Supporting Funding Adequacy
Florida’s nursing
homes care for our most frail and elderly residents. The nursing home
sector is highly regulated and highly technical. Increased demands
(staffing, liability and property insurance) and an under-funded
Medicaid payment mechanism are stressing Florida’s nursing home
community, and place residents at increased risk.
The 2006 Legislature
sought to address this situation by restoring a payment cut of $26 M in
the 2005 session that was meant to pay for a previous staffing level
increase and by infusing an additional $65M to address the partial
re-basing of the indirect patient care component and the operating
component of the nursing home Medicaid rate, which itself had not been
re-based since 1993. (This increase was to target only those nursing
homes that have been the most negatively impacted by the artificial and
arbitrary "targets" contained in the Medicaid funding formula.) Both
these items were vetoed by then-Governor Bush. We support
restoration of the 2005 nursing home cuts and ensuring the
adequacy of Medicaid nursing home payments.
Florida Senior Care – Essential Elements
The Agency for Health
Care Administration awaits legislative approval for a Medicaid
demonstration project called Florida Senior Care (FSC), which
effectively shifts Medicaid long-term care recipients into managed care
models in the panhandle and Orlando area. As the legislature considers
this proposal, we highlight three main policy concerns with Florida
Senior Care implementation:
Preserve Choice of LTC Providers
Choice of long-term
care providers should be preserved under Florida Senior Care. Persons
currently living in multi-level campus settings, or assisted living
facilities (ALFs) may be forced to leave their “homes” when they become
Medicaid eligible.
Adequate Reimbursement Must Be Provided
The current reimbursement system considers state and federally mandated
costs, such as minimum staffing requirements, in setting rates. We
recognize that it will be in the financial interest of managed care
organizations to negotiate the lowest possible rates with providers. If
rates lower than those currently in place are negotiated through Florida
Senior Care, changes in the types and level of care provided by the
non-profit nursing home sector are expected. We support the
incorporation of the current nursing home rate setting process into the
capitated payment plan to FSC providers.
Nursing Home Payments Must be Timely
Nursing homes currently file claims at
the beginning of the month. These claims are paid within the first two
weeks. Promptness of payment must continue under Florida Senior Care to
ensure the fiscal health of nursing homes, especially those with low
levels of cash on hand.
Contact: Michael
Sheedy, Associate Director for Health,
msheedy@flacathconf.org, 850-205-6824.
