The writer, of Fremont, represents District 15 in the Nebraska Legislature.
Almost everyone has family or knows someone in a nursing home. These facilities are often the lifeblood of a community, especially in the small towns throughout greater Nebraska. They are a significant employer, help drive the local economy and keep families closer together. More importantly, they keep some of the most vulnerable populations in our state safe and healthy: our elderly and disabled citizens.
A large portion of the funding for these facilities comes from Medicaid payments for our elderly. These state-allocated dollars are subject to budgetary constraints, and because of significant budget challenges in 2017 and 2018, the funding of nursing homes was either cut or left alone. The result of these cuts was disastrous to our elderly. In March 2018, after missing payroll, 21 nursing homes and 10 assisted living facilities in 19 counties across Nebraska had to go into receivership. The State of Nebraska was forced to manage these facilities to protect the residents and keep the doors open, an action that could have been prevented if we had instead prioritized this funding.
This year, to begin to address this issue, the Legislature felt it was imperative that we reinstate some of the funding that was lost and did so in Legislative Bill 294. In addition, the Appropriations Committee discovered over $7 million that had been allocated to these nursing homes, sitting in a fund going unused by the Department of Health and Human Services. Despite the fact that the Legislature passed LB 294 with 35 senators voting in support of increasing the Medicaid reimbursement rates to nursing homes across Nebraska, HHS still made cuts to over 25 nursing homes. My district, Dodge County, still recovering from recent flooding, now has the highest amount of facilities that will see a decreased rate, one of which will see a cut as high as 8%. Two of the nursing homes have already begun to close.
Where do we go from here? Many of these facilities are operating with 50% of their patients receiving Medicaid. When a nursing home closes, its residents have to go somewhere. Unfortunately, in my conversations with the facilities that remain open in my district, they have expressed concern to me about their ability to provide care to Medicaid residents and also continue to operate. This leaves residents and their families with uncertainty about their future living situation. Furthermore, HHS now places the burden on the facilities that remain of turning people away or taking them in and potentially closing down. Ultimately this forces our elderly to move to nursing homes that are further away from their hometown and their loved ones.
It has been indicated to me that HHS is now beginning the process of removing its current rate methodology for nursing homes and hospitals in its rules and regulations. Should the department remove the methodology from its regulations, there would be no public comment process and no transparency for rate changes. It is important that we allow providers to give input on these changes not only to respect the transparency of our political process but also so these businesses are able to prepare and adapt to changes in their payment structure.
The decisions we make as a state about where we spend our resources reflects our values. I believe this action by HHS could cause many in our state to suffer, while removing the transparency Nebraska residents deserve. Our state government has a duty to serve all of its citizens to the best of its ability, and those in our nursing homes, as well as their loved ones, cannot be ignored or forgotten. It is this duty to serve my constituents and our state that compels me to bring attention to this growing concern.