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Friday, June 13, 2014

Maine's rural nursing homes face an uncertain future

Maine, the state with the largest percentage of rural population, is also one of the country's neediest when it comes to funds for nursing homes. Of the state's 7,000 nursing-home residents, 56 percent have been diagnosed with dementia, and the state ranks fourth in the U.S. "in the number of nursing home residents who need help with tasks of daily living, such as bathing, grooming and eating," Jackie Farwell reports for the Bangor Daily News.

"Maine nursing homes also must meet some of the most stringent staffing ratios of any state, Farwell writes. "Despite the challenges, Maine’s facilities boast one of the lowest rates in the nation of deficiencies, such as mistreating patients or high infection rates, which is a reflection of nursing home quality. Without adequate funding, however, Maine seniors and their families will suffer, experts say."

MaineCare, the state’s Medicaid program, foots the bill for nearly 70 percent of the state's nursing home residents—above the national average of 63 percent, Farwell writes. "At some homes, particularly in poor rural areas, the program covers nearly every resident, stretching bottom lines even further." (Daily News graphic)

Medicare, which only pays a fraction of nursing home costs, has underfunded the state's nursing homes "for the last several years, reimbursing them based on their costs from 2005," Farwell reports. "The payment structure hasn’t changed since 2008, except for a 1.5 percent raise in 2012." A 52-bed nursing home in Calais closed two years, leaving 100 people without jobs, and two more nursing homes are on the brink of closure, according to independent Gov. Paul LePage.

Rick Erb, president and CEO of the Maine Health Care Association, said "The MaineCare funding crunch is affecting some families in ways they may not realize." As a result, Farwell writes, nursing homes underfunded by the state often shift the cost burden to patients with private insurance, which averages about $80 more per day than MaineCare.

Officials hope help is on the way. "The new legislation promises to give Maine nursing homes $4 million in additional state Medicaid funds in the fiscal year beginning July 1," Farwell notes. "Another $5 million is due to follow in the subsequent two years. The federal government would kick in its matching share to the tune of more than $24 million over the next three years." (Read more)

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