In face of fiscal meltdown, Illinois funds nursing home safety

Illinois is in trouble. Big, ugly fiscal trouble. The Wall Street Journal recently referred to it as “the Greece next door” after Moody’s downgraded Illinois debt to the lowest rating among all 50 states.

As expected, Gov. Pat Quinn has called for cuts to most major programs, although healthcare has been spared. Interestingly, Quinn has actually boosted nursing home funding by millions of dollars to help carry out safety reforms passed in 2010. This is because the state won’t have to touch its own coffers to distribute the cash.

Quinn announced last week that nursing homes will pay a new bed tax of $6.07 each day for every non-Medicare patient served, generating an estimated $145 million. About $125 million of that pool will go into Medicaid, which the federal government will then match with more than $100 million in additional funds.

Nursing homes will recollect a majority of those funds to meet increased staffing and quality requirements under the state’s reform laws, which are meant to improve safety at these facilities.

A little background: The Chicago Tribune investigated nursing homes a couple of years back and discovered that poorly staffed facilities had been grouping dangerous psychiatric patients alongside the normal frail elderly population of residents. Gov. Quinn responded by signing sweeping reforms in July 2010 that forced nursing homes to meet much tougher safety standards.

There was one problem, however—the state had no answer for how the facilities were to pay for these increased staffing requirements and other measures mandated by the law.  

Quinn released his Medicaid match idea one year ago this month, and it has now come to fruition. In addition to the $125 million being pooled for Medicaid, $20 million will go to the state Department of Public Health, specifically to hire 160 additional inspectors and expand home- and community-based services.

“This is positive news for people who live in a nursing home or have a loved one living in a nursing home,” Quinn said in a statement last week.

While nursing homes have agreed to pay the increased bed tax for this effort, not everyone is pleased. The Tribune reported that some nursing homes are concerned that since the money is distributed through Medicaid, the homes with larger amounts of poor patients will get a bulk of the redistributed money.

Other advocates for the elderly, including the AARP, argue that the funding match will discourage efforts to move young mentally ill residents into community-based settings, where they probably belong.

Regardless, Illinois is at least looking to make good on its promise of improving nursing home safety, and seems to have found a creative solution that won’t force the state to cough up additional funds that it doesn’t have. After signing legislation that would have punished providers without offering appropriate recourse to meet heighted expectations, this is an approach that could prove successful in 2012.

Topics: Medicare/Medicaid , Regulatory Compliance