CMS' Medicare cuts bring pain

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CMS' Medicare cuts bring pain
CMS' Medicare cuts bring pain

By Charles Perry - Executive Director Nevada Health Care Association 

The Centers for Medicare & Medicaid Services issued a rule in early August that will cut $360 million in Medicare payments to skilled nursing facilities for fiscal year 2010. The current administration also recently imposed cuts of at least $12 billion to nursing home care for seniors and people with disabilities.

As executive director of the Nevada Health Care Association, a non-profit organization of long-term care facilities and associate members in Nevada, I see first-hand the challenges faced by patients and caregivers in our nation's healthcare delivery system —a key component of which is long-term care—each day.

In representing nearly 50 Nevada-based nonprofit and for-profit assisted living, nursing facilities and sub-acute care providers that care for nearly 6,000 elderly and disabled individuals statewide and employ more than 8,000 Nevadans, I fully support meaningful healthcare reform. That's reform to improve overall patient care, raise the bar on greater efficiencies and stem rising healthcare costs – but not at the expense of our nation's nursing home residents and those who provide their care.

I understand the need for reform, but I don't believe that Congress fully understands the severe impact these combined cuts would have on the quality of skilled nursing care, as well as much-needed healthcare jobs in our community.

This isn't just a topic of discussion for the elderly and their families. The effects of cuts like these on long-term care industries nationwide would be crippling. Cuts would not only affect patients' eligibility for compensation, but they would affect the level of care, the access to care and the healthcare community as a whole.

Why? At most facilities, 80% of the patients and residents cared for rely on Medicare and Medicaid to pay for their care and services. In fact, cuts to Medicare are magnified by the fact that Medicare funding helps to balance out Medicaid's chronic underfunding of skilled nursing care—a growing problem in the current fiscal environment as many states are squeezing, or even freezing, Medicaid rates.

‘Domino effect'

Even if patients are no longer eligible for Medicare or Medicaid, they cannot be unsafely discharged from long-term care facilities. Thus, our long-term care facilities end up housing an ever-increasing number of patients for free, taking up space for those who are eligible and also causing long-term care facilities to lose funds. This creates a “domino effect.”

Because patients with no coverage are continuing to fill long-term care beds, additional folks in need of those long-term care beds are forced to stay in hospitals. In turn, those needing hospital services are forced to turn to emergency rooms for care. And those who are truly suffering from an emergency could, as a result, wait hours for the help they need.

If the deep additional cuts proposed by Congress are approved, skilled nursing facilities across the country could be forced to reduce jobs, negatively affecting the quality of care long-term care providers can offer. Hundreds of long-term care jobs could be lost as a result of these cuts.

Patient care and quality of life is directly related to sufficient staffing levels and a trained quality workforce. And while I support efforts to make certain that 47 million uninsured Americans can access the care they need, I want to ensure that the care our country's long-term care facilities provide continues to be the quality of care that every American should expect.

In addition, these proposed cuts to nursing home care are highly disproportionate as compared with other areas of healthcare. In fact, in the current House bill, providers of skilled nursing facility care would shoulder almost 10% of the cuts to Medicare revenues in the next decade.

Healthcare reform must not compromise the quality of care of patients by removing resources from an already overstretched long-term care system.