Nursing home funding

Dec. 14--There is a 2 percent difference between the increase in funding proposed by Gov. Doug Burgum for long-term care and what the industry is seeking, according to Tim Burchill, CEO of Ave Maria Village in Jamestown.

Burgum included a 1 percent increase in the inflationary portion of the reimbursement calculation for each of the years of the upcoming biennium. The industry, through the North Dakota Long Term Care Association, is lobbying for 3 percent each year.

"We're disappointed to say the least," Burchill said. "There are other good things in the budget but he seemed to have left us behind."

Shelly Person, president of the North Dakota Long Term Care Association, said the 1 percent increase proposed by the governor would reduce the level of care at nursing homes around the state.

"Ultimately, lack of funding results in unmet needs for our residents, including the availability of qualified staff members," she said. "It takes very special people to provide the care we all want for our moms and dads, grandmas and grandpas. We're already dealing with workforce shortages, and a 1 percent inflationary adjustment won't help us keep and attract nurses and CNAs (certified nursing assistants)."

The 2017-2019 North Dakota Department of Human Services budget included $550 million for the two-year budget cycle for skilled nursing home reimbursements, according to Maggie Anderson, director of Medicaid services for DHS. An additional $41 million is budgeted for basic care facilities.

Anderson said reimbursements are calculated on expense reports turned in by long-term care facilities each year. Rates are then set for each facility but must fall under a limit set by law.

"There are natural increases in reimbursement with changes to costs and caseload," she said. "There was no inflationary increase but an operational margin increase from the last legislative session."

The operational margin increased from 3 percent to 3.74 percent with the last session of the Legislature. The margin increased the formula that is used to calculate reimbursements.

Jordan Shipley, administrator and owner of Rock of Ages, a basic care facility in Jamestown, said increases based on costs and margin are not enough to keep most long-term care facilities operating.

"This (the 3 percent inflationary increase) would give us the ability to pay our staff and pay the bills," he said. "For facilities in the smaller communities it's getting tougher to pay the bills. This will help them stay open."

Burchill said that while most nursing homes are operating in the red this year, he is optimistic the budget can be increased to allow the facilities return to profitability.

"We're making the case for 3 percent to our legislators," he said. "It's being received with an open mind. Everyone has a nursing home in their district and everyone has a relative in a nursing home."

The DHS budget, including reimbursements for nursing homes, will be debated during the upcoming Legislative session, which begins Jan. 3.

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