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October 27. 2009 3:19PM

As healthcare reform bills are being discussed in Congress, the South Dakota Health Care Association is concerned that proposed Medicare cuts would harm senior care.

“Reforming healthcare is a good thing,” said Mark Deak, executive director for the South Dakota Health Care Association. “Details are very difficult.”

According to a release from the association, the House health reform bill, combined with the impact of a recently-enacted Medicare regulation, would cut Medicare-funded nursing home care in South Dakota by $100 million over a 10-year period.

According to Deak, $12 million in Medicare cuts started Oct. 1.

“Potentially, another $32 million bill is on the way,” he said. “It is hard to know the impact.”

Deak said expanding healthcare coverage for more people is a good thing, but the concern is where the dollars will come from. “In my mind, nursing homes are currently running on razor thin margin,” he said. “Cuts of this magnitude would certainly jeopardize the quality of care that South Dakota’s elderly and disabled citizens have come to expect.”

In Brandon, Bethany Meadows administrator Laura Kuehl said any Medicare reform in regard to nursing home payments would not affect her facility. “I’m sure it will affect some of our residents’ Social Security checks, but not (us),” she said.

Helping Hand Assisted Living in Brandon is licensed for 52 residents with an additional 16 independent apartments. Shannon Slocum, resident care coordinator there, said she is following the healthcare debate, probably closer than most.

“We strive to get into programs and understand programs that help us and help our people,” she said. Helping Hand is a member of the Assisted Living Association of South Dakota. Slocum is the state secretary.

The association allows state facilities to combine orders for food programs, and cleaning and medical supplies, even furniture. “It gives us access to bigger and better vendors,” Slocum said. The association also represents assisted living centers in Pierre, lobbying for them during legislative sessions.

If Medicare benefits are cut, it could affect Title 19, or Medicaid, residents at Helping Hand.

Even private pay residents often run out of money eventually, and then Medicaid takes over.

“A lot of our population is veterans,” Slocum said. “They are serviced through the VA Hospital. I don’t see their medical care changing at all.”

If the country does end up with a social healthcare system, Slocum, who is a veteran herself, suspects it would be similar to the plan veterans receive. She doesn’t advocate for it, she said, because she feels people should be able to choose their own plan.

“However, if it does happen, I’m not worried,” she said. “I believe that would be the model they would use, and it’s worked for 100 years.”

Kathy Thomas, administrator at Palisade Manor in Garretson, is more concerned about the possible outcome of the healthcare debate.

“It makes it really tough to make the capital improvements and give your employees pay raises,” she said. For example, the federal government is requiring sprinkler systems at all nursing homes within the next few years. Palisade Manor has sprinklers in part of their facility but will need to add more. Thomas doesn’t know where the money to pay for them will come from.

“Your food price doesn’t go down,” she said, “and physical therapy doesn’t go down.”

Palisade Manor also belongs to the South Dakota Healthcare Association, which represents them in Pierre.

In addition to government funding, Palisade Manor has other sources of income.
“We try to control costs,” Thomas said. “We needed a couple of new beds and one of our sister facilities got us new beds. People of the community can come in and volunteer. Volunteers (recently) went with the residents to the butterfly house (in Sioux Falls). We do fundraisers.

“All those things make a big difference,” she said. “The bottom line is just having a good reputation and a place where people want to bring their family members.”