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LTC industry seeks to avert fiscal cliff

November 19, 2012
by Bob Gatty
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The long-term care industry, concerned about the impact of potentially devastating “fiscal cliff” federal funding cuts, has launched a broad offensive in hopes of convincing Congress and President Obama to reach a deal that will prevent those reductions from being imposed.

“With more than 70 percent of our patients funded by Medicaid and Medicare, the importance of these entitlement programs is critical,” wrote Janet Turensky, executive director of Kindred Transitional Care and Rehabilitation—San Luis, Green Bay, Wis. “As discussions happen in Washington about the fiscal cliff and funding for entitlement programs, there must be a greater understanding of the role nursing and rehabilitation centers have within communities like ours.”

Turensky’s comments were in a column that she wrote November 13 in the Green Bay Press Gazette. It was entitled “Protect Medicare Funding for Skilled Nursing Care.”    

“It is only with continued support from Washington that we can continue to provide high-quality care to our patients with such positive results,” she said. “However, facilities like ours have experienced a series of deep federal funding cuts in recent years. Medicare funding reductions totaling $65 billion are slated to take place over the next ten years as a result of several federal budgetary actions and regulatory changes made by Congress and the Centers for Medicare and Medicaid Services. Our lawmakers must spare our nation’s skilled nursing facilities from any further cuts that could threaten to place an even greater burden on communities like ours.”       

Turensky’s facility recently hosted Rep. Reid Ribble (R-WI), where he spoke with patients, caregivers and family members. Ribble is a member of the House Budget Committee, and a critical player in the current battle over funding and the deficit. So that visit held special significance, assuming Ribble was impressed with what he saw and is sympathetic to the industry’s needs.

“It is only through increased understanding of skilled nursing facilities in Washington that stable Medicare funding will be achieved,” Turensky wrote.

She is correct, so the LTC industry is also hoping to create that understanding through communications with lawmakers, including its lobbying initiatives, media communications and paid advertising.

Shortly after the election, the American Health Care Association (AHCA) launched its second installment of television, print and radio ads aimed at defeating the Medicare cuts contained in sequestration—a total of $11 billion, some $4 billion of which are estimated to affect skilled nursing facilities.

The targeted buy airs on congressionally-popular cable outlets, MSNBC, CNN and FOX News, as well as WTOP radio, the leading Washington, D.C. all-news radio station, plus insider publications Politico, Roll Call and The Hill.

“Something must be done to address these deep cuts to Medicare,” said Mark Parkinson, AHCA president and CEO. “AHCA and our members stand ready to help, but that begins with never losing sight of those we care for every day. Any potential deal struck to address the ‘fiscal cliff’ must consider the impact of our residents and the much needed access to quality care that we provide.”

Meanwhile, LeadingAge has posted a detailed letter online that it suggests members send to lawmakers in Washington, pointing out the impact of the threatened 2 percent Medicare cuts, the threatened 8.2 percent reduction in the Section 202 and Section 811 housing programs, and at the Administration on Aging, which administers Older Americans Act programs.

The letter also notes that Medicare reimbursement to health care providers is due to be cut by 2 percent, which LeadingAge said “will be difficult for quality providers to absorb.”

“I hope you will support a fair and balanced approach to deficit reduction,” the letter concludes. “Please do everything possible in the post-election congressional session to ensure that our most vulnerable elders do not have to bear the brunt of federal budget deficit reduction.”

The Alliance for Quality Nursing Home Care issued a statement asking the nation’s governors to urge Congress not to limit the state’s ability to use provider assessments to help bridge the funding gap in Medicaid programs.

Federal law allows governors to use provider-specific assessments to help pay for their share of Medicaid funding, and the amount of those revenues that can be rebated to providers is capped at 6 percent. Recent federal budget proposals reduce that threshold to between 3.5 and 5.5 percent, with cuts ranging from $11.3 billion to $21.8 billion in payments to all providers over a multi-year period.

“Until such bipartisan reform is achieved and SNF care is properly and adequately funded, provider assessments are indispensible in helping governors and the hard-pressed SNFs in their states stabilize staffing and facility operations in a manner that protects their most vulnerable seniors and persons with disabilities,” said Alliance president and CEO Alan G. Rosenbloom.

All of these efforts are essential if the industry is to succeed. However, it is important to note that every interest group in the nation is bombarding lawmakers with their own, urgent needs, and all of them are competing for federal dollars.

In this atmosphere, there are signs that both the president and Republican leaders, particularly House Speaker John Boehner, are hoping to reach a solution before year’s end.

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