“The central message we are highlighting with this national grassroots initiative is the need for adequate, stable and consistent Medicaid funding, which is directly linked with high quality care, quality of life, and quality staffing, as well as job stability in communities across America,” stated Bruce Yarwood, President and CEO of AHCA/NCAL. “We need Congress to pass emergency Medicaid relief by extending critical Federal Medical Assistance Percentage (FMAP) funding. At a time when states are struggling with budgetary constraints, this enhanced FMAP funding will help states to protect seniors’ access to quality care and preserve jobs for front line staff, who care for the more than 2 million Americans in assisted living communities and rehabilitation and skilled nursing centers each day.”

“Passage of the emergency FMAP relief is essential, but it’s just the first step in the effort to bolster America’s deteriorating Medicaid program. With a $4.6 billion annual differential between the cost of providing quality long term and rehabilitative care and what is actually reimbursed by Medicaid, according to Eljay, LLC,” continued the AHCA/NCAL President. Yarwood concluded, “Meeting seniors’ growing care needs in the future will be contingent upon what we do now to reinforce the structural underpinnings of the Medicaid program itself.”

Yarwood went on to explain that Driving for Quality Care will empower seniors, family members, and caregivers by inviting them to sign the initiative’s actual or online national petition, to reach out to local legislators, to recruit supporters via social media outlets like Facebook and TwitterÔ, and to follow the tour’s progress from Washington, DC to Long Beach, CA on its interactive website, www.drivingforqualitycare.com.

“Even if Congress passes the emergency FMAP extension – which it must – the Medicaid program itself will confront a steep funding cliff in the years ahead that can only be resolved by passing federal legislation that incorporates several of the key policy and funding provisions that Speaker Nancy Pelosi (D-CA) wisely included in the House version of federal health care reform,” remarked Yarwood. “Our profession’s robust, expansive, quality improvement agenda – as well as our ability to bolster facilities’ staffing stability in the face of an unprecedented demographic challenge – requires passage of the Nursing Home Patient & Medicaid Assistance Act of 2010.”

Introduced in late May by Representative Kathy Castor (D-FL), the Nursing Home Patient & Medicaid Assistance Act of 2010 (H.R. 5457) would assist high-volume Medicaid nursing homes by providing a short term supplemental payment program for these specific nursing facilities. The bill also would require State Medicaid programs to submit details regarding annual provider payment rates and methodologies used in setting those rates to the Secretary of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to ensure rates are sufficient for covered services.

Yarwood also remarked, “Keeping America’s long term and post-acute care sector strong, keeps America strong,” citing the nation’s long term care sector as an integral, critical segment of the U.S. economy, contributing $372 billion annually in economic activity, $161 billion in wages, and helping employ 4.4 million workers. “As our Driving for Quality Care RV makes its way across America, we will remind our elected officials that, for many communities, long term care facilities may be the largest employer, especially in rural America. We also want to underscore that patients are benefitting from rehabilitative care in these facilities, which increasingly allows them to quickly return home to live productive, healthy lives.” The AHCA/NCAL President continued saying, “Rehabilitation and skilled nursing center care represents a real value for America– and a significant part of this national grassroots endeavor is to illustrate to consumers, lawmakers, and taxpayers alike how long term care funding stability benefits every citizen on a variety of health, economic, and policy levels.”

AHCA/NCAL believes that public sentiment aligns with the overarching message of the nationwide RV tour. A recent national survey from The Mellman Group finds that Americans, by significant margins, strongly support passage of federal Medicaid relief and are vehemently opposed to any additional state Medicaid cuts. Significantly, 62% of the likely voters polled favor passage of federal Medicaid relief; 78% oppose additional state Medicaid cuts beyond those already enacted by Governors and state legislatures; and 64% are more likely to vote against state lawmakers voting for more cuts to seniors’ Medicaid-funded nursing home care.

Speaking alongside Yarwood at the kickoff event were Veronica Damesyn-Sharpe, Executive Director of the Washington, D.C. Health Care Association (DCHCA) and Sandy Douglass, Administrator, The Methodist of Home of DC. Both DCHCA and The Methodist Home represent a full spectrum of rehabilitative and long term care that range from assisted living services to rehabilitative and skilled nursing care. Another key aspect of the RV tour is the national, state, and local attention it will bring to the rigorous quality improvement program, which serves as a cornerstone of the profession’s mission. They said the following seminal facts surrounding quality, and the changing nature of care, will be discussed at each of the approximately 60 events that will be held between today and AHCA/NCAL’s annual convention in Long Beach, CA starting on October 10^th – the final stop on the grassroots tour:

• “Almost 40 percent of short-stay Medicare patients were discharged to the community in 2006 after a stay of about 25 days, highlighting the interdependence of facility and home-based care.”
• Nursing and Rehabilitation Facilities of the 21st Century (Avalere Health, LLC)
• “The acuity of the nursing home resident population has increased dramatically and the length of stay of most patients is now less than 90 days.”
• Changes in the Quality of Nursing Home Care in the U.S. (Mor, et al)
• “Nursing and rehabilitation facilities have evolved to serve two distinct patient populations: short-stay rehabilitation and medically complex patients, and long-stay chronic care residents.”
• Nursing and Rehabilitation Facilities of the 21st Century (Avalere Health, LLC)
• “[Skilled Nursing Facility] SNF quality slowly improving since 2001”
• MedPAC: Assessment of payment adequacy - Skilled nursing facilities (December 2010)
• About 1 million Americans live in assisted living or residential care communities, with close to 13 percent of assisted living residents relying on Medicaid for their care.
  
• Assisted living communities provide resident-centered care that respects individual choice, dignity & autonomy. The typical assisted living residents is an 87-year-old woman with multiple health conditions (e.g., arthritis & high blood pressure – many have Alzheimer’s or other cognitive impairments), living on an annual income of $19,000, who stays 28 months on average.

“With approximately seventy percent of facility costs here in the District of Columbia and nationwide directly related to staffing, the enormous instability caused by Congress’ failure to pass emergency Medicaid relief and cumulative federal Medicare cuts of nearly $27 billion in just the past nine months places our vulnerable seniors’ ongoing care needs in direct jeopardy, and puts key facility jobs at substantial risk,” commented Damesyn-Sharpe of DCHCA. “Adequate, stable and consistent Medicaid and Medicare funding is, and always will be directly linked with high quality care and staffing and employment stability. Lawmakers need to hear this message and we intend to make certain they do.”

Sandy Doublass, Administrator of The Methodist of Home of DC, expressed alarm that the cumulative impact of Medicaid and Medicare cuts will undermine facility operations by threatening the jobs of frontline care staff. “This is a facility that attracts committed, dedicated caregivers – and it is urgent for Congress to both pass the emergency Medicaid funding in addition to strengthening the long term the health care safety net that so many of America’s seniors depend upon to meet their healthcare needs.”