Committee says nursing home payment reform needs further vetting

A 5 percent payment increase to nursing homes enacted in 2013 is often misunderstood, according to Louise Duffee, a certified nursing assistant and an SEIU Healthcare Minnesota member.

The nursing homes received the additional funding, but it was not entirely passed down to those who were cleaning residents’ rooms, preparing their meals and giving them personal care services, Duffee told the House Aging and Long-Term Care Policy Committee Wednesday.

Medical Assistance reimburses nursing homes for operating costs, among other expenses. Staff wages and salaries are part of the operating costs, as are food, supplies and utilities. Only a portion of the rate increase trickled down to bigger paychecks, which for some workers amounted to 35- to 50-cent per hour increases, said Bob Held, Nursing Facility Rates and Policy Division director for the Department of Human Services.

Rep. Joe Schomacker (R-Luverne)

Nursing homes find themselves competing with hospitals and retailers for employees.

As the state transitions to more senior adults than school-age children in the next five years, workforce demands are projected to increase to care for more seniors.

“We’re not creating a pipeline,” for tomorrow’s workforce, said Kari Thurlow, senior vice president of advocacy for LeadingAge Minnesota.

Currently, there are 1,800 unfilled nursing home positions across the state, Thurlow said. Annual nursing and dietician turnover rates hover between 35 and 55 percent, she added.

HF316 would reform the Medical Assistance nursing home payment system by specifying how the human services commissioner calculates nursing home operating payment rates beginning in October 2015. Sponsored by Committee Chair Rep. Joe Schomacker (R-Luverne), the bill was laid over, as amended, for further consideration by the committee.

Rep. Leon Lillie (DFL-North St. Paul) offered, then withdrew, an amendment that would have required a scheduled October rate increase to be applied only to nursing home employee compensation, minus administrators.

SF273, a companion bill sponsored by Sen. Tony Lourey (DFL-Kerrick), awaits action by the Senate Finance Committee.