Nursing homes in Maine are struggling, and they need help. But they don’t need it so badly that the state should rush forward with aid in a way that might backfire.
At issue is a bill providing $1.4 million over two years to increase pay at nursing homes and long-term care facilities through MaineCare, the state’s Medicaid program.
The spending was included in the budget, and the bill passed in the Legislature and was sent to the desk of Gov. Janet Mills, who is holding it until concerns are resolved over whether the spending would violate Medicaid rules and jeopardize federal matching funds.
Mills’ hesitation drew condemnation earlier this week from state Republicans, who said they couldn’t understand why the governor wouldn’t sign the bill. On Thursday, House Republicans said they think Mills made an “honest mistake” and she should correct it.
Thankfully, this isn’t 2014, when cynical politics and animosity between Gov. Paul LePage and legislative Democrats delayed much-needed funding for nursing homes for months.
In this case, there is no reason to believe that Mills is holding back on the bill for anything other than her stated reason. The bill came from a fellow Democrat — Senate President Troy Jackson, who was hardly perturbed by the delay — and Mills herself put in the budget an additional $8.5 million to help nursing homes. Unlike LePage, she has no history of acting capriciously toward the legislative process.
What’s more, since it became clear there is crisis in the Maine nursing home industry, it has largely been Democrats who have been leading the way in pushing for additional funding.
Republicans might not be the only ones saying Mills is being too cautious; the president and CEO of the Maine Health Care Association, which represents more than 200 long-term care facilities and nursing homes, says the governor is misinterpreting the law.
However, if the governor’s office has reservations, Mills is right to take a moment and get it right. There’s no reason to approve funding now if it’s only going to cause the state more problems later. It appears the matter can be settled without detriment to nursing homes when the Legislature returns.
However it comes out, the bill won’t be the last word on Maine nursing homes. About three-quarters of their funding comes from MaineCare, whose reimbursements don’t cover the full cost of care. When a Calais nursing home shut down in 2012, raising alarms, it was losing about $20 per day per resident.
Since then, labor costs have outpaced inflation. Legislators in recent years have increased reimbursement rates temporarily, but the economics continue to work against nursing homes — a total of 12 have shut down since 2012, including six in 2018.
Meanwhile, demand for long-term care in Maine is only going to increase. In 2016, Mainers over the age of 65 made up 19 percent of the population; by 2030, they will account for nearly a third of residents.
Most of them will need long-term care at some point. The majority will pay through MaineCare. If the economics of long-term care don’t improve, there simply won’t be enough places to care for them all.
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