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Patrick Springer, Published December 25 2009

Nursing homes hope to tap health care bill

North Dakota nursing homes hope they can get reimbursement adjustments similar to those slated for hospitals and clinics as the U.S. House and Senate reconcile their versions of health reform.

Shelly Peterson, president of the North Dakota Long Term Care Association, said she has told Sen. Byron Dorgan, D-N.D., that she hopes the “frontier states” amendment also can apply to nursing homes.

“We are hoping that when the bill goes to conference that our senators and representative will assist us with maybe some relief,” in the negotiations between House and Senate, Peterson said.

Dorgan and Sen. Kent Conrad, D-N.D., have said the so-called “frontier states” amendment, which includes both Dakotas, Wyoming and Montana, will increase Medicare reimbursements to North Dakota hospitals and doctors by $650 million over 10 years.

North Dakota’s nursing homes must deal with disparities in Medicare reimbursements that are similar to those for hospitals and clinics, Peterson said.

North Dakota’s average reimbursements are the lowest in the nation at $92 per nursing home resident per month below the national average, she said. Montana, the second-lowest state, has average monthly per-resident payments $22 above the average for North Dakota.

Conrad said Thursday he’s aware of the situation, and that he and Dorgan want to “get our nursing homes better treatment in the final legislation.”

Conrad added that the cost to add funding for nursing homes would be “modest,” compared to the annual provisions of $52 million to hospitals and $16 million a year to doctors, which the frontier states amendment calls for.

Grant Richardson, a senior executive at Bethany Retirement Living in Fargo, said Medicare and Medicaid funding through fiscal 2010 will remain adequate, based on the latest communication from its national association.

“I think the Senate bill is looking pretty good, based on what I know,” he said, adding that health reform remains in flux. “Regardless of what happens, we’ll have to deal with it.”

John Riewer, president of Eventide Senior Living Communities in Moorhead and West Fargo, said a reform provision that provides for long-term care insurance could be a significant boost to nursing homes when baby boomers start turning 75 and older.

“That’s when we’re going to notice a huge drain on resources to take care of all those folks,” he said.

In Minnesota, Medicaid payments for nursing home residents are underfunded by an average of $25 per day per resident. That loss must be offset by federal Medicare funds, Riewer said.

North Dakota’s 84 long-term care centers have an average operating margin of 1.9 percent, or $46,000 per year, Peterson said.

Forum reporter Kristen M. Daum contributed to this report

Readers can reach Forum reporter Patrick Springer at (701) 241-5522