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EDITORIAL: Nursing home reimbursements getting attention

Daily Oklahoman - 2/11/2019

Feb. 11--Things have improved, but one thing hasn't changed: For-profit nursing homes can't provide first-class service with third-class reimbursement rates.

Three bills at the Legislature take a carrot-and-stick approach to changing the status quo. In exchange for higher reimbursement rates, homes would have to increase staffing ratios.

The bills would require the Oklahoma Health Care Authority to pay at least 95 percent of the average cost of care. This 95 percent "solution" would be an improvement in a system that pays about $23 a day less than the actual cost of providing care, according to an industry spokesman.

A health care authority spokeswoman says the agency hasn't determined what the 95 percent rule would cost. Also to be determined is what it would cost nursing homes to hire additional staff that would be mandated by the legislation.

State law requires 2.41 hours of direct care staffing per resident, per day. The proposed legislation would raise that figure to 2.9 hours. A key question is whether additional personnel could be attracted to an industry that's already struggling to fill positions.

Like many other industries, low unemployment in general means a scramble for labor willing to work at the prevailing wage rate. As other industries raise wages to attract or keep personnel, the industries that don't -- or can't -- experience labor shortages.

Along with higher reimbursement and staffing ratios, these bills would amplify the state's quality care incentive program that ranks nursing homes according to several care metrics. The health care authority already has in its mission statement a vision of a time when all Oklahoma long-term care facilities "will earn incentive awards and Oklahoma will have the top-rated care in nursing facilities across the nation."

This will be a tall order. A 2017 report funded by an arm of the AARP ranked Oklahoma 44th nationally for long-term services and support systems for older adults. This measures more than just nursing home care, but it gives some indication of how far the state must go to achieve meaningful improvement.

We're encouraged that lawmakers remain attentive to shortcomings in the long-term care system for older Oklahomans. Well over half of nursing home residents are covered by Medicaid.

We all know the population is aging as more baby boomers reach what's known as "the third age." Perhaps the age of higher-quality, better-funded care will follow.

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