The way Orlando J. Bisbano Jr. sees it, the expected trimming this week of nearly $10 million in Medicare payments to Rhode Island nursing homes equates to kicking an industry while its down.
“This is just another kick in the rear end for us,” said Bisbano, president of the Rhode Island Health Care Association, which represents the state’s for-profit nursing homes. “We already have chronic under-funding for Medicaid patients,” he said during a Sept. 23 event staged at Orchard View Manor, where he serves as administrator.
The East Providence home was the 109th stop along a nationwide tour by a group of long-term-care advocates, which wants to convince Congress to cancel the Medicare cuts set to take effect later this week. The group plans to deliver to the steps of the Capitol building in Washington, D.C., this week a 100-foot-long petition urging Congress to pass legislation that would eliminate the Medicare cuts.
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Barring any 11th hour Congressional action, nursing homes on Oct. 1 will see their Medicare payments slashed by about 10 percent, which is equal to about $9.8 million in Rhode Island and $2 billion nationally. The cuts would cost Rhode Island nursing homes $38 per Medicare patient per day according to a state-by-state study issued by Muse & Associates, an independent public-policy research firm.
The move comes at a time when Rhode Island’s nursing homes already face a shortfall of nearly $30 million in Medicaid funding, according to a report prepared by consultant BDO Seidman LLP. The report said that in 2000, Rhode Island nursing homes lost an average of $12 a day on each Medicaid patient.
Nursing home operators long have leaned on higher-paying Medicare payments to compensate for the Medicaid shortfall.
“We’ve used Medicare to kind of support the Medicaid patients, but we can’t do that anymore,” said Jerry Romano, administrator at the 128-bed Silver Creek Manor in Bristol.
Many at Orchard View Manor said the Medicare cuts would erode revenues for nursing homes that already are too strapped to adequately pay their certified nurse assistants, who help residents with daily activities such as eating and bathing. CNAs in Rhode Island are paid about $8 an hour, according to state data.
“I’m afraid if Congress and the President don’t stop these Medicare cuts, some of our caregivers will lose their jobs,” said Orchard View Manor resident Yvonne Halpin, flanked by other residents and caregivers clutching handmade signs that read “Stop Medicare Cuts” and “Save Rhode Island Seniors.”
Romano said the drop in Medicare payments wouldn’t cause him to trim his staff, but it probably would hamper the home’s ability to make renovations or upgrade equipment.
“You can’t steal from patient care, but we’ll have to make cuts in other areas,” he said.
Legislation has been introduced in both the House and Senate that essentially would stop the Medicare cuts from taking effect.
Bisbano praised both Reps. Patrick J. Kennedy (D-RI) and James Langevin (D-RI) for their support of the House legislation.
