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Bed tax blamed for lack of nursing home staff (7/19/02 Arkansas News Bureau) By Elizabeth Caldwell LITTLE ROCK “ State lawmakers expressed frustration Thursday that the state lacks the money to require additional staffing standards at nursing homes. They also were not pleased to learn that the bed tax they implemented in 2001 to pay for more staff apparently is partly to blame. Teresa Hursey, assistant director of the Department of Human Services' Medical Services Division, told the House and Senate interim Revenue and Taxation Committees that the bed tax does not bring in enough money to fund the extra staff that was to be required starting July 1. "We did not have enough to be able to mandate that," Hursey said. "So in essence," said Sen. Tim Wooldridge, D-Paragould, "the methodology was faulty, wasn't it, of accomplishing our goal?" DHS last year switched from a fee-based system to a cost-based system to pay nursing homes for Medicaid clients. To fund the more costly system, the Legislature imposed a bed tax on nursing homes of up to 6 percent, with the tax going to draw a 3-to-1 match in federal dollars. The tax was capped at 6 percent because that's all the federal government would allow on an industry tax used to draw federal matching money. Wooldridge said legislators were told at the time that the bed tax would pay for the new funding system, whereby nursing homes are reimbursed for staff increases and other direct care costs. "We thought the increase would therefore trigger the federal funding to therefore have enough money to provide quality care," Wooldridge said. Hursey told the committees that a funding gap occurs because while the state's share of staffing costs is 25 percent, the bed tax brings in only 6 percent of that. "There will be a time that 6 percent won't fund every increase we do," Hursey said. Rep. Sam Ledbetter, D-Little Rock, noted that if the Legislature had chosen another method of paying for the new nursing home reimbursement system instead of the bed tax, there would be no limit on the amount that could be used to draw federal matching funds. Ledbetter, who did not support the bed tax during the session, said after the meeting that he would like to find another way to fund the system. Hursey also told lawmakers that the lack of funding for increased staff has nothing to do with the state's budget crisis. The state revenues were short $227 million in the fiscal year that ended June 30 and state officials cut the budget for the current fiscal year by $225. 7 million. However, Hursey's statement is inconsistent with a memo put out in June by Carol Shockley, director of the Department of Human Services' Office of Long Term Care. Shockley's memo said the state "is experiencing significant budget restrictions and will not be able to fund the increase in staffing mandated under the Act. " |