Officials address nursing home payment model, staffing shortages | Illinois

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(The Center Square) – The COVID-19 pandemic highlighted the dangers posed by overcrowded and understaffed nursing homes in Illinois, and now a state agency is calling for reforms.

The Department of Healthcare and Family Services has issued recommendations that include an increase in funding, whether from general funds or generated from an enhanced nursing home assessment, to be used to improve safety and quality for residents.

HFS reports the agency began meeting with representatives from the nursing home industry more than 18 months ago to discuss changes to the nursing home payment rate methodology. The discussions centered on the transition to the Patient-Driven Payment Model used by Medicare, as well as to trying nursing home payments to staffing.

At a House subject matter hearing Wednesday, HFS Medicaid Administrator Kelly Cunningham said the department is hopeful lawmakers can authorize a patient-driven payment model by January.

“The issues we are dealing with are urgent, continuation of the status quo is not acceptable, and we must hold long-term providers across Illinois to a higher standard,” Cunningham said.

Compared with other states, Illinois consistently ranks last in terms of nursing home staffing.

HFS Deputy Director Andy Ellison said the industry must address the worker shortage.

“And one of the ways to do that is to make it a more of a profession, to give it a pay scale, to allow for promotion, to provide a payoff for staying with it,” Ellison said.

Among the 689 Skilled Nursing Home Facilities (SNFs), HFS reports nearly half of for-profit facilities are understaffed, and high-Medicaid for-profit facilities comprise 95% of all understaffed facilities in the state.

The agency recommends introducing significant nurse staffing payments tied directly to a facility’s needs-adjusted staffing level and pay Medicaid’s share of substantial wage increases for Certified Nurse Assistants.

HFS officials also said they are hopeful Illinois can direct funds from the American Rescue Plan to nursing homes to help protect residents and staff from the next COVID variant or another virus.

HFS serves roughly 45,000 Medicaid customers who are nursing home residents across Illinois.

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Caleb Alexander

Caleb Alexander

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