This page was last updated on June 18, 2015.
Medicaid doesn’t cover cost of nursing home; Steven Welhorsky, Administrator - Beaver Valley Nursing and Rehabilitation; Beaver County Times; June 9, 2015.
Below is a detailed critique of the subject letter.
“All of us want our loved ones to receive the very best when they’re no longer able to live on their own and require the high quality 24/7 skilled care only available through a nursing home. But over the past few years, access to quality nursing home care has been threatened in many Pennsylvania communities.”
[RWC] In the interest of disclosure, my mother spent much of the last few months of her life at Beaver Valley Nursing and Rehabilitation (BVNR). The staff treated Mom with care and compassion. Mom was not a Medicaid patient. What Medicare didn’t cover, her insurance via a former employer did.
“State reimbursement for care of nursing home residents in the Medicaid program — 65 percent of all nursing home residents — does not cover the real cost of care. A recent study by Avalere Health revealed that nursing homes, like ours, which serve an exceptionally high percentage of Medicaid residents had an average margin of 0.3 percent.”
[RWC] Why didn’t Mr. Welhorsky provide the margin for BVNR or its owner in addition to the industry average he cited? BVNR is/was owned and operated by Extendicare, a Canadian company. According to its 2014 Annual Report, “Extendicare is in the process of selling substantially all of its U.S. business and senior care operations (the ‘U.S. Sale Transaction’) as part of the Company’s strategic objective to be a leading provider of care and services for seniors focused solely on Canada.” Check the Extendicare 2014 Annual Report for specifics about Extendicare getting out of Pennsylvania.
Just like doctors and hospitals (except for emergency care), nursing homes are not required to accept Medicaid patients. For example, as recently as May 2012, signs in the emergency room area of Heritage Valley Beaver (HVB) stated HVB didn’t admit patients covered by Medicaid. HVB would only do what was required to stabilize a patient sufficiently to allow his safe transfer to a facility that accepted Medicaid. I don’t know about today’s HVB policy.
From a purely business perspective, if BVNR can’t get a sufficient margin with a large proportion of Medicaid patients, it needs to determine the mix of Medicaid and non-Medicaid patients that will generate a sufficient margin and go with it.
“All nursing home administrators want to recruit and retain compassionate, competent caregivers who become an important part of our residents’ lives. These caregivers deserve competitive salaries which reflect the expertise, professionalism and commitment they bring to their physically and emotionally challenging jobs. We want to invest in technology and equipment to enhance care.
“The Wolf administration and Pennsylvania legislators need to take note: without higher Medicaid reimbursement, low-income seniors and their families will suffer as fewer options for skilled 24/7 care remain. Care of the frail and elderly in nursing homes should be a top priority in our state budget.”
[RWC] Why should the taxpayers of any government level pay for nursing home stays for “low-income seniors and their families?” This is a family/personal responsibility. Do I believe people who need help because of unforeseen circumstances should get it? Of course, but via private charities funded by voluntary contributions.
© 2004-2015 Robert W. Cox, all rights reserved.