Skilled Nursing Must-Reads: Lawmaker-Owned Operators, VA Rankings

In a week that saw more evidence of occupancy pressures for operators, smart assistants helping employees multitask at a New York skilled nursing facility, and a mixed outlook for the new therapy payment system, here are some stories that you may have missed along the way.

Conflicts of Interest Among Lawmakers Who Own Nursing Homes

An investigation into conflicts of interest among Louisiana lawmakers revealed that some elected officials in the state attempted to pass legislation friendly to the nursing home industry — despite having a financial stake in nursing properties.


State Rep. Bob Hensgens, a Republican, drew heat for sponsoring a bill that would have continued to prevent assisted living facilities from providing nursing care, according to the investigation by ProPublica and the (Baton Rouge, La.) Advocate. In addition to his role in state government, Hensgens is also a nursing home administrator.

He told ProPublica and the Advocate that the state didn’t have the regulatory manpower to supervise the expansion of nursing care in assisted living facilities, and pointed to the relatively small number of such buildings in Louisiana; that bill eventually died without a hearing, but a state senator with a 10% ownership stake in a nursing home attempted to introduce a similar piece of legislation.

“When Fred Mills tacked on that amendment again, we just came unglued again,” assisted living facility owner Terry Crochet told the journalists. “These people should at least recuse themselves and not directly vote on things that affect their pocketbooks.”


VA Releases Nursing Home Rankings

The Department of Veterans Affairs released a public database of its nursing home rankings this week, with the government agency claiming that the level of care closely tracks with the services provided at private SNFs.

The VA’s press release took a swipe at the previous administration, asserting that President Trump has created a more transparent department than President Obama.

“Now that VA has made a commitment to reporting accurate quality and comparative data on its nursing homes, we are pleased to begin adding that important information to our transparency portfolio for the benefit of veterans in making their health care decisions,” acting VA secretary Peter O’Rourke said in a statement.

The VA operates 130 nursing homes across the country, admitting any eligible veteran who requires care. The department noted that the VA’s roster of SNFs has a lower percentage of one-star facilities — as defined by the Centers for Medicare & Medicaid Services — than the general pool of more than 15,000 privately operated buildings.

New Jersey Operators Call for More Medicaid Funding

Echoing complaints in other states, nursing homes in New Jersey are asking lawmakers to boost Medicaid reimbursement rates.

Garden State skilled nursing facilities spend about $256 per day on Medicaid residents, according to statistics from the New Jersey Health Care Association presented in an NJ Spotlight story, but receive just $201 from the state’s Medicaid program. In addition, long-term care accounted for about 2% of the total Medicaid population in the state in 2015, but generated 21% of the costs.

“Nursing homes were the most expensive aspect of this care, with an average cost to Medicaid of more than $62,000 per person at that time,” NJ Spotlight observed.

A new bill working its way through the state legislature would task the state’s Department of Human Services to review its Medicaid reimbursement levels and potentially adjust them accordingly.

The Garden State isn’t the only place where nursing home operators find themselves losing money on Medicaid patients: Non-profits in Texas, for instance, have blamed closures on insufficient Medicaid reimbursements, while Montana operators recently sued the state in an attempt to curb funding cuts to the program.

Despite popular conceptions, Medicaid is by far the largest payer for skilled nursing services nationwide, covering 62% of all residents.

Written by Alex Spanko

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