Care, pay at nursing homes set to improve

Missouri nursing homes are set to receive larger Medicaid reimbursements under legislation Gov. Bob Holden signed into law Friday. Nursing home officials say that could translate into better amenities for patients and improved pay for employees.

Administrators at Cape Girardeau nursing homes welcomed the new law.

"The nursing home industry was really struggling for the last four years," said Shafiq Malik, administrator of Fountainbleau Lodge.

Nursing homes have claimed the state's current payments fall far short of their actual cost of providing care.

The legislation ratchets up the state's reimbursement rate for the roughly 545 nursing homes caring for patients covered by Medicaid.

"This bill is extremely important to patient care in nursing homes," said Earl Carlson, executive director of the Missouri Health Care Association, which represents nursing homes.

About 70 percent of all patients in Missouri nursing homes are covered by Medicaid, Carlson said.

This year, Missouri nursing homes received about $446 million in state and federal funds, according to the state Division of Medical Services. The reimbursement will increase by about $16 million in the new fiscal year that begins July 1.

Carlson said that includes an average state payment of a little more than $97 per Medicaid patient per day -- nearly $22 short of covering nursing homes' full costs.

Malik said the new law will boost the reimbursement by over $4 per patient.

Fountainbleu Lodge is a 90-bed facility, but only 30 are skilled nursing beds. Of those, about 45 percent to 50 percent are used by Medicaid patients, Malik said.

Under the bill, the state's reimbursement rate would be recalculated during each of the next three years, eventually bringing the rate close to actual costs.

"There is no question it will help," said Pat McCann, controller at The Lutheran Home in Cape Girardeau.

The nursing home has 274 skilled nursing beds. Medicaid patients fill about 40 percent of those beds, he said.

McCann said the higher reimbursement rate can allow nursing homes to offer more competitive pay, which will benefit patient care.

"Frankly, nursing homes have to be in a position to offer competitive salaries and benefit packages to keep quality people working in the nursing homes," he said.

By 2007, the state spending increase could reach $65 million. Because state appropriations attract federal Medicaid funds, total state-federal reimbursements to Missouri nursing homes could rise by $167 million by 2007.

Staff writer Mark Bliss contributed to this report.