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A waiting game for Medicaid reimbursements in Illinois

January 7, 2013
by Sandra Hoban, Executive Editor
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Long-term care organizations in Illinois face a potential six-month wait for Medicaid reimbursement  from the state of Illinois. An article in The State Journal-Register in Springfield, Ill., says that payments are deliberately postponed in an effort for the state to manage its financial woes. These payments, according to the article, finance care for two-thirds of nursing home patients and approximately 60 percent of assisted living residents

The delay in payment puts pressure on LTC facilities to find other ways to manage its finances, while still trying to provide care and maintain staff levels. Wayne Smallwood, executive director of the Affordable Assisted Living Coalition, was with the Department of Health Care and Family Services for 33 years. He says in the article that small organizations lack the budget flexibility to play the waiting game and often have to appeal to their banks for lines of credit to survive.

Even larger organizations are feeling the pinch, according to Jerry Finis, CEO of Pathway Senior Living. The unpredictability of payments makes planning difficult. Finis remarked, in the article: “It’s hard to go to your banks and say you need a line of credit that might cover me for 60, 90 or 120 days. Then the question is what happens if it goes 180 days, which is always the dilemma.”

This reimbursement problem will not be solved soon, according to Illinois Comptroller Judy Baar Topinka. A recent quarterly report indicated that the backlog grew by $2 billion last year.

LTC organizations are working with their vendors and utilities on negotiating longer payment cycles so maintain the care and comfort their residents require.

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