Print edition: 
Area nursing homes are bracing for the end of January, when they'll see the first effects of a 10 percent cut in Medicaid reimbursement from the state.
They say the cut will amount to thousands of dollars a month in lost revenue, an amount they don't know how they're going to make up.
Efficiencies such as turning out lights that aren't being used won't be enough, said Bill Ward, president and CEO of Presbyterian Manors of Mid-America.
Even if a nursing home operated in complete darkness, he said, "you can't make up the kind of cut we just got."
Medicaid provides a broad range of health services for low-income people and had low reimbursement rates before the cuts. When the cuts were announced in late November, as part of efforts to trim the state budget, the Kansas Health Care Association said providers already were losing about $9 per Medicaid resident per day.
Larry Wilkerson, owner-operator of the four area LakePoint nursing homes, said about half the state's nursing home population is covered by Medicaid.
The state figures the Medicaid reimbursement rate for an individual nursing home based on a formula "that doesn't recognize all the costs of doing business," he said.
Now, he said, "You discount that discounted rate by 10 percent."
Because of the way reimbursements are paid, the effect of the cuts will start showing up this month for most of the nursing homes.
Jerry Carley, CEO of Via Christi Senior Services, said Catholic Care Center in Wichita expects to lose about $1,000 a day because of the cut.
"We've taken a look at supplies, where are we spending, what's a need versus a want, those kinds of decisions," he said.
"It's definitely going to cause challenges."
Ward said Presbyterian Manors expects revenue to drop about $2.2 million during 2010. About half of that has to be made up in the fiscal year that ends June 30.
And with Medicaid, "you can't say, 'We have increased costs, we'll raise the Medicaid rate,' because we don't set the Medicaid rate," he said. "We could raise all our rates across the board, and it wouldn't affect the Medicaid people."
At the Presbyterian Manor in Wyandotte County, he said, nearly three-quarters of the patients are on Medicaid. There's no way the other patients can be asked to make up that shortfall.
Presbyterian Manors has dipped into its Good Samaritan donated funds in the past, but that money was never intended to subsidize a government program, he said.
A nursing home's three biggest expenses are staffing, supplies for nursing care, and food, he said, and all three of those are difficult to cut.
"We're not in a panic mode. We just know this is a real challenge. It's a severe loss of revenue," Ward said.
