Commentary: Nursing home closures a threat to state’s seniors

Many are closing because the Medicaid reimbursements are less than the costs of residents’ care.

By Robin Dale

For The Herald

In recent years, people from across Washington state, including many right here in Snohomish County, have struggled to find available and safe assisted-living or nursing home care facilities for themselves or their loved ones.

And as our state’s population continues to age, the shortage of long-term care options is only going to worsen unless something changes. We’ve reached crisis levels.

In the last two years alone, about a dozen facilities in the state have closed, totaling a loss of nearly 700 nursing home beds.

The reason behind the repeated closures of these facilities is simple: inadequate Medicaid reimbursement rates. The result of the state’s low rates leaves our seniors at risk of going without the care they need or forcing them to relocate to facilities elsewhere in the state, often miles away from their family and friends.

Our state has one of the worst reported shortfalls in the nation between the cost of providing care and the rates at which Medicaid reimburses facilities for that care. In 2017, the most recent year for which the state Department of Social and Health Services’ cost-report data is available, unreimbursed nursing home care costs averaged $43.28 per day, per Medicaid resident. That low rate means that it actually costs the facilities more money to care for each patient on Medicaid than they receive in payment.

But our Legislature can fix this. Our neighboring states have worked to address this issue over the last few years. Oregon’s average daily Medicaid rate exceeds Washington’s by $120 per resident, per day, while Idaho’s average daily Medicaid rate exceeds Washington’s by $45 per resident, per day.

Washington state lawmakers cannot continue to fail our seniors, especially as our state’s population ages. There are about 10,000 people in Washington nursing homes who rely on Medicaid funding on any given day. In 2017, the cost of caring for nursing home residents on Medicaid exceeded the Medicaid rate by more than $145 million.

Recently, I’ve spoken with a provider who is worried that two of his company’s four nursing homes are at risk of closure if our legislature doesn’t raise Medicaid rates this year. Unless something changes, we can and should expect even more facilities to close.

The string of facility closures has created an air of uncertainty making it increasingly difficult to find people adequately suited and trained to care for patients. It has begun to hurt the quality of care in Washington’s nursing homes as facilities have been forced to turn to expensive agencies to bridge staffing shortages rather than hiring dedicated full-time staff.

Washington’s seniors and their families deserve better than this. Our Legislature must act now to raise Medicaid reimbursement rates. This problem will not fix itself; it will only get worse, leaving some of our state’s most vulnerable people at risk. Contact your state lawmakers and let them know that you support investing in our seniors.

Robin Dale is president and CEO of Washington Health Care Association.

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