Chautauqua County legislators should familiarize themselves with a recently released report on county nursing homes as they prepare to hear yet another sale offer for the Chautauqua County Home.
The Future of County Nursing Homes in New York State was released earlier in August by the Center for Governmental Research, the same group that studied options for Chautauqua County, in August 2012.
As it turns out, the Chautauqua County Home's struggles aren't out of the ordinary when the home is compared to other county-owned nursing homes statewide. Employee health care and benefit costs are skyrocketing, reimbursements for services don't come close to paying the cost to care for nursing home residents and there is a lot of uncertainty over how the changing health care landscape will affect public nursing homes.
According to the study, employee compensation at county-owned nursing homes has increased 45 percent faster at county-owned facilities statewide than at for-profit homes statewide. Even more, the cost of employee health care and pensions at county-owned nursing homes statewide has increased 181 percent from 2000 to 2010.
Even more troubling is uncertainty when it comes to state and federal funding. Medicare and Medicaid reimbursements have been either cut or capped in recent years. That is troubling when Medicaid rates in New York fall about $42 per resident short of the cost to provide adequate care. While a change to the statewide pricing methods will provide stability and possibly some ability to increase revenues, more than half of all county homes are projected to receive less Medicaid money over the next six years. There is no way to know yet how the IGT program, which the county uses nearly every year, will change under the Affordable Care Act.
The final troubling issue is the looming spectre of Medicaid managed care, a system that replaces the fee-for-service reimbursement model with a system that pays set premiums to managed care plans. Nursing home providers fear the rates they will in turn be able to negotiate with the plans will fall short of current fee-for-service levels, even as their costs continue to rise. The state is planning to phase nursing home populations into managed care plans in January.
The study - which can be found as a PDF attachment to this editorial at post-journal.com - strengthens the financial arguments for selling the Chautauqua County Home. County taxpayers have spent limited amounts subsidizing the home's operations in recent years, but both CGR's statewide study and its 2012 study of the Chautauqua County Home point toward even more county subsidy in future years.
That is truly troubling.