State Can Act Now to Save Rural Nursing Homes and Health Care
OKLAHOMA CITY – The Oklahoma Association of Health Care Providers (OAHCP), working collaboratively with hospitals throughout the state, has identified a means of significantly increasing federal support for health care by participating in a federal program known as Upper Payment Limit (UPL). Participation in the program, which would require the Oklahoma Health Care Authority (OHCA) to submit an amended plan to the federal government, would increase federal reimbursements to participating Oklahoma hospitals and nursing homes by as much as $275 million annually.
The OAHCP estimates that as many as 200 Oklahoma nursing homes and hospitals would participate in the plan, many of them in rural areas. No state dollars are required to participate in a UPL plan. A full list of hospitals that qualify to participate in UPL is available here.
OAHCP President Tandie Hastings said that many rural hospitals and nursing homes are facing a funding crisis, and that quick approval for a UPL program in Oklahoma is essential. Earlier this month, Sayre Memorial Hospital closed its doors due to financial pressure.
“Many rural hospitals and nursing facilities are in danger of closing in the current environment,” said Hastings. “A lot of that financial stress is driven by very low Medicaid reimbursement rates. In fact, Oklahoma nursing homes lose $13 a day on every Medicaid patient they serve. That kind of loss is not sustainable in the long term.
“If the state acts now by embracing UPL, we can reverse that trend,” said Hastings. “Not only can we ensure these facilities continue to be financially viable, but we can use this influx in federal resources to improve the quality of services our patients and residents rely on. The flip-side of this is, every day we wait, we are in danger of losing another hospital or nursing home.”
Comanche County Memorial Hospital CEO Randall Segler also voiced support for the plan.
“Should hospitals partner with other nursing homes, everyone would benefit from better coordination of care along with the continuum of care from acute care to long-term care," said Segler. “The additional funding will be positive for nursing home residents because in order to receive the funding, quality standards must be met. And access to long-term care for Medicaid recipients will likely improve due to the increased federal funding. I would expect long term care in Oklahoma to improve on a number of fronts."
OAHCP is asking the OHCA to submit a plan amendment change to the federal government to allow new partnerships to be formed between rural hospitals and nursing homes in Oklahoma. Once that rule-change is made, non-state government owned hospitals are eligible to participate in the UPL program. Those hospitals can then agree to become nursing home operators while contracting with former owners/operators to manage the nursing homes. The partnership directs additional UPL funds to both the participating hospitals and nursing homes.
UPL program partnerships have been successfully executed in several other states, including Texas.
“Where this has been tried in other states, hospital patients and nursing home residents have seen better, more comprehensive care,” said Hastings.
While the state of Oklahoma is facing a billion-dollar budget shortfall and significant budget constraints, the UPL plan requires no state dollars and is entirely funded by the federal government.
“We understand this is a tough budget year, and a lot of organizations are coming to the Capitol asking for money and resources the state doesn’t have,” she said. “The beauty of UPL is it requires no state dollars at all. This is an opportunity for the state to see an influx of dollars in a year when we know budget-makers will be scrambling to find sufficient resources for health care and other services.”
Click here for more information on UPL.