LTC leaders sound off on gloomy 2003 - NH News Notes - Long term care

Nursing Homes, May, 2003 by Richard L. Peck

Leaders of two national long-term care organizations pulled no punches in sounding off on their industry's woes at the recent convention of the American Association of Nurse Assessment Coordinators (AANAC). Charles H. Roadman II, MD, CNA, president and CEO of AHCA, predicted that the "perfect storm" will hit in late spring and early summer, following recent Medicare cutbacks and state Medicaid clampdowns. He denigrated President Bush's call last year for market forces" to adjust nursing home financing, noting that predominantly government-supported reimbursement was more akin to Soviet-Union-style "command and control" economics. The result, he said, was federal officials trying to operate the long-term care system with a "3,000-mile screwdriver."

Another panelist, Joseph Lubarsky-- long-term care analyst for BDO Seidman, LLP, and author of recent AHCA-sponsored studies of Medicare and Medicaid shortfalls--said the situation in the field was the worst he had seen in 29 years. Following fiscal year (FY) 2003, in which most states had built in "reasonable" increases of 3% or more for nursing homes' Medicaid rates, Lubarsky said FY 2004 looked "grave," with most states proposing Medicaid cuts or freezes to cope with their red ink. He noted, too, that more than half the states are contemplating, or have in effect, provider taxes used to hike the federal Medicaid match, but these take as much as 6% of nursing homes' revenues in the process, including from private-pay. Nursing home margins are already razor-thin, he said, with half the profession teetering on the brink.

Larry Minnix, Jr., president and CEO of AAHSA, took a proactive stance, urging his nurse audience to "tell your story. Nurses are 'driving the bus,' but politicians don't know it, because no one is telling them your story. Most people in government want to do well, but they don't know the specifics--and the devil is in the details," he said. Minnix also recommended, among other things, that nurses maintain their organizations' integrity: "Don't allow compromise, because there are charlatans out there who have created a lack of trust for everyone."