By Peter Jasinski, pjasinski@sentinelandenterprise.com
LEOMINSTER -- Bill Reidt recalls that when he got his start in long-term nursing care more than 30 years ago, there were hundreds more facilities throughout the state than there are now.
"There were over 600 nursing homes in Massachusetts, and a lot of them were the smaller ones that everyone loved. But they couldn't function and they closed," said Reidt, executive director of Life Care Center of Leominster. "Right now there are buildings that have been run by the same people for 25 years, but in the past two years they're saying 'We're losing money.'"
This predicament is taking place in nursing facilities throughout Massachusetts, and many industry leaders blame the state's current system of paying reimbursements for residents and patients covered by MassHealth. The current reimbursement rate is based on figures from 2007, which critics say is antiquated and has caused the payment back to nursing homes to fall $37 short of daily care costs per person. As a result, nursing facilities are forced to make up the difference.
The American Health Care Association reports that the gap in Massachusetts is the fourth highest Medicaid shortfall in the country. The national-average shortfall is $22.46 per patient, per day.
A bill submitted by Sen. Harriette Chandler and Rep. Thomas Golden would not only increase these rates to make them more consistent with current nursing home operating costs but would also fund leadership training and scholarship programs for nursing home staffs.
During a Sept. 11 hearing of the Joint Committee on Elder Affairs, Chandler warned legislators of the financial consequences of not passing the bill. She said two-thirds of the state's nursing home residents, roughly 30,000 people, have their care paid for through MassHealth. Because facilities are having to make up the difference left over by the low reimbursement rates, Chandler also estimated that facilities are each suffering an average annual loss of $900,000.
"One of the factors that we have to consider is those more than 400 nursing homes that we currently have, some of them are living month to month," she told the committee. "[Communities] can't afford to lose any nursing homes because the next nearest nursing home may be miles away."
Though virtually all facilities are at risk, Kevin Connor, a spokesman for Chandler's office, said nursing homes in urban areas are in more danger because they tend to have a larger number of residents whose care is paid for through MassHealth.
"We fear that if this legislation is not approved, nursing facilities will be forced into bankruptcy or closure, which would disrupt resident care and displace workers. Already the state's under-funding is taking its toll on staff recruitment and retention that is threatening quality care," he said.
Connor added that the bill has so far received strong support in the Legislature, already gaining broad bipartisan support among 120 members of the House and Senate.
Reidt, who was also present for Monday's Joint Committee on Elder Affairs hearing, said he is encouraged by the number of legislators signing onto the bill and Gov. Charlie Baker's awareness of the issue.
"I think being an insurance executive prior to being elected, he knows what we go through, and I think he's been proactive," he said. "He's doing as much as possible, but it's been tough."
In 2016 the Legislature approved $35.5 million in Medicaid funds to be used for nursing homes staff pay raises. At the time, Massachusetts Senior Care Association Chairman Bill Bogdanovich said the raises would benefit some 45,000 workers, and referred to it as an important step to "creating a path for them to earn a living wage and the ability to support their families."
If approved, Chandler and Golden's bill would help keep nursing homes from closing, but it would not have an effect on other related businesses such as assisted living facilities, rest homes, and adult day programs, which can all receive payments through MassHealth reimbursements.
Like his nursing facility counterparts, Ronald Rana, who owns Village Rest Home in Leominster, said that reimbursement rates for rest homes are also out of date. He said the amount paid back falls well below the average $2,500 in monthly costs he incurs per resident.
"We aren't able to maintain things the way we should be as far as upkeep because we have such a minimal budget," he said. "We've been left out in the cold. There's no question in my mind that the nursing homes are in the same situation."