Supreme Court Ruling, Congressional Actions Potentially Threaten Illinois Nursing Homes

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Jun 26, 2012, 11:12 ET

Congressional measures to limit Medicaid payments to Illinois providers could have lasting negative effects, says national leader

WASHINGTON, June 26, 2012 /PRNewswire-USNewswire/ -- The head of the nation's largest organization representing nursing homes, skilled and post-acute care centers today called on Illinois lawmakers as well as the state's congressional delegation to re-evaluate how the state reimburses providers through the Medicaid program. Recent national data list long term care facilities such as nursing homes as the 10th largest industry in the state, yet those same facilities rank near the bottom when it comes to Medicaid reimbursements – the primary payer for nursing home care.

"The pending landmark ruling by the Supreme Court on national health reform, along with a sluggish economic recovery stand to deepen the troubles Illinois nursing homes face," said Gov. Mark Parkinson, President and CEO of AHCA/NCAL. "In these uncertain times, nursing homes need a reliable funding stream; one that ensures continued quality care can be delivered to Illinois seniors. Efforts to trim or limit that Medicaid funding will have lasting, unintentional effects."

According to a 2011 analysis of Medicaid financing nationwide by Eljay, LLC, states cumulatively under fund the true costs of providing quality long term care by nearly $4.7 billion. At the time, projections for Illinois showed approximately a $24.34 shortfall for each Medicaid patient per day. When totaled, that amount swelled to $416 million in Medicaid shortfall funding for the year.

"Adequate Medicaid funding in Illinois certainly means quality care delivered to seniors in the state's centers," said Parkinson. "But it also means more than that. For every dollar the state invests in providers through Medicaid, that means $2.25 in additional wages for caregivers and an additional $4.61 in economic activity in the state. Skilled nursing care impacts more than just the facilities and those we care for."

A copy of the Illinois shortfall report is below. For more information, visit www.ahca.org.

Illinois

2009 Weighted Average Medicaid Shortfall

Rate	$117.29
Cost	$138.85
Difference	$(21.56)
Annual Medicaid Days	17,206,357
Gross Revenue	$2,018,133,608
Gross Cost	$2,389,102,664
Disparity Between Total Medicaid Revenue and Total Allowable Medicaid Costs	$(370,969,056)
Average Shortfall in Medicaid Reimbursement per Medicaid Patient per Day	$(21.56)

2011 Weighted Average Medicaid Shortfall

Rate	$120.30
Cost	$144.64
Difference	$(24.34)
Annual Medicaid Days	17,131,505
Gross Revenue	$2,060,920,045
Gross Cost	$2,477,900,876
Disparity Between Total Medicaid Revenue and Total Allowable Medicaid Costs	$(416,980,830)
Average Shortfall in Medicaid Reimbursement per Medicaid Patient per Day	$(24.34)