N.D. nursing homes are  losing millions

LPN Shanon Kackman discusses a patient’s file with St. Gerard’s Community of Care Administrator Jill Foertsch.

North Dakota nursing homes are desperate.

Because of stagnant funding the past two years, some nursing homes in the state are deficit spending, dipping into savings and denying raises to employees.

For the first time, lawmakers two years ago did not bump funding for nursing facilities, according to Shelly Peterson, president of the North Dakota Long-Term Care Association. Because of that, nursing homes were forced to borrow from banks, dip into reserves and “literally depleted any money that they had,” Peterson said, because other costs keep increasing and they can’t keep up.

That describes the past year for St. Gerard’s Community of Care, said Administrator Jill Foertsch. This Hankinson nursing home drained its savings account as hundreds of thousands of dollars have been lost due to state funding deficits, she said.

“I mean our stash of cash, our savings, is down to $0 to meet payroll, to pay the bills, to pay contract staff, which is double what we pay our own staff,” Foertsch said as St. Gerard’s was forced to use contract nurses and CNAs because it hasn’t been easy to recruit new staff. No matter what, the nursing home is mandated to have enough staff on hand through a 24-hour period, seven days a week.

St. Gerard’s hasn’t been in the black for many years, Foertsch said. “I don’t know how we’ll survive or continue with that,” she said.

Hankinson is not alone as the entire nursing home industry in North Dakota lost $3.7 million in 2016 and projects the loss of another $8 million for 2018.

What is next?

The North Dakota Long-Term Care Association is once again asking legislators to approve a provider assessment with a two-year sunset clause in which lawmakers could assess how the program is operating. It is the second item on a shopping list to shore up the millions being lost because of this reduction in state aid. A provider assessment would require private pay and Medicaid recipients to pay an additional fee for a day in the nursing home.

Lawmakers denied it two years ago because they considered it a tax.

That provider assessment is first on Foertsch’s list. She said it is necessary and takes exception to it being called a tax. She calls it an insurance policy that ensures qualified staff, reliable staff, ones who want to work in this industry, will be retained or recruited.

St. Gerard’s is not going to close since the Sisters of St. Francis and its board are committed to keeping this facility open, said Sister Mary Louise Jundt, assistant administrator there. But the nursing home needs help in the form of restored state funding, she said.

Jundt points to the way St. Gerard’s utilizes local businesses, and said they need help now from those very same businesses to contact lawmakers and express the need to restore funding.

It isn’t a simple matter of raising rates for private pay residents either, Foertsch said, since North Dakota mandates equalization of rates. That means North Dakota nursing homes cannot charge private pay residents any more than what is paid by Medicaid. The Medicaid rate is actually set by the state, and right now North Dakota is on the cycle of reducing funding, which began a little more than two years ago when Gov. Doug Burgum initiated a 4.05 cut to all state departments.

Where you can help

The legislature convenes Thursday, and the North Dakota Long-Term Care Association is organizing to make its needs known.

Gov. Doug Burgum recently presented his budget plan that includes a 1 percent increase in nursing home funding in each year of the 2019-20 biennium.

Nursing homes are seeking a 3 percent increase to help with recruiting and retaining staff, and paying for growing costs such as building maintenance and employee health insurance. Peterson said 1 percent is a start. Alone, it’s not enough to deliver the exceptional resident care that North Dakota nursing homes are known for providing. Here, 89.5 percent of North Dakota nursing homes have four- or five-star ratings in both resident satisfaction and staffing, compared to 42.4 percent of other U.S. nursing facilities, according to information compiled by the LTC association,

Nursing homes are struggling across the nation. According to a recent story by McKnight’s News, an unprecedented wave of nursing home closures is hitting South Dakota, fueled by what advocates call chronic underfunding of Medicaid. Three nursing homes shuttered or closed in the last three years, which includes the one in Rosholt, South Dakota, while two more are slated to close in February and another 18 are in the hands of a court appointed receiver, which means they are on the brink.

That concerns Foertsch, she said, because South Dakota nursing homes can charge private pay residents more, sometimes up to $75 a day more than, what is paid by residents utilizing Medicaid.

As a whole, things are dire for the entire nursing home industry, Foertsch said. She asks that area residents contact lawmakers in both District 25 and 26 to tell St. Gerard’s story and ask that funding be restored to the 3 percent level favored by the LTC association.

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