approved plan, the district would partner with operator Optimum Healthcare to participate in the state's “Upper Payment Limit” program, which would pay the difference between Medicaid and Medicare payments, according to published reports.
Glitches cause overpayment
COLORADO — The federal government is working to recoup more than $2.5 million in supplemental overpayments made to the state over a two-year period.
The U.S. Department of Health and Human Services Office of Inspector General recently uncovered the mistake in payments made in 2010 and 2011, and recommended measures to prevent it from happening again. The disbursements involved miscalculated prospective payments to nursing facilities.