As NGA Convenes, National Long Term Care Leader Underscores Crucial Nature of Medicaid 'Provider Assessment' in Preserving Seniors' Access to Quality Nursing Home Care

Feb 22, 2013, 14:37 ET from Alliance for Quality Nursing Home Care

AQNHC: As Governors Grapple With Medicaid Expansion, Federal Government Must Preserve States' Ability to Fund Existing Medicaid Commitments and Range of Federal Mandates

WASHINGTON, Feb. 22, 2013 /PRNewswire-USNewswire/ -- As the National Governors Association (NGA) convenes in Washington, D.C. today for its 2013 Winter Meeting, the Alliance for Quality Nursing Home Care (AQNHC) underscored the crucial role so-called "provider assessments" play in ensuring states' ability to fully fund Medicaid.  State Medicaid programs pay for the costs of two out of every three nursing home patients nationally.    

"As Governors grapple with whether to expand Medicaid on the one hand, the federal government, on the other, should preserve states' ability to fund their existing Medicaid commitments as they already struggle to pay for necessary health care services of the poorest and most vulnerable senior citizens," said Alan G. Rosenbloom, President of the Alliance for Quality Nursing Home Care, a coalition of 10 leading post-acute and long term care organizations providing skilled nursing facility (SNF) care in approximately 1,400 facilities, in 44 states nationwide. "Governors are already inundated by a wide range of federal mandates, and preserving provider assessments is essential to state budget stability as our economy moves slowly out of the deep recession."

According to Rosenbloom, data show that state Medicaid programs already underfund long term care services by an unprecedented $22 per patient, per day (Source: Eljay).  "That's a funding shortfall of $6.3 billion in 2012," he added.  "Limiting states' ability to employ 'provider assessments' in their Medicaid programs will undermine already seriously overburdened Medicaid programs."

The Alliance leader praised Maryland Governor Martin O'Malley's recent letter to President Obama and the Leadership of both the U.S. Senate and House, which stated, "SNFs depend on stable and appropriate Medicaid financing not only to retain high staffing ratios of direct caregivers (such as nurses and nursing aides) to residents, but also to ensure that providers may remain open and stable in the face of cuts made by other payers. As a result, the provider assessments, which are a necessary component of state Medicaid financing to SNFs, are essential."

Federal law currently allows Governors to use provider-specific assessments to help pay for their share of Medicaid funding, and the amount of such revenues that can be rebated to providers is capped at 6%. States have relied on provider assessments to fund their SNF Medicaid programs compared to other Medicaid providers -- and substantially more SNF provider assessment programs operate at or near the 6% ceiling than those for other providers.

Recent Administration and Congressional proposals seek to reduce the maximum 6% assessment threshold.  

"With 80 percent of SNF patients dependent upon Medicaid or Medicare funding for their care, and 70 percent of all SNF expenses related directly to labor costs, facilities nationwide are especially sensitized to the cumulative negative impact of Medicaid cuts at the state level," Rosenbloom continued. "In recent years, Congress and the Administration have cut more than $55 billion from SNF Medicare funding over then next 10 years.  With the soon to be implemented sequestration cuts, Medicare SNF reductions will exceed $65 billion over that same period."  

Concluded Rosenbloom: "Medicaid cuts on top of these deep Medicare cuts would be unsustainable.  It is imperative that federal lawmakers better understand the logic, rationale and significance of preserving the provider assessment as a key tool in sustaining access to quality nursing home care amid ongoing SNF Medicare cuts."


Ellen Almond    703/548-0019

Rebecca Reid  410/212-3843

SOURCE Alliance for Quality Nursing Home Care