State News for March 2017

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The 55% surcharge on SNF services was proposed by former Gov. Jack Dalrymple.
The 55% surcharge on SNF services was proposed by former Gov. Jack Dalrymple.

PLAINS/MOUNTAINS

Residents to pick up the tab for funding reductions

NORTH DAKOTA — The state's 80 senior care centers faced a difficult choice when they agreed with a proposed 5% surcharge on the services they provide. In the end, it was either accept the fee or make deep staffing cuts to stay open.

The proposal in House Bill 1130, prepared by former Gov. Jack Dalrymple's (R) administration, would generate about $20 million in annual state revenues through June 2018 and provide a revenue source to restore all budget reductions caused by a process called allotments. The new administration has yet to announce its fiscal budget for the coming year.

Proponents say the surcharge would help offset about $25 million in allotment cuts, which include the loss of federal funds and reduced private payments that legally must match state support. The 5% surcharge would be passed on to nursing home residents and could increase their monthly bills by $300 to $350 a month, according to published reports. A spokesperson for the North Dakota Long Term Care Association told the Bismark Tribune that 43 states and the District of Columbia have approved similar surcharges.

Should the new administration not restore prior year funding cuts, the North Dakota Long Term Care Association said it would seek a two-year sunshine clause to avoid the 5% surcharge becoming permanent.

Dental care backlog eased

KANSAS — State health officials intervened in late January on behalf of about 385 disabled and elderly residents who were being turned away for dental care because their Medicaid applications were caught in processing limbo.

Sterling Dental, the state's contracted provider, reportedly notified nursing homes it was suspending services to those residents because their Medicaid applications were either denied or unapproved. The backlog was caused, in part, when the state switched to a new computer system in mid-2015, and then switched to a new contractor to process applications. The Kansas Department of Health and Environment said the problem arose because its clearinghouse for Medicaid applications reported not receiving paperwork Sterling Dental said it sent in October 2016.

Patient advocates, including Cindy Luxem, CEO of the Kansas Health Care Association, have criticized the backlog for leading to a system that left many unapproved applicants without needed care and services.

Plan to move beds fails

SOUTH DAKOTA — Lawmakers roundly voted down a measure that would have allowed nursing home operators to transfer unoccupied beds to other owned facilities or sell them to the highest bidder.

In voting down House Bill 1003, lawmakers such as Rep. Karen Soli (D-Sioux Falls) criticized the proposal, saying it would have led to beds going to those willing to pay the highest prices, instead of going to those who needed them most. Soli also contended that because Medicaid reimbursement in the state is so poor, the plan would have unfairly led to costs being shifted to more private pay residents.

The bill's main sponsor, Rep. Wayne Steinhauer (R-Hartford), claimed the plan would redistribute nursing home beds to areas where they were most needed — a possible hard sell in a state that has the nation's highest nursing home bed occupancy rate.

The state has had a moratorium on the number of nursing home beds since 1988.

NORTHEAST

Wage plan boost wanted

MASSACHUSETTS — One of the state's leading facility advocacy groups says the newly proposed fiscal budget is about $55 million short of a plan to ensure a “living wage” for nursing home workers.

Tara Gregorio, president of the Massachusetts Senior Care Association, called a $35 million wage pass-through in the proposed $41 billion budget a “good start” while pleading with lawmakers to come up with the additional funding. Without it, Gregorio said, skilled nursing facilities could face closures and more workforce destabilization.

The association's Quality Jobs for Quality Care campaign calls for $90 million in total funding to provide a pathway to a living wage for nursing home workers.

“Massachusetts nursing homes face an unprecedented financial crisis,” Gregorio said in a prepared statement. “Nearly half are operating in the red, vacancies for critical staff positions are increasing at a sharp rate, and quality of care is threatened due to inadequate Medicaid funding for nursing home care, which pays for two-thirds of patients.”

MIDWEST

Measure limits granny cams

MINNESOTA — Newly proposed guidelines designed to balance privacy and transparency in nursing home care will likely raise the bar for permission to use so-called “granny cams” in the state's 377 nursing homes.

The panel has proposed granny cams be allowed only if informed consent (or legal representative's blessing) is obtained from of all residents in a room.