‘It’s challenging’: Pandemic piles on financial problems for nursing home facilities

VERONA, Wis. – As pandemic restrictions are loosened for many businesses, one sector heavily impacted by the virus still has a long road ahead.

Prior to the COVID-19 pandemic, long-term care facilities such as nursing homes were already facing a challenging financial situation.

“It’s really difficult when you’re charged with taking care of these residents, providing the best care possible, and you can’t afford it,” said Lynn Howard, administrator and owner of Four Winds Manor in Verona, adding that additional safety measures such as personal protective equipment for staff and residents is often expensive and hard to find.

“Our focus is to keep (our residents) safe. They are the most vulnerable population,” Howard said. “That’s the last thing we want to do is have a virus come in that’s going to be devastating.”

The nursing, rehabilitation and assisted living facility is still restricting those who enter the building to staff members and emergency personnel. As of now, she’s unsure when that will change.

“It’s challenging,” Howard said. “It’s been very difficult for residents and families. A lot of families are used to coming every day.”

Zoom meetings, phone calls and window visits aren’t the same, Howard said, but what haven’t changed are financial challenges that existed before the pandemic. Because of the current Medicaid reimbursement rate, Four Winds Manor loses between $70 to $90 a day on each Medicaid resident — a figure similar for skilled nursing facilities statewide, according to John Vander Meer, president of the Wisconsin Health Care Association/Wisconsin Center for Assisted Living.

“We have the second worst Medicaid reimbursement in the country,” Vander Meer said, referring to the results of a recent national study.

He said with Medicaid patients making up about two thirds of the patient population in such facilities statewide, they each lose about one million dollars a year.

“When you add to that facilities are paying up to 500% increases in the cost of personal protective equipment or PPE, as well as more than double workforce costs, there are significant financial and operational challenges that facilities are facing in addition to obviously the clinical challenges they face in fighting COVID-19 on the front line,” Vander Meer said. “I think that whatever can be done to support the important work that they are doing on behalf of our state’s frail older adults and people with disabilities can and really should be done in these challenging times.”

While federal coronavirus CARES Act money has been made available for long-term care facilities, and last year the state budgeted a Medicaid reimbursement rate increase, Vander Meer and Howard said a long-term solution requires sustained payment reform.

“That’s where we really have to have people focus. Get that reimbursement back up where it needs to be,” Howard said. “We’re going to see an increase in the number of people needing the assistance through the Medicaid program. If we don’t see increases in that funding, I’m not sure. Where are they going to get the care they need?”