Alliance for Quality Nursing Home Care President expresses concern over job instability

Pointing to new job losses at a Nebraska nursing home attributed to a new federal Medicare regulation reducing funding by 11.1 percent ($79 billion over 10 years, according to Avalere Health), the President of the Alliance for Quality Nursing Home Care today expressed concern that the Nebraska job loss example represents the leading edge of additional job losses and layoffs at skilled nursing facilities (SNFs) throughout the nation, as facilities, care staff and patients struggle with an accumulation of Medicare and Medicaid funding reductions.

"The nursing home job losses just announced in Nebraska -- attributed specifically to the 11.1 percent CMS Medicare funding reduction that will go into effect tomorrow -- coincides with growing concerns in other states such as Ohio and Florida that facility job losses are imminent as they also battle new state Medicaid cuts," warned Alan G. Rosenbloom, President of the Alliance, a coalition of 12 leading post-acute and long term care organizations providing skilled nursing care in approximately 1,400 facilities in 44 states nationwide.

The Lincoln Journal-Star reports in, "Medicare Cuts Force Tabitha to Trim Jobs," Tabitha Health Care "eliminated roughly 30 positions last week, mostly in response to a pending 11 percent reduction in Medicare payments for skilled nursing care." The story notes, "Approximately $1 million of the lost income will result from a federal 11 percent reduction in Medicare payments for skilled nursing care -- care for temporary patients discharged from hospitals but not ready to go home -- that takes effect Oct. 1."

Observed Rosenbloom: "Because the U.S. nursing home sector has the lowest operating margin of all health care providers, we have deep concern that multi-year federal Medicare funding reductions combined with Medicaid cuts in states like Ohio, Florida and elsewhere will inevitably manifest themselves in the form of facility job losses and the inevitable negative impact on patient care. The prospect of still more Medicare cuts stemming from Congressional Super Committee activity would obviously be devastating to nursing home patients, disastrous to caregiver jobs, and undermine facilities' ability to admit, treat and return to home a rapidly increasing number of patients requiring intensive post-acute rehabilitation, and care for multiple chronic illnesses."

An analysis by Avalere Health finds the new Centers for Medicare and Medicaid Services (CMS) regulation going into effect October 1 will reduce Medicare payment to the nation's nursing home sector by $79 billion over 10 years. This new and latest reduction in payments to the sector -- America's second largest health facility employer -- cumulates on $29.4 billion in Medicare payment cuts enacted to fund healthcare reform, and a $16.8 billion Medicare payment reduction in 2010 regulation.

The Alliance leader said additional $42 billion Medicare cuts proposed earlier this month by the Obama Administration -- on top of the new CMS regulation, and on top of the state Medicaid cuts – "will significantly contribute to further destabilizing the state's second largest health facility employer, and the substantial economic activity nursing homes generate throughout rural, suburban and urban America."

Rosenbloom said the recent Standard & Poor warning about increased volatility in the nation's nursing home sector is a direct result of government payment decisions. S&P, according to news reports, characterized the CMS funding reductions as "larger than expected" and "ignited worries that reimbursement reductions will impair cash flow prospects." Said Rosenbloom: "The S&P warnings made earlier in the summer should have been heeded, and for the benefit of patients and local job preservation, we urge Congress and the President to help bring about payment stability to the nation's nursing home sector – not more economic chaos."