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Our sorry state

Friday, Apr 19, 2019

* Jerry Nowicki

Since March 2014, 20 state-licensed skilled-care nursing homes have closed for financial reasons, while many of those continuing to serve the state’s neediest elderly populations face staffing shortages and operating deficits caused by diminishing state government investment. […]

“These facilities are closing, and I can tell you more are going to close,” said Pat Comstock, executive director of the Health Care Council of Illinois, a nursing home advocacy group. “It’s happening because we have a situation in Illinois where they can no longer financially survive.”

The pace of closures has quickened in recent years, with five skilled-care nursing facilities – those that house the sickest and most vulnerable – closing from 2014 to 2016, six closing in each of 2017 and 2018, and three already shutting their doors in 2019, according to the Illinois Department of Public Health.

To fully quantify the issues facing the industry and their possible solutions, HCCI commissioned a study conducted by the business advisory firm Plante Moran, the Claude Pepper Center of Florida State University, and managed care Medicaid expert Meredith Duncan.

The 85-page report states Illinois’ Medicaid ranks 49th in the nation for Medicaid reimbursement rates, and nursing homes lose approximately $15,000 per year – or an average of $41 per day – for each Medicaid-funded patient. Those shortages create a $649 million single-year funding shortfall across the industry in Illinois.

There’s a lot more to this story, so click here for the rest.

- Posted by Rich Miller        

34 Comments
  1. - wordslinger - Friday, Apr 19, 19 @ 9:48 am:

    Another area where the MCOs don’t appear to be up to their job.

    If your sole reason for being is processing claims, shouldn’t you be competent at it?


  2. - JS Mill - Friday, Apr 19, 19 @ 9:55 am:

    =49th in the nation for Medicaid reimbursement rates=

    The people screaming about population loss and how a progressive tax may run high income earners out of Illinois may want to consider how this affects us.

    Doctors and medical professionals are directly affected by this low reimbursement rate.


  3. - I Miss Bentohs - Friday, Apr 19, 19 @ 9:59 am:

    I do not care that Illinois has no taxes on retirees. I have been advising my elderly relatives to get out of Illinois and this was one of my arguments. (I’m happy to say that as of last week, 14 of the 15 have left to Missouri, Tennessee, or Colorado … two uncles went for the pot not because of my advice).


  4. - illini - Friday, Apr 19, 19 @ 10:01 am:

    I can relate to a local situation that is related but slightly different from the one presented here.

    A regional developer/operator built two 18 bed homes in my small community designed to care for adults incapable of living on their own. Many worked during the day at the county sheltered workshop, but yet were dependent on the state for their principle support. One of these homes closed 5 years ago and I understand the other is likely to close as well.

    As Rich said “Our Sorry State”


  5. - Dome Gnome - Friday, Apr 19, 19 @ 10:02 am:

    I don’t give a fig about money for nursing homes. We get the most bang for our buck by supporting people in their homes and local communities. The Community Care Program (CCP) sustains older adults in Illinois who are eligible for Medicaid. CCP is designed to prevent unnecessary intstitutionalization (i.e. nursing home care) of older adults who have difficulty with household and personal care tasks.


  6. - Perrid - Friday, Apr 19, 19 @ 10:06 am:

    Dome Gnome must not have read the part of the article where it said the diversion programs, like CCP, changes the population so NF residents are sicker and more Medicaid, which exacerbated the funding problem.


  7. - don the legend - Friday, Apr 19, 19 @ 10:07 am:

    Is there at least one reliable source that can calculate Illinois’ revenue needs based on a minimum required funding level to take care of our most vulnerable citizens, pay our back debt, fund a capital plan, fund our statutory commitment to education and fund our pensions?

    Tell all of us what that number is and then calculate a graduated income tax structure and gas tax needed to meet this budget number.


  8. - LTSW - Friday, Apr 19, 19 @ 10:10 am:

    Dome Gnome, yes CCP is useful for keeping people in their homes, but people do get to the point where skilled nursing care is their only option. Illinois only pays around $3,700 a month for nursing home care. That rate doesn’t cover the cost for some homes.
    Congress really needs to take look at these asset trust transfer schemes, there are many who could pay but are on Medicaid.
    On top of that, cuts in state employment have put us months behind in determining Medicaid long term care eligibility.


  9. - RNUG - Friday, Apr 19, 19 @ 10:11 am:

    It’s not just the actual nursing homes that have staffing problems. My mother-in-law lives in a church affiliated private pay assisted living facility and even they have a high rate of turnover on the nursing staff. The maintenance and office staff seems to be stable,mostly the same people the last 5 years, so I assume the pay is reasonable. But assisted living is a lower level of service than a nursing home.

    I suspect part of the high price of nursing homes here in Illinois is the need to overcharge those that can privately pay in order to cover the shortages of the Medicaid reimbursement. And I’m sure the Medicaid shortages have a relationship to the lower pay and staffing levels at most nursing homes.


