The closure of 11 nursing homes in Montana over the last two years has spurred some tough conversations and a $2.75 million study on Medicaid rates, but little action.
Advocates filled a hearing room in the state capital late last week to implore lawmakers to raise Medicaid rates to counter a budget crisis that is getting worse by the day. The study, conducted by an independent consultant at the direction of the state Legislature, found that Montana’s Medicaid providers are underpaid by tens of millions of dollars. But the budget proposal by Gov. Greg Gianforte (R) only increases rates for nursing home operators by about a third of what the study recommended.
“We’ve got to strike a good balance. In the end, we need the Legislature’s help to actually improve these reimbursement rates,” Gianforte said at a recent press release, noting that his budget proposal is the largest rate increase “in the history of the state.”
The state currently pays assisted living facilities $104 per day per patient while nursing homes receive $212 per day for residential care per patient. That’s nearly 22 percent below the “benchmark standards” for the real costs of care, according to the study by Guidehouse Inc. released in September. The study recommended increasing reimbursements to nursing homes to $278 per day.
The state lost more than 850 nursing home beds in 2022, according to the Montana Health Care Association. Providers have said that even the study’s recommendations might not be enough to give them the financial stability they need.
At the hearing, one nursing home administrator told lawmakers that he couldn’t compete with the wages being offered at Target, which is paying $20 per hour.
“Healthcare providers can’t compete with that because we can’t just increase our rates,” said Michael Coe, administrator of the Pines of Polson.