Louisiana nursing homes will get higher payments from state

BATON ROUGE, La. — Louisiana lawmakers are allowing a change to the payment formula for the state's powerful nursing home industry that will boost their bottom line, despite objections from groups that advocate for more at-home services for the elderly.

The Advocate reports the chairmen of the House and Senate health care committees don't plan to hold hearings on the payment changes planned by the Louisiana Department of Health. Without legislative intervention, the new regulation goes into effect Dec. 20.

The rule adjusts the complex formula used to determine how much each of the approximately 260 nursing home operators receive through state and federal Medicaid financing to take care of their residents. The change will increase the square footage allowed for many nursing home rooms.

That will give nursing home owners about $6 million more each year. The facilities, which are large campaign contributors and carry considerable political sway in Louisiana, already receive about $1.2 billion annually in state and government funding.

The Louisiana Nursing Home Association requested the rule change, telling the state health department the new reimbursement rate will update a 19-yearold formula to encourage operators to renovate their facilities for more single occupancy rooms.

Opponents argue the money would be better spent providing seniors with services that allow them to stay at home, rather than leaving institutionalization as the primary choice for care.

House Health and Welfare Chairman Larry Bagley, a Republican from DeSoto Parish, said he received a lot of correspondence opposing the proposed changes. But he said he felt nursing homes had been pressed by lawmakers to provide more and larger single rooms for their residents, particularly given the need for social distancing during the coronavirus pandemic.

“If we don’t use that rule, that money isn’t necessarily going to be spent on community care,” Bagley said.

Sen. Fred Mills, the St. Martin Parish Republican who chairs the Senate health committee, said he supports the reimbursement change.

"I can see the opponents’ standpoint, and I understand the money issues. But the policy has been, for years, to increase the square footage,” Mills said. “I thought the explanation from the nursing home standpoint made sense.”

Disability Rights of Louisiana told the health department it was “concerned that putting more money in nursing homes is taking the state in the wrong direction.” AARP Louisiana Executive Director Denise Bottcher wrote House Speaker Clay Schexnayder, asking for his help in scheduling a hearing on the rule to no avail.

“We believe it is shortsighted to allocate the states’ limited resources to provide for nursing homes, which will only make the cuts that fall on other critical services more severe,” Bottcher said.

She said more than 11,000 individuals are waiting for an opportunity to receive long-term support and services at home, rather than in a facility. The state's increased payments to nursing homes would help 200 people stay in their own homes, she said.

“It would seem to be more appropriate to spend that money on serving people rather than paying for square footage,” Bottcher wrote Schexnayder.