  10. - LTSW - Friday, Apr 19, 19 @ 10:12 am:

    Word, the MCO’s aren’t the issue here. It’s the state’s low reimbursement rates and the lack of cash flow that delays payments to the homes.


  11. - RNUG - Friday, Apr 19, 19 @ 10:16 am:

    == Illinois only pays around $3,700 a month for nursing home care. ==

    In my experience, that amount is the lower end of what private pay assisted living facilities charge. Even downstate, actual nursing homes charge quite a bit more.


  12. - anon2 - Friday, Apr 19, 19 @ 10:24 am:

    === Illinois ranks 49th in the nation for Medicaid reimbursement rates, and nursing homes lose approximately $15,000 per year – or an average of $41 per day – for each Medicaid-funded patient.===

    Not much to be proud of. No wonder so many nursing homes can’t stay open.


  13. - The Way I See It - Friday, Apr 19, 19 @ 10:24 am:

    Nursing home finances are quite a bit more complicated than that. A lot of nursing homes are paying out a lot of money to related entities for supplies, management fees, rent, etc. If a facility is closing it is at least in part because they weren’t keeping beds filled.

    All that said, the state needs to do a lot more to make sure that care is being adequately funded because they are taking in a lot more people with significant long term health issues.


  14. - Perrid - Friday, Apr 19, 19 @ 10:24 am:

    LTSW, the MCOs are contributing to the problem. We can argue which factor is the biggest problem but the NF having to argue with the MCOs about whether they should be paid and what they should be paid is not helping.


  15. - Anon221 - Friday, Apr 19, 19 @ 10:26 am:

    LTSW- “MCO’s aren’t the issue here”

    I disagree in part. Mom’s application for Mediciad, once her private insurance and Medicare options ran out, was “lost” at least twice over two years by the company processing her application. My folks were not rich, and had paid into this system all their lives. They only had their home place as “collateral”, and met all the Medicaid qualifications for Mom.

    So, Dad had to gather all the information required for the application over and over again, and resubmit. Meanwhile, the resident doctor ignored Dad’s repeated requests for him to check Mom for possible pneumonia or flu. Finally, he ordered an X-Ray, confirmed pneumonia, and she died a few days later at the nursing home, without a Medicaid eligibility ruling.

    It’s not going to get any better for the immediate future, either. I was shocked when Liberty Village closed in LeRoy, and wonder what is going to happen to the other care centers owned by that company across the state.

    We are all, possibly, going to be elders at some point in our lives. It’s way past time to address the numerous issues over elder care, and come up with workable solutions and funding methods that WORK and don’t go more to lobbyists and lawyers.


  16. - Earnest - Friday, Apr 19, 19 @ 10:28 am:

    Aside from the MCOs, who send profits out of state, the money to pay for these services provides services people in their local communities, supports companies that purchase goods in their local communities, and provides jobs and wages for people who live, shop and pay property taxes in their communities. We hear a lot of arguments against state spending, but too few for the best ways it can be spent.


  17. - wordslinger - Friday, Apr 19, 19 @ 10:30 am:

    –Word, the MCO’s aren’t the issue here.–

    Read the section “Bureaucratic Delays.” MCOs certainly are part of the problem here, just as they are in other areas of the Medicaid program.


  18. - Effected - Friday, Apr 19, 19 @ 10:30 am:

    Dome Gnome missed the point. I am in the unfortunate position to be both a provider to these skilled care facilities and the son of a resident requiring these services. Most important is the constant thrashing it takes to get adequate care for a disabled family member stuck In this Medicaid funding vacuum. This article is spot on. My family fears for the well being of our loved one because of the system. Now focus on how rediculous it is to go months to get paid and be told that you can only be compensated at a rate 40 percent below the cost for the services you provide that are essential aspects of care. That’s 60 percent below a profit margin. Truely agonizing. I wish this on no one.


  19. - Nonbeleiver - Friday, Apr 19, 19 @ 11:00 am:

    Illinois pays $3700 a month ($44,400 a year) per person.

    Yes, it is not enough to pay the costs but it is a staggering amount for taxpayers. Not sustainable in the future and that is the dilemma.


  20. - Robert the 1st - Friday, Apr 19, 19 @ 11:07 am:

    The people screaming about the highest paid state workers getting $20k+ in back pay and fully funding 6-figure pensions may want to consider how this affects us. Don’t you think JS? Hey aren’t you a superintendent?


  21. - I have heard - Friday, Apr 19, 19 @ 11:25 am:

    When Medicaid patients moves to a nursing home they often have a house. If there is no one else living there, the house is supposed to be sold and the proceeds are supposed to be given to the nursing home to cover patient care. I have heard that the nursing homes rarely get these proceeds and the money is often lost. I hope someone looks into this.


  22. - wordslinger - Friday, Apr 19, 19 @ 11:29 am:

    –I have heard that the nursing homes rarely get these proceeds and the money is often lost.–

    You heard wrong. The elderly have to burn through their assets before Medicaid will pay a dime.

