While Congress debates homeland security and the possibility of war with Iraq, nursing homes are keeping a worried eye on the federal Medicare budget. A ten-percent cut in skilled nursing payments is scheduled to go into effect Monday. That money pays for specialized care for some of the sickest nursing home patients. The facilities are hoping Congress cancels those cuts before adjourning. NHPR?s Trish Anderton reports.
SUSAN BUXTON IS WRITING HER NEXT BUDGET AT THE HAVENWOOD HERITAGE HEIGHTS RETIREMENT COMMUNITY IN CONCORD. AS VICE PRESIDENT OF HEALTH AND SUPPORT SERVICES, SHE?S NERVOUSLY AWAITING WORD ON THE FATE OF THE MEDICARE BUDGET.
I am absolutely watching the cuts
THE NEW HAMPSHIRE HEALTHCARE ASSOCIATION SAYS THE TEN-PERCENT CUT IN SKILLED NURSING FUNDS WOULD COME OUT TO ABOUT 36 DOLLARS PER PATIENT PER DAY. SINCE NURSING HOMES SPEND MOST OF THEIR MONEY ON PERSONNEL, STAFF CUTBACKS WOULD BE THE SIMPLEST WAY TO MAKE UP THE DIFFERENCE. BUT THE ASSOCIATION?S JOHN POIRIER SAYS THE KIND OF REHABILITATIVE CARE THIS MONEY PAYS FOR REQUIRES A LOT OF ONE ON ONE NURSING. CUTS AREN?T ALWAYS AN OPTION. POIRIER SAYS IN RECENT YEARS ABOUT A THIRD OF NURSING HOMES HAVE GONE INTO BANKRUPTCY.
We?ve seen facilities go into bankruptcy, about half have come back out, and if these cuts take place some of them could go back, and it could be chapter 7 instead of chapter 11, which would mean closing these facilities instead of just realigning their debt.
THE CUTS GO BACK TO THE BALANCED BUDGET ACT OF 1997, WHICH SOUGHT TO REFORM MEDICARE AND TRIM ITS BUDGET. NURSING HOMES ARGUED THE CUTS WENT TOO FAR. CONGRESS RESTORED SOME OF THE MONEY, BUT ONLY TEMPORARILY. THE RESTORED FUNDS EXPIRE OCTOBER FIRST. BUT NOT EVERYONE AGREES NURSING HOMES NEED THE MONEY. LAST YEAR AN INDEPENDENT GOVERNMENT BOARD CALLED THE MEDICARE PAYMENT ADVISORY COMMISSION CONCLUDED THE FACILITIES NEEDED ONLY A PORTION OF THE FUNDING TO BE FINANCIALLY SOUND. THE NURSING HOMES DISAGREE, SAYING THE COMMISSION DIDN?T TAKE A CLOSE ENOUGH LOOK AT THEIR OVER OVERALL FINANCIAL HEALTH. THEY?RE HOPING TO CHANGE THE SCOPE OF THE COMMISSION?S WORK IN THE FUTURE. IN THE MEANTIME, THE NURSING HOMES HAVE POLITICS ON THEIR SIDE. IN AN ELECTION YEAR, FEW CONGRESSPEOPLE WANT TO EXPLAIN TO THE VOTERS WHY THEY ALLOWED CUTS IN FUNDING FOR MEDICALLY NEEDY SENIORS. FOR NHPR NEWS I?M
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