As work continues in Olympia toward adopting a new supplemental budget to fund day-to-day state-government operations, the state Legislature finds itself in the enviable position of having far more money than expected.
With a projected $2.4 billion surplus over four years, lawmakers have the chance to do something transformative for seniors — to save the skilled-nursing facilities that provide the level of care our aging parents and grandparents so desperately need.
Unfortunately, my friends across the aisle who control Olympia are about to let them down.
In the past three years, 20 nursing homes have closed statewide. In the last nine years, 10% of Washington’s skilled-nursing facilities have closed at a loss of nearly 1,100 beds. Only about 6% of the seniors in those facilities are considered “low-care.” The rest need a higher level of nursing care than many places, such as assisted-living facilities, are equipped to provide. And with an aging population, double the current number of beds will be needed by 2035.
The main reason for the closures? State Medicaid reimbursements for skilled-nursing facilities are dangerously low, and at any given time the rates are based on data that is as much as four years old. The amount of the deficit between actual costs and reimbursements is $116 million.
Chronically inadequate reimbursement rates mean facilities can’t pay the bills and must close their doors. This forces the tragic relocation of the residents they serve. Often, that disruption in care can be a death sentence. To stay open, many facilities no longer accept new patients who receive Medicaid. Those patients are simply left out in the cold.
Last July, like all of Washington’s lawmakers, I received an urgent letter from the skilled-nursing facility industry all but begging us to take action in the upcoming session to shore up the gaping chasm created by years of inadequate Medicaid reimbursements. After meeting with industry leaders, I was convinced we needed to do just that and authored Senate Bill 6396. My bill would have closed that gap quickly by requiring annual rate updates. Despite solid bipartisan sponsorship, the bill died in committee.
Instead, the majority party is taking a stopgap approach. It increases Medicaid payments, but only by less than 50% of what is needed, if you include federal matching funds.
It’s like trying to patch a chest wound with a Band-Aid.
To add insult to injury, the Legislature enacted a new business tax (Senate Bill 6492) that hits skilled-nursing facilities along with a long list of other businesses.
With a $2.4 billion surplus, we should do better. After raising us, paying a lifetime of taxes and building our communities, our seniors deserve proper care.
We don’t need to speculate about what will happen if the Legislature fails, again, to adequately fund skilled-nursing facilities: We likely lose another 1,000 beds and at an accelerated rate. Many nursing facilities are barely hanging on in the hopes that the Legislature will fill the $116 million hole this session. If the meager funding for these facilities in the Senate budget stands, the crisis will deepen.
Betsy, a skilled-nursing facility resident in my district who has had to relocate after a sudden facility closure, told me the experience is profoundly troubling and resulted in, “a lot of older people suffering needlessly. For what?”
Sometimes, as elected leaders, we are called on to make a tough choice. This is not one of those times. There is but one obvious choice. Adequately fund skilled-nursing homes now, or dozens more will close, and our seniors will be pay a terrible price for our failure.