We would like Ms. Langianese and the community to know that Medicare certification is something we have suggested should be a part of any solution, and this licensing process is currently an avenue the care center is pursuing. However, it is important to understand that revenues from having Medicare certification and skilled nursing ability at the care center are not a solution to the financial situation in themselves but could be part of a multi-faceted approach to make the care center sustainable.
First, Medicare reimbursement for skilled nursing in a nursing home is determined by “resource utilization groups (RUGS),” which define the level and amount of care that was provided. There is no automatic guarantee of the rate to be paid. It may be $700, but it could range between $200 and $400 based on the RUG calculation, which is what many smaller nursing homes are experiencing.
As to the quality of care issue, the best and most appropriate place for a long-term care resident is in the familiar surroundings of his or her own room. But to suggest that obtaining Medicare skilled nursing certification to keep the long-term care patient “at home” is the only way to ensure the continuity of quality care is unfair to the hospital, the care center and the resident.
If the care center obtains Medicare certification, this may permit both skilled nursing care and other services but it may not produce the desired increases in demand. The hospital has not seen nearly the amount of skilled nursing care demand that it expected in the new facility. If the care center has skilled nursing beds, it will be competing with the hospital’s skilled nursing.
One obstacle for the care center is that it was not designed to accommodate rehabilitation services such as physical and occupational therapy and to take these services out of the care center would limit reimbursements and possibly add costs to the certification process. The care center board of directors and administration are looking at this option as well as all others that have been presented by the task force, and we continue to welcome public input at any time.
–Joey Allred and Tom Edwards