By LeAnn R. Ralph
COLFAX — Rep. Rob Summerfield says he hopes the state Legislature can find a way to increase Medicaid reimbursement rates for nursing homes.
Rep. Summerfield (R-Bloomer), the representative for the state’s 67th Assembly District, met with residents and staff at the Colfax Health and Rehabilitation Center February 27.
[emember_protected] Nursing homes in Wisconsin are reimbursed for 65 percent of the cost of caring for a resident, and Wisconsin has the lowest reimbursement rate for nursing homes in the United States.
Residents and staff met with state Senator Terry Moulton several weeks ago to discuss nursing home reimbursement rates and problems with hiring and maintaining staff because of a lack of money to pay them adequately.
Waiting lists and other difficulties with the logistics of training also have contributed to a staff shortage and have created a situation where people who want to become a Certified Nursing Assistant (CNA) or a registered nurse cannot get the schooling they need in a timely manner.
Gengler said Colfax Health and Rehab loses between $50 and $65 per day per resident for Medicaid reimbursement.
If, for example, a facility has 20 Medicaid residents, that would amount to an annual shortfall in revenue of between $365,000 and $475,000.
The shortfalls in revenue mean that facilities have difficulty paying a living wage to CNAs, Gengler said.
“We see it all the time,” said one CNA. “Young people can go to Kwik Trip and make more money. It’s hard work here.”
“We’re making less money than ditch diggers, and we are taking care of people,” she said.
“I can name eight places that people have left here to go (for a job),” Gengler said.
Difficulty in hiring and retaining staff means CHRC is often short-staffed.
“At the end of the day, as a nurse or a CNA, you can’t even feel good about the job you did, because you just didn’t have enough time with all of them,” said another CNA.
Personal care workers who work in the assisted living portion of CHRC can be trained in-house, Gengler noted.
“When we identify someone who wants to move on (to CNA), to be able to have funds or a scholarship available would be huge,” Gengler said.
“Sometimes it’s someone older who never thought they would like healthcare, and now they want to continue on in their training, but they need $600 for the course, and they lose wages, too. If there was some kind of fund to help us sponsor them, that would make a big difference,” she said.
Making CNA training more available and eliminating waiting lists for nursing programs also would be helpful, Gengler said.
For right now, the state Legislature is waiting to see what the federal government does with Medicaid funding, Rep. Summerfield said.
The federal government may distribute Medicaid funding to states in a block grant, he said.
The argument for distributing Medicaid money as a block grant is that states would have greater flexibility in how they use the money.
The concern about Medicaid as a block grant is that states might receive fewer dollars overall, and different entities, such as nursing homes, hospitals and people who qualify for medical assistance, would be competing against each other for the money.
“Hopefully we can find something to address this, because if we don’t, you’re going to close. Cornell is going to close. Hetzel is going to close in Bloomer,” Rep. Summerfield said.
“Sixty-five percent reimbursement is not adequate. Maybe we can get it up to 75 percent or 80. One hundred percent would be nice, but I don’t think that’s ever going to happen,” he said.
Regarding the state budget and money that might be available, another problem is that transportation and education also need increases in funding, Rep. Summerfield noted.
“I feel now like we have an audience,” Gengler said.
“We have been talking for a long time, that is is going to happen, it’s going to break. People are starting to see the breaks with the facilities running half full and not taking admissions and some even closing,” she said.
Rural legislators are banding together in the Rural Initiative to try to educate legislators from more urban areas, Rep. Summerfield said.
Legislators from urban areas do not understand that if a nursing home closes and people have to move to another nursing home five miles away that they are often moving out of the community where they have lived for a long time, he said.
“They think, if a nursing home closes, oh well, there’s another one five miles away,” Rep. Summerfield said.
“Sixty-five percent is not adequate. It is basically a hidden medical tax,” he said.
“Everybody here who is private pay has to pay more to make up for the loss we have on Medicaid residents,” Gengler said.
Rep. Summerfield said he is concerned nursing homes would get into situations where corporations would offer to buy the facilities for 40 cents on the dollar, “come in, change everything, as we lose all of our hometown atmosphere.”
Gengler noted that as a non-profit, CHRC expects to operate without a profit.
“A big corporation coming in here is not going to be okay with that,” she said.
Several CHRC staff said they had worked for both for-profit and non-profit nursing homes and that there was definitely a different emphasis between quality of care and the bottom line on profit.
If a for-profit corporation owned CHRC, “you’re going to end up with a very different product than the one we are offering here. And that’s not fair to the community,” Gengler said.
Colfax Health and Rehabilitation Center employs about one hundred people.
Most of the employees live within a half hour of Colfax, Gengler said.
Rep. Summerfield said he would be willing to return to CHRC to talk about the state budget and what is available from the federal government after the Legislature receives more information. [/emember_protected]