Harbor Haven grapples with Medicaid reimbursement – Fond du Lac Reporter
FOND DU LAC – The Fond du Lac County Board gave the Harbor Haven Health & Rehabilitation Center, the county’s nursing home facility, more than $400,000 to balance its budget earlier this month.
About $677,000 from the county general fund was given to a dozen departments with overdrawn budgets, and Harbor Haven received the largest amount: $462,493.
Harbor Haven administrator Mark Radmer said the overage resulted from a $650,000 loss of revenue needed to pay for services and employee salaries. A recent remodeling project had an impact on the number of residents the facility serves, and on the amount of revenue received.
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The $2.9 million remodeling project, finished recently, included the creation of 39 private resident suites, modernizing 23 semi-private rooms, spa rooms with a state-of-the-art whirlpool bathing system and a restaurant-style dining room. The living spaces were meant to offer a “true sense of home,” Radmer told USA TODAY NETWORK-Wisconsin in 2016, each with its own flat-screen television, telephone and Wi-Fi access.
“It’s not only an issue of those beds not being in service where the construction is happening, it’s also taking residents from other portions of the building and putting them in beds that they would otherwise not be,” Radmer said at the April County Board meeting. ”Then you have a scenario where you cannot have a new customer in that bed because it’s being utilized by one of our existing residents.”
The remodel resulted in a reduction of beds from 117 to 85, adjusting for the decline of people living out their final years in a nursing home and a rise of in-home care. Currently, residents are using 80 of those 85 beds, Radmer said.
While the construction impacted the amount of revenue, Radmer told the board that the main issue was the low Medicaid reimbursement rate. Harbor Haven is a Medicaid and Medicare-funded facility, with most long-term residents enrolled in the Medicaid program. The cost to provide services outweighs what the facility receives for reimbursement from the Medicaid program.
Harbor Haven lost $56.44 per Medicaid resident per day, totaling $1.4 million in 2015-2016, Radmer said. While services cost $215 dollars a day, Medicaid reimburses Harbor Haven $154 per day.
Radmer said the governor’s budget gives a two percent increase in Medicaid funding, which would give the nursing home a two- to three-dollar reimbursement rate increase per day. He is appreciative of the support, but said it’s only one step in the right direction.
“What’s really needed, and this is the long-term solution, is Medicaid reform,” Radmer said. “Reimbursement reform for our industry because our industry for years through one means or another has been underfunded.”
The County Board also passed a resolution requesting that the state Legislature increase nursing home Medicaid funding in the 2017-2019 budget, citing that 65 percent of nursing home residents in Wisconsin are Medicaid recipients and an average nursing home in Wisconsin loses about $55 a day for care of one Medicaid resident.
“We want to ensure that the governor and other legislators are going to preserve (Medicaid funding) because there are a lot of providers, a lot of not-for-profit and county providers that have done a lot work in bringing this to people’s attention, how underfunded Medicaid is, particularly in the State of Wisconsin,” Radmer said.