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<DIV><FONT face=Arial color=#0000ff><A
href="http://news.yahoo.com/s/ap/20091004/ap_on_re_us/us_meltdown_nursing_home_cuts">http://news.yahoo.com/s/ap/20091004/ap_on_re_us/us_meltdown_nursing_home_cuts</A></FONT></DIV>
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<H1>Waves of new fund cuts imperil US nursing homes</H1>
<DIV class=byline><CITE class=vcard>By DAVE COLLINS, Associated Press
Writer <SPAN class=272473317-05102009> </SPAN></CITE><ABBR
class=timedate title=2009-10-04T12:14:37-0700>Sun Oct 4,
3:14 pm ET</ABBR> </DIV><!-- end .byline -->
<DIV class="mod ad darla_ad" id=darla-ad__LREC> </DIV>
<DIV class="mod ad darla_ad">HARTFORD, Conn. – The nation's <SPAN
class=yshortcuts id=lw_1254683710_0>nursing homes</SPAN> are perilously close to
laying off workers, cutting services — possibly even closing — because of a
perfect storm wallop from the recession and deep federal and <SPAN
class=yshortcuts id=lw_1254683710_1>state government spending</SPAN> cuts,
industry experts say.</DIV>
<P>A Medicare rate adjustment that cuts an estimated $16 billion in nursing home
funding over the next 10 years was enacted at week's end by the <SPAN
class=yshortcuts id=lw_1254683710_2>federal Centers for Medicare and Medicaid
Services</SPAN> — on top of state-level cuts or flat-funding that already had
the industry reeling.</P>
<P><FONT size=5>And Congress is debating slashing billions more in Medicare
funding as part of <SPAN class=yshortcuts id=lw_1254683710_3>health care
reform</SPAN>.</FONT></P>
<P>Add it all up, and the nursing home industry is headed for a crisis, industry
officials say.</P>
<P>"We can foresee the possibility of nursing homes having to close their
doors," said David Hebert, a senior vice president at the <SPAN class=yshortcuts
id=lw_1254683710_4>American Health Care Association</SPAN>. "I certainly foresee
that we'll have to let staff go."</P>
<P>The funding crisis comes as the nation's baby boomers age ever closer toward
needing <SPAN class=yshortcuts id=lw_1254683710_5>nursing home care</SPAN>. The
nation's 16,000 nursing homes housed 1.85 million people last year, up from 1.79
million in 2007, U.S. Census Bureau figures show.</P>
<P>Already this year, 24 states have cut funding for nursing home care and other
health services needed by low-income people who are elderly or disabled,
according to the Center on Budget and Policy Priorities, a nonprofit research
firm based in Washington, D.C.</P>
<P>Some facilities are now closed because of money problems — including four in
<SPAN class=yshortcuts id=lw_1254683710_6>Connecticut</SPAN> — and others have
laid off workers because of what industry officials say are inadequate Medicaid
reimbursement rates. Medicare cuts are troubling, they say, because the higher
Medicare reimbursements have been used to compensate for the lower Medicaid
rates.</P>
<P>In Griswold, Conn., the community's only nursing home shut down earlier this
year because of rising costs and an inability to pay for $4.9 million in needed
renovations for the 90-bed facility.</P>
<P>"A 92-year-old woman was screaming and crying as she was loaded into the
ambulance, saying 'This is my home,'" <SPAN class=yshortcuts
id=lw_1254683710_7>Griswold First Selectman Philip Anthony</SPAN> said. His
88-year-old mother was a resident of the same home at the time.</P>
<P>Anthony sought and found a new facility for his mother, but she died of
pneumonia before the Griswold Health and <SPAN class=yshortcuts
id=lw_1254683710_8>Rehabilitation Center</SPAN> closed in the spring.</P>
<P>"To be hit with a sudden and deliberate closure like this, it just drained
the heart right out of you," Anthony said.</P>
<P><SPAN class=yshortcuts id=lw_1254683710_9>Connecticut Gov. M. Jodi
Rell</SPAN> and <SPAN class=yshortcuts id=lw_1254683710_10>state
lawmakers</SPAN> gave no Medicaid rate increases to nursing homes in the state
last fiscal year and kept the funding flat for the next two years.</P>
<P>The Griswold home was one of four nursing homes in the state that have closed
since December because of financial problems, a higher rate than usual, said
Deborah Chernoff, a spokeswoman for District 1199 of the New England Health Care
Employees Union in Connecticut, which represents more than 20,000 <SPAN
class=yshortcuts id=lw_1254683710_11>health care workers</SPAN> in the
state.</P>
<P>"We're really teetering on the edge of what we see as the collapse of the
<SPAN class=yshortcuts id=lw_1254683710_12>long-term care system</SPAN>," she
said.</P>
<P>Chernoff said many of Connecticut's 240 or so nursing homes have been
reducing workers' hours to deal with money problems, while two are in bankruptcy
now.</P>
<P>Also this year across the country:</P>
<P>• The <SPAN class=yshortcuts id=lw_1254683710_13>Motion Picture &
Television Fund</SPAN> said in January it would close a hospital and nursing
home in Woodland Hills, Calif., founded to care for actors and other <SPAN
class=yshortcuts id=lw_1254683710_14>entertainment industry workers</SPAN>,
because of financial losses.
