Legislators are accepting a reimbursement rule change that puts money in the pockets of the politically powerful nursing home industry and anger in the hearts of advocates for the elderly.
Chairs of both the House and Senate healthcare oversight committees said they don’t plan to hold a hearing on the new rule that nursing homes wanted but that advocates for the aged call a grab for dollars. Without a hearing before Thursday, the new rule automatically goes into effect on Dec. 20.
The rule adjusts a part of the complex formula used to determine how much each of the 260 or so nursing home operators are paid. By increasing the square footage allowed for many nursing home rooms from 450 square feet per bedroom to 550 square feet, the operators will receive about $6 million more each year. Nursing homes already receive about $1.2 billion annually from state and federal government sources.
Opponents argue that the money would be better spent providing seniors with services that would allow them to stay at home, as most states do, rather than leaving institutionalization as the primary choice for care.
The politically powerful nursing home industry, which pockets about $1.2 billion annually, is seeking a minor change to one of Louisiana’s com…
Louisiana House Health and Welfare Committee Chair Larry Bagley, R-Stonewall, said Tuesday he received a lot of correspondence opposing the proposed changes but, in the end, felt that nursing homes had been pressed by lawmakers to provide more and larger single rooms for their charges, particularly given the need for social distancing during the pandemic.
“If we don’t use that rule, that money (the $6 million extra) isn’t necessarily going to be spent on community care,” Bagley said. “I don’t have any intention of having a hearing Thursday.”
Neither is state Sen. Fred Mills, the Breaux Bridge Republican who chairs the Senate Health and Welfare Committee.
“From the policy standpoint, I’m okay. I can see the opponents’ standpoint and I understand the money issues. But the policy has been, for years, to increase the square footage,” Mills said. “I thought the explanation from the nursing home standpoint made sense.”
The Louisiana Nursing Home Association, which requested the rule change, argued to the Louisiana Department of Health that the new reimbursement rate would update a 19-year-old formula to better represent the realities of 2020 and would promote more operators to renovate their facilities for more single occupancy rooms.
Louisiana Department of Health report to the Legislature on nursing home rule
Usually proposed regulations are handled within an agency and move through the process without attracting the attention of anyone but those directly involved.
This rule change has attracted the ire of advocates, including Volunteers of America, seeking more state funding for services to allow the elderly to stay at home rather than go to nursing homes.
Disability Rights of Louisiana told the health department that it was “concerned that putting more money in nursing homes is taking the state in the wrong direction.” The Louisiana Budget Project voiced concern “that this rule has to do with the broader fiscal crisis that the state is facing.”
AARP Louisiana Executive Director Denise Bottcher wrote House Speaker Clay Schexnayder Friday asking for his help in scheduling a hearing on the rule.
AARP letter asking House Speaker Clay Schexnayder to call a hearing to oppose a nursing home reimbursement rule
“We believe it is shortsighted to allocate the states’ limited resources to provide for nursing homes, which will only make the cuts that fall on other critical services more severe,” Bottcher said. She added that more than 11,000 individuals are waiting for an opportunity to receive long-term support and services at home, rather than in a facility.
“Five million dollars — the same amount nursing homes would receive under this rule – would help 200 people. It would seem to be more appropriate to spend that money on serving people rather than paying for square footage,” Bottcher wrote Schexnayder.
“This issue deserves a public discussion to determine if this is the best use of taxpayer dollars,” Andrew Muhl, director of advocacy for AARP Louisiana, said Tuesday when informed the Legislature would not hold hearings and would allow the new rule to into effect.