The nursing home last year had an operating loss of $800,000, but this year that loss is expected to be much less, about $200,000 to $250,000 which includes money owed to Medicaid, he said.
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“When I say an operating loss that really is not quite fair to the Care Facility,” Young said. “There are some prior year obligations related to Medicaid that have to be repaid… We expect the actual operating margin for this year to be somewhere between $100,000 to $150,000 negative, but next year we expect to at least break even.”
The facility’s new Administrator Jennifer Strickland said as part of the Affordable Care Act, Medicaid started doing audits of payments made to nursing homes from previous years. If a facility can’t for some reason provide adequate documentation for a particular reimbursement, the government asks for the money back.
“In most cases it is definitely not a case where the facility has done anything wrong,” she said. “It’s just an effort to recoup as much money as possible.”
She said they are now working through about $114,000 worth of services the home provided, that Medicaid is now questioning. Now that the home has electronic records, Strickland said this problem should eventually resolve itself.
In December, commissioners had to loan another $225,000 to the facility so payroll could be met through the end of 2016. That brought the Care Facility’s outstanding bill up to $750,000, just below a previous loan amount of $1.1 million.
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The 109-bed facility is one of 31 county-run nursing homes left in Ohio. The nursing homes were mandated in all 88 counties when the first facility was built in 1830 to serve the infirm, poor and homeless. Many of the facilities closed after the state legislature lifted the mandate and counties opted to let the private sector handle nursing care as government budgets shrank.
With Medicaid rates and regulations on a virtual roller coaster through the years it has been difficult for the home to stay afloat without help from the general fund. Commissioner T.C. Rogers sees the latest Medicaid rule as one of a series of unfunded mandates that make local governing very difficult.
“We get funds from the state, then they change the program and we’re still supposed to continue the same services without the funds there were before…,” he said. “We just need rules which are maintainable for a specific period of time.”
He said in years past they have successfully gotten the Medicaid bill lowered and they are hoping the same this year.
Young said in two weeks the commissioners will be asked to consider forgiving the $750,000 debt completely. The latest transfer wasn’t a loan so it won’t have to be repaid to the general fund.
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