NURSING HOMES: Lobby for Medicare Increases
Nursing home industry leaders pleaded with the Senate Special Committee on Aging yesterday to increase Medicare payments for nursing homes, the AP/Washington Post reports. Charles Roadman, American Health Care Association president, said to the committee: "Our long term care community is facing a squeeze with the real potential for absolute collapse." Five of the nation's 10 largest nursing home chains -- Vencor, Genesis Health Ventures, Sun Health Care, Integrated Health Services and Mariner -- have gone bankrupt in the last two years. These companies represent about 10% of the 17,000 nursing homes in the Unites States.
The Blame Game
Sen. Charles Grassley (R-Iowa), head of the Special Committee on Aging, disputed the claims and implied that the industry's financial woes are due to their own poor business decisions, even when Medicare reimbursement was "essentially unlimited" (Carter, 9/6). Grassley said, "some [nursing home] corporate executives, their investors and bankers gambled on a vision of ever-growing government largesse. They got hurt because this vision wasn't based on reality. Others took a more cautious approach, and now they're well-positioned to operate in the new era of tightened Medicare budgets. As Congress listens to pleas from nursing home executives for more Medicare funds, we must keep this complete picture in mind." Grassley said he is "not convinced" that the nursing home companies need more money, and the real question is whether patients have adequate nursing home care (Senate Special Committee on Aging release, 9/5). According to George Grob, HHS deputy inspector general, "there is little sign that patients are having substantial trouble getting into nursing homes." Grob said that hospitals have reported difficulty with enrolling only about 5% of patients seeking nursing home admission (MacDonald, Hartford Courant, 9/6). Grassley also noted that there is "little evidence that patient care has been jeopardized" by Medicare reforms established in 1998 that mandated fixed payments for medical services. Laura Dummit, a General Accounting Office official, said the GAO found that the new Medicare payment plan offers "sufficient -- and in some cases, even generous -- compensation for services furnished to Medicare beneficiaries." Moreover, President Clinton has proposed increasing Medicare payments for nursing homes by about $1 billion over the next five years. Despite the increases, nursing home advocates are complaining of staffing shortages and instances where severely ill patients requiring costly treatment are being turned away (AP/Washington Post, 9/6).