Crisis in Long Term Care
Minnesota’s Seniors Public Policy Issues
Toby Pearson, Vice President of Advocacy, Care Providers of Minnesota
Heidi Holste, Director of Government Affairs, Care Providers of Minnesota
Kari Thurlow, Vice President of Advocacy, Aging Services of Minnesota
WHO WE ARE
The Long-Term Care Imperative is a collaboration of Aging Services of
Minnesota and Care Providers of Minnesota, two of the state’s largest
long-term care associations.
The Long-Term Care Imperative is committed to advancing a shared
vision and future for older adult housing, health care and supportive
services.
Supporting the Economy
LTC Supports $6.7 billion in Economic Activity
Economic Impact of Long Term Care Facilities for Minnesota Prepared by the Lewin Group for AHCA-NCAL
Powering the Workforce
LTC Contribute to Approximately 112,600 Jobs
Economic Impact of Long Term Care Facilities for Minnesota Prepared by the Lewin Group for AHCA-NCAL.
The Payment Gap
Projected 2012 Nursing Facility Shortfall Between Medicaid
Reimbursement and Allowable Medicaid Costs (Per Patient Day)
Minnesota vs. North Dakota
The annual cost of eliminating the shortfall to the State would be $78.5 million.
Information and data on Shortfalls in Medicaid funding based on Report Prepared by ELJAY, LLC FOR THE AMERICAN
HEALTH CARE ASSOCIATION
Nursing Facility Rebasing
Unallottments, Suspensions, and Repeal (State Savings)
Source: Long Term Care Imperative 2013
% of Nursing Facilities at Risk of Closure
(Operating Margins of -5% or Worse)
Approximately 85
Nursing Facilities in
MN are facing a
financial crisis, placing
more than 12,000 jobs
at risk.
Northwest 21.1%
Northeast 45.0%
West Central 20.8%
East Central 29.4%
Legend
=<15%
=15%-25%
=25%-35%
Metro 8.2%
=>25%
Southwest 23.7%
Southeast 32.7%
LTC Imperative 2011 Nursing Facility Financial Survey Prepared by CliftonLarsonAllen LLP
The Wage Gap
Senior Living Workers Underpaid in the Marketplace
Gap=$17.39 per hour or $36,171 per year
Gap=$15.77 per hour or $32,802 per
year
Gap=$2.07 per hour or $4,306 per year
Gap=$1.81 per hour or $3,765 per year
Gap=$5.79 per hour or $12,043 per year
Gap=$6.13 per hour or $12,750 per year
Sources: 2011 LTC Imperative Salary Survey and 2011 MN Health Care Cost Information Service Hospital Salary Data
The Worker Gap
Estimated Number of Selected Vacant FTE Positions in Minnesota’s
Nursing Homes
Source: Long Term Care Imperative 2013 Legislative Survey
The Worker Gap
Vacant FTE Positions as a Percent of Budgeted Positions in Minnesota’s
Nursing Homes
Source: Long Term Care Imperative 2013 Legislative Survey
Losing Workers
Employee Retention Percentage Declined in Care Centers
Source: DHS Nursing Home Cost Reports (2011)
Staff Turnover
Source: American Health Care Association, LTC Trend Tracker
Nursing Home Costs Without the Elderly Waiver Program
Elderly Waiver Program Saved State Up To $275 Million in 2010
Decrease due
to increased
Federal
Match
Source: DHS Spending Forecast November 2010
Rate Changes
Nursing Facility and Elderly Waiver/Customized Living
Assisted Living (Elderly Waiver
Customized Living)
Nursing Facility
• No base increase in last four years
• In 2011, 70 low rate homes received increases of up
to 2.45%
• In 2012, 7 homes were designated “critical access”
and received rate increases
Source: LTC Imperative 2012
2013 Legislative Proposal
Nursing Facility and Elderly Waiver Rate Increases
Employees
Quality
• 3% rate increases for nursing • 2% rate increases for both nursing
facilities and EW is targeted to
facilities and EW providers to
cover increases in
develop new quality improvement
compensation and other
efforts.
operating costs, including
– Nursing facility increase to
wages, benefits, recruitment
focus on Advancing Excellence
and new staff costs.
– EW is targets toward
– 1% of these increases is to
implementing a new quality
address workforce needs
improvement program.
such as staff training and
retention.