Medicaid expansion could impact local care centers

January 20, 2019

MITCHELL — As the local population continues to age, the City of Mitchell has taken on the challenge to provide housing and care that meets the needs of its older citizens.

Until the last couple of years, the Mitchell Care Center has had its financial ups and downs as it accumulated a large amount of accounts receivable.

In 2017, then Mayor Brian Taylor organized a care center committee with members from the private sector. The group worked closely with Rural Health Development, which operates the center, to streamline the entire operation.

Newly-elected Mayor Dave Curtis said the center is now on a positive trend and is becoming more profitable, so things are looking up.

“The committee spent a lot of time brainstorming ideas on how to save money, become more profitable and do things more efficiently,” Curtis said. “We’ve seen a huge difference in how the care center is being operated now.”

The Mitchell Care Center got a big boost last year from neighboring Scottsbluff when its city council voted to offer some financial support from the city’s LB 840 economic development fund.

At the time, Scottsbluff Economic Development Director Starr Lehl said the city’s economic plan includes support for surrounding communities because the area needs to work together to retain businesses and grow the number of employees.

Those LB 840 funds are primarily being used to help Mitchell Care Center with bond payments on the facility. Scottsbluff approved $306,400 to be paid out through August 2021.

Now the facility faces another challenge — what impact the state’s recently expanded Medicaid program will have on small, rural care centers.

“The care center relies heavily on Medicaid reimbursement to remain profitable,” Curtis said. “We just don’t know what the future will be for our senior population. The state was already cutting back on Medicaid for care centers before the voters approved the expansion. That extra funding could possibly go to other areas.”

The Mitchell Care Center isn’t a for-profit facility, but more than half of its residents are enrolled in Medicaid.

Curtis added the federal government currently reimburses care centers less than the cost of care for residents.

“We need Medicaid funding if we’re going to continue to grow,” he said. “We don’t know where we’ll be in that piece. It’s a huge concern right now.”

Gov. Pete Ricketts’ proposed budget for the 2019-21 biennium would pay for Medicaid expansion through a $63.1 million increase in general funds, including offsetting budget savings and a $526.2 million increase in federal funding over the biennium.

District 48 State Sen. John Stinner still has his concerns. He’s often spoken on the hardships small, rural health care centers face to remain financially viable.

That concern became even more evident last year when 21 nursing homes across the state went into receivership after missing payroll. Included were facilities in Scottsbluff and Sidney.

One of Stinner’s interim studies would examine the financial hardships experienced by rural long-term care facilities across the state, including nursing homes, assisted-living facilities and rehabilitation centers.