As nursing home closures displace residents across the country, state legislatures are scrambling to place stopgaps for operators, their residents and families facing access issues.
The two bills introduced in the Montana legislature last week both stem from closures in the state – 11 in the past year, which is about 16% of the state’s nursing homes.
And Montana isn’t alone. Iowa saw 19 nursing home closures since 2022, with five more slated to close this year. Meanwhile, the Centers for Medicare & Medicaid Services (CMS) in February said that 135 nursing homes have closed their doors in 2022, with Texas and Nebraska with the most closures compared to other states.
The first piece of Montana’s proposed legislation, House Bill 891, will help nursing homes backfill financial losses for the current fiscal year. This bill is sponsored by Rep. Jennifer Carlson (R-Churchill) and would issue $40.9 million to nursing homes in the state, $14.9 million from the state’s general fund and $47 million in federal dollars.
Legislators have also considered a per diem Medicaid reimbursement of $279, linked to the number of Medicaid beds filed in the fiscal year, a national consultant’s recommended per diem, subtracting one year of inflation, according to a report from the Daily Montanan.
Any sort of Medicaid rate increase wouldn’t take effect until the summer, hence the backfill legislation in the meantime. There doesn’t appear to be any stipulations on how nursing homes should spend the money, unlike other states that have tied Medicaid rebasing to staffing levels.
HB 899 will provide funding to help communities and families already affected by nursing home closures, up to $1,000 for moving expenses related to closures. Community organizations or nonprofits could also apply for up to $25,000 to reopen facilities that were in operation between July 1, 2021 and closed before July 1, 2023, according to the bill.
One of the bill’s stipulations include forcing community organizations reopening a facility to make 40% of beds available to people on Medicaid.
In total, the bill will appropriate $850,000 for individual grants and $300,000 for communities trying to reopen facilities. Legislators arrived at these amounts based on the number of lost beds – 857 – noted in the Daily Montanan article.
Rep. Paul Tuss (D-Havre), sponsor of HB 899, said during the state legislative session that a loss of jobs due to nursing home closures was also a big factor in drawing up the bill. Tuss used Hi-Line Retirement Center in Malta as an example, where 40 jobs were lost in a town of 1,300 to 1,400 people.
The devastation of a nursing home closure has been felt more in rural or small market settings, where the nursing home is often one of the largest, if not the largest employer in town.
Towns such as these tend to have older age demographics, and when the nursing home workforce leaves, there isn’t much of a community left, CliftonLarsonAllen’s (CLA) Cory Rutledge said in a previous interview.
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