EVERETT — Pete Wolkin celebrated a funding increase for nursing homes included in the most recent state budget, but would love to see a longer commitment from lawmakers.
“Certainly the new budget will help us out,” Wolkin said. “It will help us provide the care that we need to for Medicaid residents. It will help us pay our staff more and cover our expenses.”
Wolkin is the director of operations at Nightingale Healthcare, which oversees two facilities in Snohomish County and five more in Washington and Oregon.
The two-year state budget increases the Medicaid rate for skilled nursing facilities by 14% over the next two fiscal years, and adds funding for some specialty care. The Washington Health Care Association calculated the total additional Medicaid funding to be $406 million.
The Legislature did not pass Senate Bill 5526 that would have codified into state law a formula for adjusting Medicaid funding for these facilities. That means funding is only guaranteed for nursing home owners and operators for the next two years.
“It’s a little scary,” Wolkin said. “We’re thankful for the increase in the budget, but it would be much easier to plan for the future if we had a long-term commitment to that higher funding, to a sustained increase over time.”
Lawmakers will revisit the patient Medicaid rate for nursing homes in 2025.
As The Daily Herald reported in February, an estimated 6,800 skilled nursing beds sat empty in the state as of June 2022. That’s a 35% bed vacancy rate. Numerous indicators point to a workforce shortage being a major contributor to that vacancy rate. For example, nursing homes have significantly increased spending on temporary labor in recent years.
Wolkin said staffing has improved in the past few months, with one Snohomish facility no longer hiring any temporary labor and fewer staff vacancies overall. Nightingale had previously increased starting wages, then made adjustments up the pay scale to recognize existing employees’ “loyalty.” He said the long-term budget uncertainty is particularly challenging with wage increases, since they can’t take those back.
Adam Glickman, secretary-treasurer of SEIU 775, said with more funding, workers who have a collective bargaining agreement will negotiate for higher wages and improved benefits.
But Glickman, like Wolkin, would like to see more predictability.
“The Legislature did the right thing ultimately in providing the funding,” he said. “We’re going to continue to push for the longer-term fix and certainty that putting it into statute would provide.”
Alyssa Odegaard, vice president of public policy at LeadingAge Washington, agreed with the mix of celebration and disappointment about Medicaid rates.
“We’ve continuously seen about a $100 million annual underfunding gap,” she said. “And while we might make progress closing it now, without those permanent changes in the rate structure, that gap will then just grow in future biennium.”
LeadingAge represents more than 40 skilled nursing facilities among its membership of about 165 senior care and housing facilities.
In addition to adjustments for the base Medicaid funding rate for nursing facilities, lawmakers approved funding for specific types of care. With this funding, more nursing facilities will be willing to take patients from acute care, which in turn helps hospitals to discharge patients when they are ready, Odegaard said. LeadingAge shared that the rates for specialty behavior services increased on average by 2%, ventilator care by 10% and tracheotomy management by 3%.
Wolkin felt hopeful about these special rates for nursing homes, as well as extra funding for memory care in assisted living facilities.
“I think in the long-range picture the state is going to need to figure out how to meet specific demands — not all seniors and not all people that need long-term care are the same,” Wolkin said. “The more we can cater the services to the people that need them, the better the delivery and the more cost-effective across the board.”
Joy Borkholder: 425-339-3430; firstname.lastname@example.org; Twitter: @jlbinvestigates.
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