Lawmakers Back Medicaid Changes To Boost Nursing Home Wages

April 10, 2017, Mina Corpuz, LowellSun.com - The entire Lowell delegation is backing a pair of bills that would increase wages for nursing home workers and maintain quality care for patients.  Rep. Tom Golden, a Lowell Democrat, and Sen. Harriette Chandler, a Worcester Democrat, offered bills that would "increase the bottom line" for the state's nursing homes and rehabilitation facilities by updating a decade-old Medicaid reimbursement that facilities rely on to operate and pay workers.

"We ask these professionals to take care of the folks who are in most need in our community and that's one of the pieces that I think is very, very vital," Golden said.  "We have to increase some dollars going back into the skilled nursing facilities."  The bills are under consideration by the Legislature's Committee on Elder Affairs.

There are about 420 nursing facilities in the state that care for 40,000 residents and employ 77,000 skilled workers, according to the Massachusetts Senior Care Association. Nursing facilities can generate about $4.3 billion for the state.  Lowell is home to eight of these facilities, including the D'Youville Life and Wellness Community, which provides daily long-term care and short-term rehabilitation aid.

"We're a safety net for elders and their families because if they could be at home getting care they would be at home getting care," said Naomi Prendergast, CEO and president of D'Youville.  "People come to us as a last resort, but it's up to us to make every day of their life as wonderful as it can be."

Facilities lose about $37 a day per patient because of a gap between costs and Medicaid reimbursement, according to the senior care association.  About 75 cents of every dollar nursing facilities make goes to staff wages and benefits, according to the association.

"When we have funding increases when the Legislature has had resources, there is corresponding increases in wages," said Tara Gregorio, president of the association. "There is that link between government funding and investment in staff and investment in quality."

Medicaid reimbursement is lower at nursing homes compared to home health centers and hospitals.  More than 100 legislators have co-sponsored the legislation, including half of the Republicans in the House and two-thirds in the Senate.  Reps. Marc Lombardo, R-Billerica, Jim Miceli, D-Wilmington, James Arciero, D-Westford, and Colleen Garry, D-Dracut co-sponsored Golden's bill. Sens Jamie Eldridge, D-Acton, Michael Barrett, D-Lexington, and Jennifer Flanagan, D-Leominster co-sponsored Chandler's bill.

"Increased state funding for this human service is the right thing to do in order to provide the highest level of care for our seniors who truly deserve no less from us," Arciero said in a statement.  Flanagan said the Legislature should look at how to get Medicaid reimbursements for care and wages on par with inflation.

"Certainly the workers that work there aren't making a lot of money," she said.  "They're providing around the clock care for their patients, sometimes very complex patients. We need to take a look at the place nursing homes have in our health system."

Certified nursing aides make a median hourly wage of $13.82, according to the senior care association. Licenses practical nurses earn $25.54 an hour and registered nurses receive $28.86.

D'Youville "went out on a limb" to increase its average nursing assistant wage by about a dollar, Prendergast said.  Certified nursing assistants now make about $14 an hour.

"What we've done is kind of a risk," Prendergast said.  "If it's taken away next year, our wage scale is our wage scale.  We would still have to pay it and not have the reimbursement, but we felt it was very important to get that wage up because if the certified nursing assistant is the person that is providing all the direct care."

Golden and Chandler's bills also call for funding for career advancement through the Commonwealth Corporation, created by the Legislature in 1997 to help ensure a pipeline of skilled workers, and a scholarship program for certified nursing aides through the Department of Public Health.

The support would encourage job stability and help make up the shortage of direct care workers at nursing facilities. 

"As much of a difficulty that we see today in filling the jobs with qualified and trained people, you can only imagine how that's going to worsen if we don't do something about this," said Sen. Eileen Donoghue, D-Lowell, who co-sponsored Chandler's bill.

Golden filed a similar bill last session that garnered about 80 co-sponsors.  It was referred to the elder affairs committee and had a hearing, but did not make it through the Senate.

Even if the bill does not pass in the Legislature, Golden hopes that there is room in the House budget to increase a line item a to help nursing homes and their workers.

"We try to keep moving the ball every year," he said.  "It's something that we just need to get done.  I think this will be a continued fight year in and year out."

Read more: http://www.lowellsun.com/todaysheadlines/ci_30911889/lawmakers-back-medicaid-changes-boost-nursing-home-wages#ixzz4drbszHsg