    And don’t try to get hinky transferring assets before landing on Medicaid. There’s a five-year lookback.


  23. - Illinilaw - Friday, Apr 19, 19 @ 11:33 am:

    Take a look at what nursing home owners and the nursing home PACs contribute to politicians. It’s interesting reading.


  24. - Grandson of Man - Friday, Apr 19, 19 @ 11:45 am:

    “The people screaming about the highest paid state workers getting $20k+ in back pay”

    Those are the lowest-paid, newest workers who the court and labor board found to have been ripped off by Bruce Rauner, who made $333 million in 2015-2017. That’s right. They were ripped off by a multimillionaire and by extension the billionaires and anti-union, anti-tax organizations that supported him.

    While the multimillionaire and his billionaire backers were ripping off those making $40-$50,000 a year, they were decimating social services and making the nursing home situation worse. It’s beyond shameful how the most vulnerable were purposely hurt by the richest. That’s why we need to tax the rich more, so that we don’t repeat this.


  25. - Robert the 1st - Friday, Apr 19, 19 @ 12:08 pm:

    =Those are the lowest-paid, newest workers=

    My best friend works for DOC and made $108k in 2018. We calculated his back-pay at $27K when factoring in the 7% interest. But keep the fairy-tales alive Grandson.


  26. - Downstater - Friday, Apr 19, 19 @ 12:14 pm:

    Since Dome Gnome “doesn’t give a fig” about nursing homes, I thought I’d share a clip from the article:

    “’Nursing homes are no longer like the old age homes that one would think of, they’re no longer grandma in the corner knitting and grandpa playing pinochle with his buddies,’ Ginther said. ‘They’re incredibly sick, fragile people that require medically complex care around the clock.’

    “In recent years, Illinois has promoted nursing home alternatives such as aging-in-place programs, and seniors often stay in their own homes or move to lighter care facilities until their health deteriorates to a point that they need nursing home care.

    “While the HCCI supports age-in-place programs, the shift to a more Medicaid-dependent population in many nursing homes means an increase in homes operating at significant funding deficits.”

    So, Dome, you going to set up one-on-one 24 hour nursing care for the current NH resident who has dementia, a feeding tube, and IV anti-biotics running through a PIC line three times a day in her home? If you kill NH’s that is what you are looking at.


  27. - Generic Drone - Friday, Apr 19, 19 @ 12:18 pm:

    Thr richest nation in the world throws away its elderly. We can do better if we want to. Greedy politicos cause issues like this.


  28. - wordslinger - Friday, Apr 19, 19 @ 12:40 pm:

    –Thr richest nation in the world throws away its elderly.–

    Let’s not go nuts. Social Security, Medicare, Medicaid, SNAP, et. al. have lifted tens of millions of elderly out of abject poverty over the decades.


  29. - Stuntman Bob's Brother - Friday, Apr 19, 19 @ 1:35 pm:

    ==Let’s not go nuts. Social Security, Medicare, Medicaid, SNAP, et. al. have lifted tens of millions of elderly out of abject poverty over the decades==

    Yep. Availability and advances in medical technology has also had the effect of prolonging our later years regardless of the quality. Rahm’s brother Zeke, one of the architects of Obamacare, pushed for dialogue on how we are going to handle our ever-aging population, and was rewarded with claims he was endorsing “death tribunals” by conservatives for doing so. I believe his own personal plan was to forego life-extending (like cholesterol or blood pressure) medications once he hit 75 years of age or so - it will be interesting to watch whether he has the courage of his convictions when the time comes. We need to open this discussion back up for debate.


  30. - Demoralized - Friday, Apr 19, 19 @ 2:05 pm:

    Robert the 1st

    Not a fan of paying people what they are owed are we.

    Rauner would have been proud of you.


  31. - Demoralized - Friday, Apr 19, 19 @ 2:06 pm:

    ==We calculated his back-pay==

    Back. Pay. Money owed. You have a problem paying people what they are owed?


  32. - Dotnonymous - Friday, Apr 19, 19 @ 2:08 pm:

    While it’s indisputable Social Security, Medicare, Medicaid, SNAP, et. al. have lifted tens of millions of elderly out of abject poverty over the decades…I believe the bar must be set higher than abject poverty.

    I wonder how many senior citizens are forced to live just above that low standard?


  33. - Grandson of Man - Friday, Apr 19, 19 @ 3:01 pm:

    “Not a fan of paying people what they are owed are we.”

    Not only that, but deliberately misrepresenting what the large majority of what newer state workers earn. They earn nowhere near $108,000 a year. They were ripped off by a multimillionaire and his billionaire backers during their deliberate budget sabotage that whacked social services and nursing homes.


  34. - Nonbeleiver - Friday, Apr 19, 19 @ 4:04 pm:

    Illinilaw - Friday, Apr 19, 19 @ 11:33 am:

    Take a look at what nursing home owners and the nursing home PACs contribute to politicians. It’s interesting reading.

    Do you have a sit for this?


Sorry, comments for this post are now closed.


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