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Proposed Medicare Cuts Put Seniors’ Care at Risk

Despite the fact that we in the long-term care profession strongly support the broader effort by Congress and the administration to increase every Americans’ access to affordable, high-quality health care, it is essential we achieve this desirable objective in a fair and equitable manner. Ensuring America’s most vulnerable seniors and the care staff they depend on are not hurt in the complex process of actually passing a bill into law must be integral to the effort. [IMGCAP(1)]At this juncture of the health care reform process, we are concerned that deep cuts to Medicare beneficiaries’ nursing home funding will place seniors’ care needs at risk and put the jobs of almost 60,000 caring employees who make a real difference in care quality in jeopardy. Under proposed reform legislation now pending in the House, Medicare funding for senior care in nursing homes that provide skilled nursing and rehabilitative care would be cut by $32 billion over 10 years. This is on top of the $12 billion in Medicare funding cuts over 10 years just enacted by the Centers for Medicare and Medicaid Services.From a broad-based policy perspective, nursing homes are caring for an increasingly diverse patient base and providing a greater variety of acute care and rehabilitative and convalescent services that cannot be delivered elsewhere. These are the very services our patients depend on in order to recuperate and return to their homes — a central objective of every facility. These massive proposed funding cuts would thus undermine our ability to effectively treat this more medically complex patient population and undoubtedly place at risk the quality care our patients require.The Medicare funding cuts already put in place by the CMS coupled with proposed cuts in the pending House health care reform legislation would slash Medicare funding by $44 billion nationwide during the next 10 years, with 15 states facing a cut of $1 billion or more, according to a new American Health Care Association analysis. Seniors’ care in just the five states of California, Florida, New York, Texas and Ohio will suffer cuts of more than $15 billion alone over 10 years. While unfortunately the broken long-term and post-acute care systems now plaguing seniors and providers alike are not remedied in the current reform proposals, our profession was proud to put forward at the beginning of the reform process a sustainable, patient-centered, cost-effective proposal.When scored in a responsible, Congressional Budget Office-like manner, our Long-Term and Post-Acute Care Financing and Coverage Reform plan would have saved $35 billion in the first 10 years of its enactment into law. Protecting the care of our nation’s frail, elderly and persons with disabilities — and the jobs of those who care for them — must remain a top priority for Congress when it returns in September to tackle health care reform. The bottom line is that U.S. seniors’ Medicare-funded nursing home care will be substantially undermined by the pending House health care reform bill.Arguments that the House bill will not actually reduce seniors’ benefits ignore the hard and fast fact that when Medicare cuts provider reimbursement, providers, in turn, are forced to cut staff because labor expenses comprise 70 percent of facility costs. Cutting staff within any facility has a direct, immediate, negative impact on patients and their care.While stable Medicare funding for nursing home care is already important when taken in isolation, it becomes particularly vital when considering the chronic Medicaid underfunding for skilled nursing care — with seniors in many states having already endured or soon facing substantial funding cuts as a result of recent state legislative actions. Medicare and Medicaid funding are inextricably linked, and the combination of cuts to both programs squeezes local facilities in a manner that is harmful to beneficiaries’ care needs, our local economies, and the caregiver jobs base.The long-term care sector supports and is well-positioned to help the Obama administration and Congress advance the systemic health care reforms we all know are necessary. However, the need to ensure stable, adequate Medicare funding must be a key part of any final health care reform bill so as to ensure seniors continue to receive the quality care they are accustomed to, and which they so clearly deserve.Bruce Yarwood is president and CEO of the American Health Care Association in Washington, D.C.

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