<P>• The Westchester Medical Center in suburban <SPAN class=yshortcuts
id=lw_1254683710_15>New York</SPAN> said it would close a nursing home and cut
400 jobs to deal with Medicaid and other fund cuts.
<P>• The Dove <SPAN class=yshortcuts id=lw_1254683710_16>Health Care</SPAN>
nursing home in <SPAN class=yshortcuts id=lw_1254683710_17>Glendale,
Wis</SPAN>., near Milwaukee, closed this summer because of heavy debt.
<P>• Medicaid reimbursement rates to nursing homes were cut this year by <SPAN
class=yshortcuts id=lw_1254683710_18>Rhode Island</SPAN> (5 percent); <SPAN
class=yshortcuts id=lw_1254683710_19>Michigan</SPAN> (4 percent) and Florida (3
percent).
<P>• <SPAN class=yshortcuts id=lw_1254683710_20>Washington state
legislators</SPAN> whacked nursing home funding by $93 million for the next two
fiscal years.
<P>Gary Weeks, executive director of the <SPAN class=yshortcuts
id=lw_1254683710_21>Washington Health Care Association</SPAN>, said some of the
organization's 400 assisted living and nursing homes have laid off workers. Some
will not survive, he said.
<P>At the request of Weeks' association, a federal judge in July issued a
temporary restraining order blocking the cuts because state officials didn't do
a required analysis of how the reductions would affect care quality and access.
<P>"There's a lot of pain going on everywhere, but it's clearly a crisis in
<SPAN class=yshortcuts id=lw_1254683710_22>long-term care</SPAN>," Weeks said.
<P>"You're going to find that some folks go out of business," he said. "Some
will look for more Medicare patients — Medicare pays more than Medicaid."
<P>In Washington, D.C., health care interests are resisting President Barack
Obama's plan to pay for his health care overhaul by slowing Medicaid and
Medicare spending. Obama wants to trim $313 billion from the two programs over
10 years.
<P>It's not clear exactly how all the health spending cuts will affect nursing
homes.
<P>A <SPAN class=yshortcuts id=lw_1254683710_23>University of Pittsburgh</SPAN>
study earlier this year found nearly 1,800 nursing homes nationwide closed from
1999 to 2005, about 2 percent each year.
<P>One of the study's authors, health policy and <SPAN class=yshortcuts
id=lw_1254683710_24>management professor Nick Castle</SPAN>, said the annual
closure rate is rising, for reasons that include inadequate Medicaid
reimbursement rates and the push for more home and community care.
<P>"It's come to a head recently with state budgets being in such jeopardy that
they're cutting in all areas," Castle said.
<P>The federal <SPAN class=yshortcuts id=lw_1254683710_25>stimulus
package</SPAN> approved in February includes $87 billion in Medicaid funding to
help states. But <SPAN class=yshortcuts id=lw_1254683710_26>Connecticut</SPAN>
and several other states are using a loophole in the legislation to divert the
money to budget items unrelated to health care, according to a congressional
study.
<P>On average, Medicaid payments by states to nursing homes fell short by $12
per patient, per day last year — nearly $4.2 billion in unreimbursed costs for
Medicaid-allowed expenses, according to the AHCA.
<P>In <SPAN class=yshortcuts id=lw_1254683710_27>New York City</SPAN>, the
Metropolitan Jewish Health System laid off about 200 of its 1,000 employees at
three nursing homes in Brooklyn because the state cut Medicaid funding by 10
percent to 14 percent, said President and Chief Executive Eli Feldman.
<P>"We understand there's a recession/depression," Feldman said. "But this is
not <SPAN class=yshortcuts id=lw_1254683710_28>health reform</SPAN> ... and the
victims are basically the people who live in the facilities. The <SPAN
class=yshortcuts id=lw_1254683710_29>Legislature</SPAN> basically says, 'Too
sick, too old, too bad."</P></DIV></BODY>
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