OPINION-EDITORIAL: A nursing home crisis is brewing
In the next few days, the Park Royal Health and Rehabilitation Center nursing home in Longview will close—permanently.
The closure of this award-winning nursing home — which specializes in caring for people with advanced Alzheimer's disease and dementia — means that 38 frail seniors will need to find new places to live. These people require a high level of personal care, including assistance with dressing, eating, using the bathroom, bathing, “cueing” (gentle reminders) and medication management.
The loss of Park Royal is the loss of a community asset. It has received quality awards from the American Health Care Association. It's owned and operated by EmpRes Healthcare Management, a 100 percent employee-owned company based in Vancouver, WA.
So, why is Park Royal closing?
Almost all of the people living at the center rely on state Medicaid to pay for their care and services. And Medicaid, more commonly known as “AppleCare,” has been stingy when it comes to paying nursing homes in Washington. These payments, called “reimbursements,” have been systematically reduced by the state. Park Royal is the 19th nursing home in Washington to close or announce closing since 2017.
According to Park Royal managers, the AppleCare reimbursement-rate shortfall has meant losses of between $40,000.00 and $60,000.00 per month over the last several years. Several Park Royal employees, plus one higher-up executive, warned me personally that trouble was coming. All of these employees — including the executive — got emotional when talking about the effects these troubles would have on their patients.
Until June 2018, AppleCare reimbursement rates for nursing homes were calculated using estimated costs from 2014. Current rates are based on costs from 2016 and aren't adjusted for inflation, minimum wage increase or other real-world cost drivers. So, we're constantly trailing the marketplace by several years.
Earlier this year, the state House budgeted some money to close the gap in AppleCare nursing home reimbursements—an expenditure that I supported and still support—but that was cut by the majority caucuses in House/Senate “conference” negotiations. Those negotiators wrecked our chance to avoid the current problems. And, maybe, to have kept Park Royal open.
To simplify slightly, my colleagues across the aisle are pushing an agenda to expand the number of people who qualify for AppleCare coverage by cutting the amounts that AppleCare pays to doctors, hospitals and nursing homes. This is bad public policy.
Some legislators don't seem to care about bad outcomes. I've heard the Democrat Chair of the House Health Care Committee dismiss closure of nursing homes like Park Royal as routine and normal. And scoff that companies like EmpRes are just “whining” when they talk about unsustainable operating losses.
Bad policy supported by lawmakers from the Puget Sound area always seems to hurt our corner of Washington first—and worst.
Park Royal staffers are working with AppleCare and state agencies to find places for their patients to go. The outlook isn't great. EmpRes operates other facilities in Cowlitz County—but there aren't options like Park Royal close by. Some residents will be transferred as far north as Bellingham.
The residents at Park Royal are a microcosm of nursing home patients throughout the state. They are people who've lived and worked to build value in their communities. AppleCare has promised to pay for their nursing home care. We shouldn't play games about short-paying that promise.
It's a cruel irony that many legislators who call themselves “progressive” are so often willing to under-fund promises that the state makes to working people. I hope you will join me in urging the majority caucuses in Olympia to do the right thing—and match AppleCare nursing-home reimbursements to actual market costs.