Opinion Columns & Blogs

Nursing home fee is good policy

Legislation pending in Topeka calls for an annual fee on every licensed bed in Kansas nursing homes. As the author of the proposed legislation and a licensed nursing home administrator in Kansas for more than 25 years, I am concerned that many residents in Wichita assisted-living and nursing facilities are not being provided with a true picture of the benefits of the proposed legislation.

The $30 million from proposed assessments on licensed beds would draw down an additional $57 million in federal dollars. The total $87 million could only be spent, per the legislative language, by returning those dollars to nursing homes, based on their percentage of Medicaid residents, for maintenance of current funding and for improved quality of care. The assessment would not drastically affect the homes' Medicaid rates, automatically increasing private-pay rates, as some have indicated.

The federal funds are tax dollars that Kansans have sent to Washington, D.C. Why wouldn't we want to get them back to Kansas for our nursing home residents? Thirty-seven other states have made that decision.

Shawn Sullivan, executive director of the Kansas Masonic Home in Wichita, said that he would have to raise private-pay rates to meet the assessment requirement ("Nursing homes ponder bed fee," April 13 Eagle). Because 45 percent of its residents are funded by Medicaid, according to the most recent cost report, the Masonic Home would pay an assessment of $159,000 and receive $324,317. Consequently, the facility would receive $165,317 of new funding, which would seem to be an exceptional return on investment.

Some have stated that this proposal is "bad public policy," but it is just the opposite. It is good public policy to find funding, especially in these difficult financial times, that would be dedicated to quality care for nursing home residents.

Because of the 10 percent reduction in Medicaid payments imposed by Gov. Mark Parkinson to address the shortfall in state revenues, some nursing homes already have raised private-pay rates. Others are in serious financial difficulty that could force facility closures. These additional federal funds would retroactively repair funding inequities and provide additional funding for quality enhancements for skilled nursing care facilities.

As people determine whether this is good or bad public policy, they need to understand why some homes gain and others lose revenue. Of the 345 nursing facilities in Kansas, 320 would benefit. They would receive back their entire assessment, plus additional revenue to meet the demands of providing quality care for their residents. The 25 facilities that would pay more in assessment than they receive serve less than 15 percent Medicaid residents. The negatively affected that oppose this legislative change, eight of which are not-for-profit facilities, could mitigate their costs by caring for more than 15 percent Medicaid residents.

In reality, some that oppose this change allow a person to "buy in" to their residential facility and then live independently in a tax-exempt home as part of a not-for-profit facility until nursing care is needed. At that point, the person can transfer to the needed comprehensive level of nursing care.

One might question if that arrangement is good public policy and consistent with standards for receiving a not-for-profit charitable tax exemption.