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By LeAnn R. Ralph
MENOMONIE — Imagine what your budget would look like if you had to spend $63 more per day per member of your family for necessities than what you earn in salary.
For a couple, that would amount to spending nearly $46,000 more per year for necessities than you earn in income, and for a single person, it would be $23,000 more.
For a family of three, that would amount to $69,000 more than you earn in a year, and for a family of four, it would amount to $92,000 more than you earn in a year.
Wisconsin has the lowest Medicaid reimbursement rate for nursing homes in the nation, resulting in an average loss of $63 per day per resident, prompting the Dunn County Board of Supervisors to approve a resolution at the January 16 meeting urging the Wisconsin Legislature and Governor Tony Evers to provide sufficient Medicaid funding to address the Medicaid deficit faced by nursing homes.
Medicaid is a joint federal and state program that helps pay medical costs for United States citizens or legal permanent residents who have a limited income. Medicaid recipients can include low-income adults, their children, and people with certain disabilities.
Carmen Flunker, the administrator at the Neighbors of Dunn County, spoke to the county board about the losses incurred with Medicaid reimbursement.
“This has a huge impact on our financials,” Flunker said.
According to background information included with the resolution, about 65 percent of Wisconsin nursing home residents are Medicaid recipients.
At the Neighbors, about half of the residents are on Medicaid, Flunker said.
The average cost of caring for a resident at the Neighbors is $300 per day, and the facility loses out on about 25 percent of the cost of caring for each resident, she said.
Vaughn Hedlund, county board supervisor from Boyceville, asked if any of the states in the country reimbursed Medicaid costs at 100 percent.
None of the 50 states are at 100 percent, although one state is a few cents shy of paying 100 percent, Flunker said.
Larry Bjork, county board supervisor from Menomonie, said he had been traveling recently in a nearby state.
“They were up in arms over losing $30 per day,” he said.
Nursing homes in Wisconsin suffered a loss of nearly $352 million in Medicaid reimbursement in 2016-2017, Flunker said.
According to information included with the resolution, about 99 percent of the nursing homes in the state’s database received Medicaid payments in 2016-2017 that failed to cover the cost of the care for their Medicaid residents.
A study in May of 2017 ranked Wisconsin’s Medicaid nursing home payments as the worst in the nation when comparing payment rates to allowed Medicaid costs.
The information included with the resolution also notes that nursing homes and assisted living facilities in Wisconsin are in a workforce shortage crisis, with one out of seven caregiver positions being currently vacant.
A direct correlation exists between staffing and quality of care.
“Medicaid underfunding and the strict limitations on increasing local tax revenues severely limit the ability of county-owned nursing facilities to compete in a tight labor market to recruit and retain qualified and caring staff,” the information states.
State-imposed revenue limits that only allow a small increase in the property tax levy per year were put into place in 1993.
The revenue limits were supposed to be temporary but are still in place 25 years later.