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Nursing Homes Fear Future Cutbacks

Tuesday, February 03, 2015
North Haverhill — Upper Valley nursing home administrators said they are wary of Gov. Maggie Hassan’s decision to pull back $7 million designated for New Hampshire nursing homes as part of a plan to balance the budget, because they fear the cut may herald further funding reductions in the future.

If this proposal succeeds, they said, what’s to stop it from happening again in the future.

“If the governor can go ahead and take this money, going against the legislature, what’s to stop her or the commissioner (for the Department of Health and Human Services) down the road to say we need another $10 million?” said Craig Labore, administrator of the Grafton County Nursing Home in North Haverhill.

The plan to reallocate the $7 million is part of a proposal to address a $58 million shortfall in the Health and Human Services budget.

William Hinkle, a spokesman for Hassan, said budget change is not a reduction in reimbursement rates; rather, the move would mean forgoing a planned increase in the Medicaid rate of reimbursement to the nursing homes.

“While the nursing home rate increase might be worthwhile, it would be hard to justify cutting other critical health services in order to pay for a rate increase ,” Hinkle wrote in an email.

Hinkle said the executive branch was forced to make reductions to comply with budget cuts initiated by the legislature.

“Those unspecified reductions mean that the Executive Branch has to cut funding for services that the legislature approved,” Hinkle wrote. “We have to make difficult but necessary choices to ensure a balanced budget.”

State Sen. Jeanie Forrester, R-Meredith, chairwoman of the Senate Finance Committee, said she opposes using the nursing home reimbursement rate to help paper over the department’s budget shortfall.

“It’s just very, very frustrating,” she said. “(We) made a promise to the nursing homes. They planned their budgets around it.”

A footnote in the approved budget states that funds remaining at the end of the year and designated for the state’s nursing homes should be carried over and applied to the following year, Forrester said.

The footnote states, “any balance remaining at the end of the fiscal year shall be paid as additional rates based upon the rate setting methodology in effect at that time.”

Forrester said the footnote was intended to protect the nursing home money from such a “raid.”

Forrester, whose district includes the Upper Valley communities of Haverhill, Piermont, Grafton, Dorchester, Orange and Orford, has proposed a bill that would restore the $7 million.

Asked where she would look to fill the gap in the Health and Human Services budget, Forrester suggested the state take back pay increases for state employees.

Forrester, however, said she wasn’t convinced there was a need for such a reduction at all because of the governor’s announcement last month of a $1 million predicted surplus in the state budget.

“I’m very skeptical about what’s going on; whether the need is really there to pull that money from the nursing homes,” Forrester said.

She predicted the cut — should it go through — would force nursing homes to eliminate staff positions or shift costs to county taxpayers.

Most of the patients who live in the state’s county nursing homes are Medicaid recipients.

For example, nearly 85 percent of patients in the Unity nursing home are Medicaid recipients, said Ted Purdy, administrator of Sullivan County Health Care, a nursing home in Unity.

Medicaid reimbursement rates were set on Jan. 1. Statewide, the new rates represent a 3 percent change over those set last July, Purdy said.

In Sullivan County, the decline in rates has meant a reduction of $5.35 daily, or $109,000 over the six months from January until July 1 when new rates will be set.

“(If the) $7 million that was appropriated (were to be) put back into the system for nursing homes, (it) would go a long way to recovering that 3 percent loss,” Purdy said.

Purdy said he was conservative in budgeting for this year and the $109,000 — $218,000 over the course of the year — reduction “should be fine.”

He doesn’t anticipate having to make any changes in staff as a result of this cut.

But county taxpayers, who now support the $13.2 million operating budget of the Sullivan County nursing home with approximately $1 million annually, could be forced to contribute a greater share of the nursing home’s cost, he said.

Forrester said she is hopeful that members of the public will write to the governor’s office to request the restoration of the nursing home funds.

“At this point we’re moving forward ... hoping that public pressure on the governor will get her to back off on this,” she said.

Nora Doyle-Burr can be reached at or 603-727-3213.

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