Letter from the CEO in the Sunshine Times Feb.-March 2019

We need your help!

Every two years the Governor, Senate and House produce a State budget together. We have reviewed Governor Inslee’s State budget proposal for 2019. House and Senate budgets will be out soon.

WE NEED YOUR HELP TO ADVOCATE FOR AND EDUCATE THE GOVERNOR AND LAW MAKERS ON NURSING HOME, ASSISTED LIVING AND ADULT DAY HEALTH FUNDING NEEDS.
PLEASE SEND ME YOUR EMAIL ADDRESS SO WE CAN HELP YOU ADVOCATE FOR SENIORS ON THE BUDGET SITUATION. MY EMAIL ADDRESS IS terryr@josephinecc.com.

His budget fails to fund care for seniors in Washington State. Spending in his budget is the largest tax increase in history in a booming economy with unemployment under 4%. We also noticed in his press briefings about the upcoming budget there is a nothing said about senior care. Absolutely nothing about funding for nursing homes, assisted living facilities nor adult day health. He is increasing funding for behavioral health. Sixty two percent of nursing home residents have a diagnosis of dementia. With the diagnosis of dementia comes harmful behaviors, or behavioral health. Care givers in nursing homes have been dealing with behavioral health issues forever. I find this very concerning that our Governor is proposing a huge tax increase yet fails to adequately fund care for Washington State seniors. I am hoping this is just an oversight and not a policy statement.
Here is what we are up against.

Nursing Home
1. Josephine has provided over $1,000,000 of unfunded care every year for the last 11 years. We lost $1.6M in 2018 on our Medicaid patients. The cost of caring for 100 residents who rely on Medicaid to fund their care falls short by over $1,000,000 every year.
2. Certified Nursing Assistant labor cost is up 30%. That’s right 30%.
3. Registered Nurse and Licensed Practical Nurse labor cost is up 10%
4. All other wages are up 4-6%.
5. Labor cost takes 70 cents of every dollar of revenue.
6. The cost of complying with new nursing home regulations is staggering. Nursing homes are now dealing with the largest increase in regulations in over 20 years. The Obama administration put into effect the “Requirements of Participation” for nursing homes. The effects of which we are feeling now. We are mandated to add a full time Infection Control Specialist. The labor cost to train 200 staff members on all these new regulations is significant as well as the added time for paper compliance. We spent in excess of $250,000 last year in training and newly added positions.
7. The cost of dealing with compliance from State surveyors is way up . Our Department of Social and Health Services nursing home surveyors have increased the harshest citations by 500% since 2015. Washington State surveyors write twice as many citations as the national median, or average. With these citations come millions of dollars of mandated fines and millions of dollars of lost revenue from the State shutting down nursing home admissions.
8. Twelve nursing homes have closed. Three of those were for sale with no buyers. Many others have, or are planning to reduce bed size by giving bed licenses back to the State. Josephine being included in nursing home bed reduction. The Department of Social and Health Services itself says that Snohomish County has 1,000 less nursing home beds than it needs to meet the demand. The price to buy a nursing home bed in the United States is around $100,000. A 100 bed nursing home would cost $10,000,000. Nursing home owners can’t give away a bed in Washington State because of the under funding, increase in costs of labor and huge cost of compliance.

Assisted Living
There is a dearth of Assisted Living facilities that accept Medicaid here in Washington State. This is because the cost of care exceeds the cost to provide that care. The average daily Medicaid reimbursement for assisted living is around $70.00 a day. An inexpensive hotel costs $70.00 a day. Yet the Governor’s budget expects owners of Assisted Living facilities to provide not just an apartment but utilities, meals, assistance with care needs and cost of complying with assisted living regulations. Most Assisted Living facilities require a new admit to pay privately for three years before converting to Medicaid.
If you need Assisted Living care today but have no saving or income to pay for your care you are out of luck.

Adult Day Health Case Study
Christian Health Care Center in Lynden is a similar organization to Josephine. They are also a nonprofit public benefit corporation which provides 140 nursing home beds. Three years ago they acquired St. Joseph hospital’s Adult Day Health Program. They built a new 5,000 sq. foot Adult Day Health Center. Cost to build was $1,500,000 which they paid for with cash reserves. They have lost between $100,000 and $175,000 every year since opening. And this is with no mortgage cost. They closed the program and discharged their Adult Day residents about 4 months ago. They could not afford to continue the program with these heavy losses. That is how underfunded Adult Day Health programs are here in Washington State.

PLEASE SEND ME YOUR CONTACT INFORMATION. WE WILL NOT SHARE IT WITH ANYONE.
SENIORS IN WASHINGTON STATE NEED YOUR VOICE NOW.
Terry Robertson, CEO