Nursing homes will suffer unless Congress restores Medicare

ST. LOUIS -- Marcella Gersman worries who will help her dress each day.

Hazel Emery, 84, wonders if she will get her medicine on time.

Phyllis Young is concerned that her mother, who suffers from the mind-disorienting disease of Alzheimer's, will be unable to find a nursing home bed.

Missouri nursing homes will lose $37 million in Medicare funds, along with as many as 1,184 nurse's aides, unless Congress restores money set to expire at the end of September.

A new report shows how the cut will affect some of the state's most vulnerable citizens.

"I do need help with my socks," said the 74-year-old Gersman, who has lived at the Beauvais Manor nursing home in St. Louis for two years.

"And shoes. I can't put them on by myself. I need help washing my clothes and taking a bath.

"I don't like the idea of making cuts like they are talking about."

An analysis released Thursday by the Service Employees International Union, the largest union of nursing home workers in the state and the nation, showed that the nation's nursing homes already are underfunded and cannot staff at optimal levels. It will only get worse if the Medicare budget is cut 10 percent or $1.7 billion, as it is scheduled to, at the end of September.

The Balanced Budget Act of 1997 severely cut Medicare funding -- forcing some nursing homes into bankruptcy. Congress responded in 1999 and 2000 to restore the funds that are now set to expire. President George W. Bush's budget did not include funding to maintain the current levels.

Of Missouri's 500 nursing homes, 79 percent fall short of optimal staffing levels, the report said.

On average, a Missouri nursing home resident receives just over three hours of nursing care -- mostly from nurse's aides -- in a 24-hour day. That is 28 percent less than experts recommend.

'Crisis in medical care'

"These cuts will create a crisis in medical care," said U.S. Rep. Lacey Clay, D-Mo, who helped present the findings at a press conference at the St. Louis nursing home. "These cuts are intolerable. This dire situation must not occur. We must adequately fund Medicare and our nursing homes."

U.S. Sen. Jean Carnahan, D-Mo., said, she too, is concerned about the cuts in Medicare and what the funding shortage will do to patients.

"These cuts will have an effect on the quality of care they receive," Carnahan said. "The budget proposed by the current administration does not maintain current funding levels for nursing home care. This is a major step backwards."

The Missouri Republican Party criticized the report, saying the labor union was not telling the whole story. The party has become a vocal critic of the union's political activity and has filed a Federal Election Commission complaint over the matter.

"It's one thing to outline the problems facing nursing homes, but to suggest it lies at the feet of President Bush isn't telling the whole story," said Scott Baker, spokesman for the Missouri GOP.

Kate Ries is the director of nursing at Beauvais Manor. The staff, she said, already is stretched thin.

"If Congress doesn't take action, medically complex Medicare residents will encounter many problems," Ries said. "They will have to stay in hospitals longer and that will cost the taxpayer more in the long run. As a provider of skilled care, I am concerned."

Using a model developed by the federal government to determine staffing time necessary for certain critical care tasks, the report projects the specific daily impact on residents of this decrease in staff:

10,600 incontinent residents will not be changed, repositioned or toileted as often as they need to be.

All incontinent residents will have to wait 25 minutes longer to be changed.

17,000 residents will not get all the help with exercise they need each day.

-- The 19,700 residents who need help with feeding will get less assistance and wait longer for it.

-- Many of the more than 37,000 residents who need assistance with dressing and grooming in the morning will have to wait longer to get help.

"Men need to be shaved everyday," said Malika Robinson, who has been a certified nurse assistant for five years. "The bodies of our residents are fragile. We won't be able to give our residents the care they need and deserve."