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Letters To The Editor

Dear Editor,

I have just come back from giving testimony on the Medicaid rates for nursing homes in Montana. It was a well-run hearing. The governor presented his budget proposal. There were over 40 opponents stating that their nursing home or assisted living facility would be closed or stop providing for Medicaid residents if they didn’t get more help than the governor is proposing.

The governor said the people want to have home care, so he proposed significantly cutting the home care budget? He said let’s try it for two years and then make adjustments. What is there to adjust in two years? Every part of the budget for care of the elderly is underfunded. In-home care is underfunded. Assisted living is underfunded. Nursing homes are underfunded.

The governor and the folks at the Department of Health and Human Services paid an outside consulting firm Guide House (who knows how much money) to determine the adequacy of Medicaid rates for nursing homes. The study on Montana nursing home facilities was finished and a report prepared. The consultant looked at cost reports from all nursing homes in the state.

The consultant’s recommendation is that Montana nursing homes be paid $278 per day. As I understand it, nowhere in the report does the consultant state what the total reported costs were on average - a number that was obviously available to them. The $278 recommendation represents a large rate increase but even that does not reflect the true cost of providing services to Medicaid patients.

The nursing homes’ costs were reduced by an “occupancy adjustment” which penalized nursing homes for having low occupancy even though the low occupancy is caused by their inability to accept new residents because they don’t have the money to hire staff because of very low Medicaid rates. A vicious cycle.

One legislator tried to figure out how much the penalty amounted to and what the real costs were before the “discount” but was stonewalled by both the department and the consultants. The committee was left stranded knowing that the true costs were probably over $325/day, but the study and DPHHS were intentionally silent on the dollar amount. The study was also silent on the unique problems and costs faced by our most rural facilities.

The committee will need to fund Medicaid at a rate that is very close to true cost if we are to avoid more nursing home closures and more elderly Montanans being forced to move away from family, friends and the place they’ve lived all their life. If you believe the State has some responsibility in taking care of the poorest, sickest elderly please email the following people and ask for them to fund Medicaid rates at true cost.

Email: [email protected] gov Email: [email protected] gov.

Email: [email protected] gov

Email: [email protected] gov. Email: [email protected] gov.

Email: [email protected]

This reminds me of the story of the Good Samaritan. The high priest (governor) has walked by because it may cost some money. The legislature is standing beside this hurting individual and deciding what to do. They need your encouragement to be a Good Samaritan and do their part. Daryl Toews Former Montana Senator

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