The elderly in our nursing homes have a problem. The state puts people on Medicaid and promises them services, then fails to pay those who provide those services at a rate commensurate with actual costs. Seventy-five percent of the people in our nursing home are on Medicaid and down to their last $2,000.
Valley View, a non-profit care home in Glasgow did quite well in 2019 and 2020. Then around mid-2021 it hit. We were facing many new regulations with no funding, COVID outbreaks that required quarantine and meant we couldn’t accept new residents, families that didn’t want to quarantine their family members, a severe shortage of nurses and other staff and agencies who charged us three times the normal traveling nurse salary and sometimes tried to steal the nurses we had.
The ultimate mistake made that will need to be corrected in the next legislative session is the $0.65/day increase in the rate that Medicaid pays by the state to nursing homes, which received less than 1% of rate increase during a pandemic while caring for the most vulnerable Montanans. A similar rate increase of 0.3% is scheduled for July 1 — less than 1% over a 2-year period. These tariffs are what these facilities depend on to operate on a day-to-day basis.
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Mistakes happen, good! That’s why the state of Montana has reserves of $400 million. When I was in the Legislative Assembly, we always had a bill to cover extra expenses for fires, disasters, cost overruns in our prisons, and any other crisis that arose between sessions. This money was approved by the Governor, and the Legislature approved it in the following session. Our reserves at Valley View will be gone by mid-summer.
We have had donations and received money from the county, but that will not be enough. Valley View and other nursing homes are looking at what the closure will look like and the costs involved. All state aid related to COVID ended in October, but COVID has not ended. We are in the third year of high costs, declining revenues and severe labor shortages. Governor Gianforte was the most disturbing. He sells himself as a businessman, which is why he got my vote. ARPA labor funds are readily available to help recruit and retain workers, but his answer was no. His answer to this nursing home problem is to do nothing. A current example of doing nothing is the mess on the southern border. This shows us what doing nothing looks like. You do nothing wrong, you do nothing. A businessman who has run a business for a short time may think this makes sense, but by not helping short-term cash during a crisis, it often costs more in the long run. If many of the more rural care homes are closing, it’s because they don’t have short-term help. Then we will need places for the elderly, so the government will spend a lot of money to build old people’s homes in the big cities. Tens of millions of dollars spent in a short-term crisis will save hundreds of millions of dollars in future spending.
Now is the time for the Governor and my Republican legislative friends to do something. Let’s prove that we can not only create new businesses, but also keep old nursing home businesses running. And maybe caring for our elderly can be considered one of those “high-paying jobs” worth training for and having.
Daryl Toews is a former Montana State Senator and Valley View Home Board Member.