Nursing Home Operators, Advocates Disagree Over Effects of Medi-Cal Reimbursement Law
Nursing home operators say a bill (AB 1629) recently signed into law by Gov. Arnold Schwarzenegger (R) that addresses Medi-Cal reimbursement rates for nursing homes will help improve patient care, but critics say it does not include adequate provisions to guarantee that increased reimbursements will lead to improved care, the Sacramento Bee reports (Weaver Teichert, Sacramento Bee, 10/15). The law will allow the state to use $250 million in federal funds to increase Medi-Cal reimbursement rates for nursing homes. Under the law, the state will require health care providers to pay a quality assurance fee to obtain the federal funds. The law also will require the Department of Health Services to reimburse nursing homes based on their labor and capital costs rather than using a flat rate (California Healthline, 9/30).
Gary Passmore, executive director of the Congress of California Seniors, said, "The industry is underfunded right now through Medi-Cal," adding that nursing homes previously have been "forced to skimp on quality care."
Betsy Hite, spokesperson for the California Association of Health Facilities, said that without the law, families' choices were being limited because an increasing number of nursing homes were not accepting Medi-Cal beneficiaries. After it implemented Jan. 1, 2005, Hite said that the law will provide nursing homes with $900 million in additional federal funds during the next four years, while increasing costs for private-pay patients by a few dollars per month, according to the Bee.
Groups that opposed the new law, such as AARP and California Advocates for Nursing Home Reform, say it does not provide adequate safeguards to ensure that the increased funding results in improved care.
Charlene Harrington, a professor at the University of California-San Francisco who has studied the national nursing home industry, said, "There is nothing that happens to [nursing homes] if they don't comply" with state and federal regulations. She added that nursing home operators often use revenue from increased reimbursement rates to fund projects other than patient care, the Bee reports (Sacramento Bee, 10/15).