Nursing home looks to county for funding help

The plight of publicly owned nursing homes is so dire, you may want to start clearing out the spare bedroom for Grandma.

It could be a long-term arrangement.

"Nursing homes are in jeopardy," Hubbard County commissioner Dick Devine said at Wednesday's county board meeting. "Most won't survive."

Heritage Community, owned by the county, will be hit with an 11.7 percent reduction in Medicare reimbursements. Devine said Heritage is under-funded by $27 per day on elderly waiver rooms; Director Kurt Hansen said it's losing $25 dollars a day on private pay rooms.

Another 5 percent cut will hit the memory care unit.

State funding has "flatlined," Hansen said. There will be no increases in state aid. "State moneys helped us break even," Hanson said.

That prompted Hansen to approach the board for funds from an annual insurance dividend.

"Inflationary adjustments are difficult," he told the board. "The price of raw foods and utilities have gone up" while nursing home administrators are being asked to get by with less funding.

With state and federal reimbursement uncertainties, Devine said Hubbard County may have to look to the long term solution of whether it can support the village, which offers memory care, skilled care, an assisted living community, an independent senior community and a respite care facility, knowing the facility would be in the red annually.

"Canada is paying relatives to take them," Devine said of nursing home patients.

"They want them to go away," commissioner Lyle Robinson said of the federal government. With Medicaid covering the lion's share of nursing home costs, it's one of the biggest drains on the federal budget.

"They don't even care," Robinson said of the federal government. "They got no solution to the problem."

And the growing elderly population puts states in a quandary because dispensation of the Medicaid program is a massive expense to states as well. Devine worries about the quality of and access to long-term care.

Nursing homes have long complained Medicare reimbursements have never made them whole. Heritage is no different. It has never covered their actual costs, which continue rising.

"I think it's a case where the people have to say, 'Enough,'" Devine told the board. "When these politicians come around" to conduct local forums "we better tell 'em what we think."

The practical reality of children taking their parents in becomes a case of "old people taking care of old people," commissioner Cal Johannsen said.

"The kids are 75 years old," Robinson said.

Hansen also asked the board to renew an application for a program the county has twice applied for that seeks matching funds offset higher salaries and operating costs at the village.

The Equitable Cost Sharing for Publicly Owned Nursing Facilities bill passed by the 2010 Minnesota Legislature began Jan. 1, 2011 and runs 57 months. It would match a county share of funds once with state monies and again with federal funds. This year the program was tinkered with so publicly held nursing homes could opt out.

But for a $30,000 contribution the county could receive triple that in matching state and federal donations. Hansen said the paperwork has been sent back twice now with no action taken.

That irked Robinson, who maintains the state and federal government are unreliable partners.

Hansen hoped the village would be rewarded the third time.

"As long as we understand it's the first step in paying the state and federal government's bills," Robinson said.

The board said it would look into seeing if the annual dividend from the county's property, casualty and worker's comp insurance could be tapped to offset Heritage losses.

Because Heritage pays 20 percent of the county's premium, Hansen reasoned it would be fair to get 20 percent of the dividend, which was around $350,000 this year. The county only budgets for a $100,000 dividend, so this year's check was a bit of a windfall.

Those funds generally go into the county's building fund for repairs and upkeep of county facilities, including Heritage.

Robinson wondered if it was more important "to take care of you than having a few dollars" distributed from the fund.

"It would be of value for our cash flow issues," Hansen said.