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Maine's nursing home funding challenges to continue

Maine officials are relieved they found a way to provide the state's nursing homes with an additional $13 million but warn that a long-term strategy must be developed to aid the facilities in the nation's oldest state.

Officials hope the one-time money will stem the tide and prevent the closure of more nursing homes for now but emphasize that uncertainty remains as the state attempts to undo years of underfunding and grapples with a rapidly graying population.

"This problem is not over," Republican Gov. Paul LePage said Thursday. "This is bridge financing until we can get a better handle on what is the true cost of our nursing homes in the state of Maine and to get the appropriate funding in place."Meanwhile, the issue is certain to resurface in the campaigns with LePage touting his ability to find the extra funds and bashing Democrats for not hauling the Legislature back to fix the problem. Democrats counter that the governor is trying to use nursing homes to cover up what they call a damaging record on seniors' issues.

The new funds, together with legislation the Democrat-led Legislature passed last session, mean the homes will receive an additional $25 million in combined state and federal dollars in the fiscal year that began this month and $10 million over the two following fiscal years.

But officials say the problems in the long-underfunded homes won't be fixed overnight and having a long-term plan is vital in Maine, where the median age of 43.5 years is the highest in the country. Maine will see a 58% increase in residents age 65 to 74 and a 42% hike in ages 75 to 85 by 2022, said Mary Mayhew, commissioner of the Department of Health and Human Services.

Democratic House Speaker Mark Eves of North Berwick, who's leading an initiative on Maine's elderly population, said part of a long-term solution must be improving resources like transportation and in-home care that can help seniors live in their own homes longer.

"While this is kind of a Band-Aid over something much bigger, we need to have a strategy as a state to make sure that we are ready," he said. "This is nothing compared to our future if we can't keep people in their communities and in their homes."

Rural nursing homes in Maine have fared the worst, mainly because they have a higher percentage of residents covered by Medicaid. While it costs about $200 a day to provide long-term care, nursing homes are reimbursed only $180 for Medicaid residents, said Richard Erb, president and CEO of the Maine Health Care Association. That has forced homes to shift the burden onto private-pay residents and cut costs by delaying maintenance or nixing staff raises.

In addition to the increased funds, the state will also begin to regularly update reimbursement rates to reflect the facilities' more recent costs and provide enhanced reimbursements to facilities with a high percentage of Medicaid residents. A commission will examine other policy ideas, like a program that rewards nursing homes that are performing strongly.

Two homes have already announced that they plan to close in the coming months. Erb said that because the amount each home will receive varies, it's tough to say what impact the new funds will have on other homes now on the verge of closing their doors.

"But we are hopeful that this will make a difference," he said.
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