Healthcare Compliance Perspective:
In situations of financial distress, it is important to remember that creative marketing strategies which target Medicare beneficiaries or providers, create risk of violating the Federal Anti-Kickback Statute. The Anti-Kickback Statute prohibits offering to pay remuneration of any kind in exchange for referrals.
Medicaid reimbursement rates that are not keeping up with the costs involved in providing care may be the reason for the growing number of Wisconsin nursing home closures according to some nursing home providers. The Wisconsin Department of Health Services (WDHS) recently reported that ten, long-term care facilities closed in 2017 compared with six that closed in 2016.
The executive director for the Wisconsin Health Care Association says that an average long-term care facility experiences a loss of about $1 million per year in connection to the Medicaid residents they serve. Specifically, nursing homes in Douglas County lost $2.3 million and the only nursing home in Bayfield County lost $811,00 from 2015 to 2016.
While the Bayfield County Administrator indicated that providers would like a 5 percent increase in the reimbursement rate, the current state budget will be increasing the reimbursement rate for skilled nursing facilities by 2 percent annually. Providers are worried that a growing population and lower reimbursements together are cause for concern that more nursing homes will be closing. In addition to the losses being experienced, the reimbursement rates are making it harder for facilities to find and retain workers. One industry survey taken in 2016 of almost 690 providers across the state found “11,500 unfilled caregiver positions.” Providers are finding it difficult to compete with the wages paid by convenience stores, big box retailers and fast food services.
The WDHS has initiated what it calls, “the WisCare Caregiver Career Program” in response to the shortage of Certified Nurse Aides (CNAs), and involves an investment of $2.3 million to help providers attract and retain about 3,000 CNAs.
