Nursing homes in Illinois have again come under attack for simply trying to provide quality care to our residents in the face of abysmal Medicaid reimbursement rates from the state.
Our state provides cents on the dollar for the care that Medicaid patients receive, even though it is obligated to cover the cost of their care. Let me be clear: The state of Illinois is legally obligated to cover the cost of care for our most vulnerable residents.
Most people are unaware of how Medicaid costs for low-income nursing home residents are covered in Illinois. Essentially, there are three main expenditures the state is required to reimburse nursing home operators for: program costs for individual residents, which covers things like therapies, dentures, podiatry care and many other services; general costs like food, supplies and staff; and capital expenditures, such as mortgages and property taxes.
Every year, nursing homes submit reports detailing these costs to the state that is, in turn, required (after complex calculations) to pay for the costs of providing these services to our low-income residents.
Unfortunately, Illinois has not looked at nursing home reports for general costs since 2014, and the state has not updated its capital reimbursement rates since 1999. That means the state is reimbursing nursing homes for property tax rates that are 25 years old, and basing their reimbursement for costs such as staff and food on rates that are nearly a decade old.
Generations at Regency in Niles has seen its property tax increase from $300,000 in 1999 to nearly $1.6 million last year, but the state still bases its reimbursement rate on the 1999 taxes. Similarly, with increases in the cost of food and services in the last 10 years, Illinois’ reimbursement rate, based on 2014 costs, doesn’t even cover the expense of feeding our residents. This is unconscionable.
On top of abysmally low Medicaid reimbursements, Illinois has two separate property tax systems for nursing homes, one for Cook County and one for those in the other 101 counties. Every other county in Illinois recognizes that nursing homes are homes where vulnerable people live, and their property taxes are classified as such. It is a matter of fairness and consistency that nursing homes throughout the state be treated equally.
It is shameful the state has repeatedly walked away from our most vulnerable residents. By failing to act, the state has said “no” to adequate funding for Medicaid recipients. The state has essentially said “do more with less,” and we have, but there comes a point when stretching a dollar eventually tears it in two.
We are proud, as the leaders of this industry, of our efficiencies and our good management, but we are close to the breaking point. Many nursing homes are on the verge of closing because the state demonstrates negligence and has shirked its responsibility.
Medicaid reimbursement rates for Illinois nursing homes that care for low-income residents are just about rock bottom among the 50 states. That’s right, Illinois reimburses nursing homes like ours less than almost every other state in the country, all while providing the highest quality of care with these meager funds.
While we continue to fight for adequate funding for critical medical services provided to our residents on Medicaid, we know equitable health care coverage for the poorest is a long, hard fight. Indeed, we’ve been fighting for decades for adequate funding for our seniors and the disabled who call our facilities home.
We all wish our property taxes were the same as they were in 1999. We all wish eggs cost what they did in 2014, but wishes don’t pay the bills. Illinois has been seriously remiss in its obligations for decades, and the situation is dire.
It’s time for our state to step up, meet its obligations and properly fund nursing homes that care for the people who need us the most. Many nursing home residents cannot speak for themselves, so we are their voice. Let them be heard.
Monica Plymale is a licensed nursing home administrator at an Illinois nursing home. She has worked in long-term care since 1991 when she began her career as an activity aide.
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