Medicaid funds turned to profit
(2/22/02 News Tribune, WA) By Paula Lavigne Sullivan

About 20 percent of for-profit nursing homes in Washington withheld Medicaid money for hiring nursing home staff in order to get a profit bonus from the state, said a report released Thursday.

But nursing home administrators say the majority of nursing homes don't get enough money from the state to cover the cost of accepting Medicaid patients and have to make up for the loss.

The report by Washington Citizen Action shows that 39 of the state's 196 for-profit nursing homes got a total of $430,000 in state reimbursement money in 2000 by not spending state-allocated Medicaid money on hiring and retaining staff. The group says its report highlights the need for more accountability in how nursing homes spend government money.

Although the data came from the Department of Social and Health Services, the department that regulates nursing homes, officials there said they have not had time to confirm the accuracy of the report's findings.

Reimbursements range from about $3,000 to $30,000 per home in the report, which includes nine nursing homes in Pierce County.

Nursing homes get Medicaid money from the state to pay for the hiring of nursing home staff, including nurses and assistants. If the nursing home does not spend the money, it all goes back to the state except for a portion that the nursing home is allowed to keep as profit.

That reimbursement was designed as an incentive for nursing homes to save money, but some homes used it to boost their profits, said Charley Reed, former assistant secretary of the aging and adult services division of the Department of Social and Health Services.

Nursing homes need to be spending the state money they get for hiring more staff because many of the homes don't have enough nurses or assistant to meet patients' needs, said Will Parry, president of the Puget Sound Alliance for Retired Citizens.

Parry was joined by Stephanie Quitugua, a nurse assistant at a Bremerton nursing home where she said she tends to between 13 and 17 patients each day.

"We love our patients, but we are forced to work short-staffed," she said. "It's very difficult when there aren't enough workers to do these things."

Nursing homes aren't getting enough government funds for other services, including food, utilities and housing, which could also prevent them from hiring more staff, said Mike Neeld, executive director of the Washington Health Care Association.

Nursing homes in Washington spent $35 million beyond what the state gives them for Medicaid patients -- a shortfall of $9. 18 per Medicaid patient per day, according to the Washington Health Care Association.

Neeld said nursing homes have nothing to gain if they cut or limit staff to get the state's reimbursement money because they would be ineligible for reimbursement funds if they provide substandard care.

The real reason some homes didn't spend all the money they received for hiring staff was because they couldn't find enough people, especially nurses, qualified for the jobs, he said.

A shortage of nurses and turnover makes it difficult for any nursing home to fill jobs, said Chuck Sheridan, administrator of The Highlands*Dementia Care Center in Tacoma, which was among the homes cited in the report. He wasn't in that job during the period studied and wasn't aware of the findings.

"I would love to give my staff more money," he said. "I think they have very difficult jobs. I think they work very hard and very honestly. If the state gave me money to spend on my staff, I would be willing to do that."