Community meeting aims to help raise awareness on nursing home crisis

Wednesday, April 10, 2019
Hillcrest Nursing Home (HNH) administrator Brad Cheek, left, and HNH board president Randy Dean are guest speakers at the Gazette's April "Coffee with a Cop" community open forum at Sehnert's Bakery Tuesday morning. Julie Dunn of Vancouver, Wash., told Cheek and Dean that her grandmother, Elaine Skiles of McCook, receives "very compassionate," responsive care from the staff at Hillcrest. "It's great that my grandmother is known as 'Elaine,' not by her room number'," Julie said.
Connie Jo Discoe/McCook Gazette

Connie Jo discoe

Regional Editor

McCOOK, Neb. — The crisis facing Hillcrest Nursing Home — shortfalls in Medicaid reimbursement from the State of Nebraska — will be the topic of a public community meeting Wednesday, April 24, at 7 p.m., at the Historical Fox Theater in downtown McCook.

The problem started at the state level — it's at the state level that it has to be addressed and corrected.

Local supporters of the nursing home in McCook want as much local support for legislative bills that can help correct the situation that Hillcrest finds itself in — losing $1,500 a month on each of the 40-some residents whose care at the nursing home is paid through Medicaid (a joint federal-state program that provides health coverage and/or nursing home care to low-income, low-asset people).

The end of Nebraska's 2019 legislative session is June 6, BUT letters of support for four legislative bills must reach law-makers long before that date so that the bills can come out of committee meetings and onto the floor for debate.

This information was shared by Hillcrest Nursing Home Administrator Brad Cheek and HNH board of trustees president Randy Dean at the Gazette's April "Coffee with a Cop" public forum meeting Tuesday morning. "We're in deep trouble. This situation is critical," Cheek told those gathered at Sehnert's Bakery. Without changes in a reimbursement formula developed by the Nebraska Department of Health and Human Services, Cheek said, many nursing homes in the state will be forced to close or go into receivership.

These people in our nursing homes deserve our attention, Cheek said. "They're the ones who have built Nebraska. They're our family. It's critical that we take care of them. Where are these people going to go? Without something happening soon, it'll be devastating."

Cheek said at the Coffee with a Cop that Hillcrest and other long-term care facilities cannot survive continuing to lose this amount of money. "Things have to change," he said. Offsets made with payments made by private pay and Medicare pay residents "aren't enough to pay for Medicaid shortfalls."

"We don't want to make tons of money on reimbursement," Cheek emphasized. "We just want to break even."

Cheek said that Nebraska legislators had appropriated $30 million to the Department of Health and Human Services for Medicaid reimbursements, but that the appropriation was used in other parts of the DHHS budget. "What we want," Dean said, "is our own 'bucket' of (Medicaid reimbursement) money that can't be used anywhere else."

The proposed bill that assigns Medicaid funds for nursing homes, creating that "one bucket" of money, is LB404, Dean said. "We have to get the formula changed … we have to get our own bucket of money that can't be shuffled around."

Cheek said that DHHS is the "holder of the dollars. There has been money in the budget. It's just been misappropriated by 'the formula'," which he said appears to be purposely convoluted, baffling and misleading.

Cheek said that he has turned away requests for rooms for Medicaid residents, because they will upset the fragile balance between Medicaid pay and private pay/Medicare pay.

He continued, "We can't offset the reimbursement shortages with more residents because that involves hiring more nursing personnel required to cover the additional residents."

Cheek assured everyone at Sehnert's that the care to all Hillcrest residents is the same. "It doesn't matter to us the pay source. Every resident gets absolutely the best care we can provide," he said.

Cheek said that Hillcrest employees do not know the pay source for any resident. "The care is not short-cut for any resident, regardless of pay source," he said.

Speaking of Medicaid reimbursement, Cheek said, "We are in deep trouble. We have to get this corrected." Dean agreed.

"These are all great residents … Hillcrest is a great community. We just can't lose that place. We're not going to lose that place."

Jacque Riener, a former Red Willow County commissioner, said that DHHS's calculation (formula) has been manipulated improperly for the last four years, leading to a decrease in funding for Medicaid.

The latest calculations are from 2016, she said.

The bills before the Legislature are:

LB181 — Imposes a moratorium on changes to long term care.

LB403 — Stops the state from using negative inflation.

LB404 — Assigns Medicaid funds for nursing homes.

BL468 — Delays the implementation of "managed care" in nursing homes until 2021.

For more information, contact Brad Cheek at (702) 267-7062; or Jacque Riener (308) 340-0063.

Email campaign planned

At the townhall meeting scheduled April 24, supporters will have a sample letter that can be mailed to District 44 Sen. Dan Hughes, P.O. Box 94694, Lincoln, NE 68509.

They are also encouraging contact by email with senators on the legislature's Appropriations and Health/Human Services committees:

Sen. John Arch, jarch@leg.ne.gov; Kate Bolz, kbolz@leg.ne.gov; Machaela Cavanaugh, mcavanaugh@leg.ne.gov; Robert Clements, rclements@leg.ne.gov; Myron Dorn, mdorn@leg.ne.gov; Steve Erdman, serdman@leg.ne.gov; Ben Hansen, bhansen@leg.ne.gov; Robert Hilkemann, rhilkemann@leg.ne.gov; Dave Murman, dmurman@leg.ne.gov; Tony Vargas, tvargas@leg.ne.gov; Lynne Walz, lwalz@leg.ne.gov; and Anna Wishart, awishart@leg.ne.gov.

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