ELLSWORTH — U.S. Rep. Bruce Poliquin (R-Maine) was in town Aug. 10 to explore issues facing nursing facilities in the state.
Poliquin met with Ken Huhn, administrator at Seaport Village Healthcare.
Huhn had invited Poliquin, who is in the midst of a re-election bid for Maine’s 2nd Congressional District.
“Let me put my arms around this again,” said Poliquin. “At the state level, the cost of labor because of minimum wage increases is putting a squeeze. At the federal level, it’s the cost of regulations putting a squeeze.”
“It’s a squeeze from the top and the bottom,” Huhn nodded.
The crisis in caring for Maine’s seniors is not new. Last week, two nursing homes — one in Patten and one in Jonesport — announced that they would be shutting their doors, leaving dozens of residents scrambling to find housing.
Both facilities cited low MaineCare reimbursement rates as part of the reason for their closure.
MaineCare is Maine’s version of Medicaid, which provides insurance for low-income residents. The program is jointly funded by the state and federal governments.
In a statement after the meeting, Poliquin said he planned “to push reforms to lighten the heavy paperwork burden faced by our nursing homes and will do everything I can for those in need of this critical care.”
Asked whether he would support increasing reimbursement rates, Poliquin said, “In addition to the minimum wage increase, falling occupancy and a shortage of nurses, all of which have put pressure on our nursing homes in Maine, lower reimbursement rates is an issue and I will fight for fair reimbursement rates.”
Poliquin expressed surprise at the low reimbursement rates on Friday as Huhn explained the payment structure.
The economy, Poliquin said, is also part of the picture. “Running any business is easier when the economy is stronger,” he said.
The two-term representative has questioned MaineCare in the past, opposing its expansion.
“We need to be honest about how Medicaid is an open-ended program with no budget which continues to grow beyond the taxpayers’ ability to pay for the health care benefits,” Poliquin said in a 2017 statement. “It’s simply not sustainable.”
It cost around $321 per day for a private room in a Maine nursing home in 2017, according to CareScout, which conducts yearly cost-of-care surveys across the United States. There are other options — adult day health care, semi-private rooms, a home health aide — but even the least expensive is over $100 per day.
And costs for care are steadily rising. Rates for every single care option increased between 2016 and 2017, according to Genworth, an insurance company that supports the CareScout survey.
Yet reimbursement rates for MaineCare, said Huhn, hover at an average of $189 per bed per day. Medicare, by contrast, pays out $450 per day. And with around 70 percent of Seaport Village Healthcare’s revenue coming from MaineCare, Huhn said, low reimbursement rates are a big problem.
The rates have risen in recent years, said Rick Erb, president and CEO of Maine Healthcare Association (MHA), in a separate interview. The state spent $261 million of MaineCare funds on reimbursements to nursing facilities in 2016, according to the Department of Health and Human Services, up from $197 million in 2011. But this has still not kept pace with labor costs, Erb said.
Huhn told Poliquin the same on Friday.
“I happen to think that raising the minimum wage is a positive thing,” said Huhn, to which Poliquin nodded emphatically. “But that doesn’t help me when all of my people are getting raises and no increase in reimbursements.”
Brenda Gallant, executive director of the nonprofit Maine Long-Term Care Ombudsman Program, which advocates for seniors and their families, acknowledged that labor costs are part of the reason overall costs have risen.
“It’s very complex, difficult work and it’s very demanding,” she said. “In a good economy, when there are other jobs available that pay more and are less demanding it’s difficult to attract staff.”
Maine also has higher staff-to-patient ratio requirements than many other states, which Gallant said could account for some of the high labor costs. But, she said, this is also a reason the state is consistently highly rated for quality of care.
“By and large, Maine nursing homes are better, their deficiencies are fewer, and that has historically been because Maine has higher staff standards,” Gallant said.