Medicaid Formula ‘Transformed' Nursing Homes

by Gwen Moritz  on Monday, Apr. 8, 2013 12:00 am  

Jim Cooper

They are older and sicker when they enter a nursing home because the state has dramatically expanded home-care and assisted living options, he said.

And many — as many as 30 percent — are short-term rehabilitation patients, mainly paid for by Medicare. In years past, Cooper said, those rehab patients would have been kept in hospitals “at about five times the rate that we can do it for. Or some of them would have gone directly home and not got hardly any therapy, or maybe a couple of home-health visits.”

Last year, about 17,000 Arkansans received rehab therapy in nursing homes, generally for five days to five weeks. “They came in, got therapy and left,” he said.

Baby boomers, the oldest of which are turning 67 this year, have not yet arrived in nursing homes in large numbers. “You’ll see that happen in about five years,” Cooper said.

Medicaid Daily Reimbursement Rates

Highest  
1 Jonesboro Healthcare Center $193.05
2 Pines Nursing & Rehab Center, Pine Bluff $190.62
3 Green House Cottages of Southern Hills, Rison $188.03
4 Summit Health & Rehab Center, Taylor $187.96
5 Maumelle Health & Rehab $187.47
6 Byrd Haven Nursing Home, Searcy $187.01
7 Ridgewood Health & Rehab, Benton $186.41
8 Fountain Lake Health & Rehab, Hot Springs $185.97
9 White Hall Nursing & Rehabilitation $185.03
10 Rolling Hills Nursing Center, Batesville $184.79

_______

Lowest  
1 White River Healthcare, Calico Rock $120.97
2 Southern Trace Rehabilitation & Care Center, Bryant $125.53
3 Longmeadow Nursing Center-Malvern $125.57
4 Yell County Nursing Home, Ola $131.3
5 Murfreesboro Rehab & Nursing $134.74
6 Ozark Nursing Home $139.8
7 Chambers Nursing Home Center Inc., Carlisle $140.07
8 River Ridge Rehabilitation & Care Center, Wynne $140.88
9 Mitchell’s Nursing Home Inc., Danville $141.02
10 Dermott City Nursing Home $141.57
     
State Average (225 facilities) $164.94

Source: Arkansas Department of Human Services. Ranked by daily reimbursement for January-June 2013, a weighted rate that compensates or penalizes nursing homes whose 2012 rates were either above or below their actual costs.

Legislative Agenda

AHCA, which represents more than 90 percent of the state’s nursing homes, has two items on its legislative agenda this session, but “they aren’t through yet,” Cooper said last week.

One would subject negligence and wrongful death lawsuits filed against nursing homes to the same procedural hurdles as medical malpractice cases. Litigation against nursing homes, big news a decade ago, “has become a way of life for us,” Cooper said. “It’s harder to get the big verdict anymore, but it’s still a big scare.”

The other bill, which Cooper called the “Don’t Kick Grandma Out of the Nursing Home Act,” would require legislative approval if DHS wants to balance its budget by cutting nursing home reimbursements.

 

 

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