A small town in Oklahoma will forge ahead with its plan to own 28 nursing homes, even though the hospital it intended to pump up through the acquisitions has closed.
Originally, officials in Pauls Valley, OK, planned to use the 28 facilities around the state to gain funding from a new government program to help shore up their public hospital’s finances. But the Pauls Valley Medical Center closed last month, Oklahoma Watch noted in a report Tuesday.
Municipalities have acquired 18 other nursing homes around the state with similar hopes of cashing in, even though the Centers for Medicare & Medicaid Services has not yet given the go-ahead for the customized reimbursement program.
Funds would be collected by municipalities, if nursing homes show quarterly improvements on four quality measures — falls, pressure ulcers, use of antipsychotics and restraints.
“It is pay for performance,” said Eddie Parades, senior VP with Stonegate Senior Living and one of the architects of the new program. “Some people think it’s a get-rich-quick scheme and there’s millions in benefits, but you know who benefits? The patient. We have to prove quality improvement to earn it.” Stonegate manages nine of the nursing homes now owned by Pauls Valley.
The “Nursing Facility Upper Payment Limit” program would grant millions of dollars in extra Medicaid payments to qualified nursing homes. Owner municipalities stand to get a 25% cut of the extra payments. If approved, the program would open the door for $18.5 million in extra Medicaid funds in the next federal fiscal year.
Pauls Valley officials told Oklahoma Watch that they’re still debating how they might use the funds, if the program is approved. Ideas floated include improving ambulance services and building a new urgent care clinic. A decision from CMS is expected in mid-January. Federal authorities rejected Oklahoma’s first application in 2017. Oklahoma is modeling its proposal after Texas’ program, one of 11 upper payment limit programs already in existence.
