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PCHD looking into partnership with area nursing homes

Weatherford Democrat (TX) - 10/29/2014

Oct. 28--The Parker County Hospital District is looking into partnering with local nursing homes with Medicaid beds, a move that is intended to bring more state money to both the nursing homes and the district.

The PCHD board of directors unanimously authorized district staff to move forward with talks with Optimum Healthcare regarding participation in the state's Upper Payment Limit program, which would pay the difference between Medicaid and Medicare payments.

Optimum Healthcare operates College Park Rehabilitation and Care Center, Hilltop Park Rehabilitation and Care Center and Willow Park Rehabilitation and Care Center.

"This program allows hospital districts to partner with the owners of nursing homes and ultimately raise the amount of money that is paid for Medicaid residents," the district's attorney, Brian Jackson, said, adding that he believes the state program is relatively new, and he has investigated and participated in other areas of the state. "The program recognizes that nursing homes are not paid an adequate amount of money per day per person that is on Medicaid and by partnering with a hospital district, the nursing home has that payment raised."

Jackson said the owners of the nursing homes have approached the district about participating in the program.

He recommended the district look into it and said he is hopeful the district benefits financially and that the program will ensure that quality measures at the nursing homes are met.

"At this point in time we don't have a contract," district CEO Randall Young said, asking that the board authorize the district to move forward and flesh out an agreement with the company.

Jamie Bodiford, a member of the board of directors, invited other nursing homes that accept Medicaid to contact the district about the opportunity to participate.

"I hear this all the time -- people cannot get a bed," Bodiford said. "Medicaid beds are very, very limited in Parker County."

Young said that in the past it's been hard to find Medicaid beds for loved ones because the government pays so little.

"So these nursing homes [in Texas] wanted Medicare beds but not Medicaid beds," Young said. "So you ended up with a lot of little, kind of dirty, not well-managed nursing homes that were doing Medicaid. This program would give them the same money as Medicare and this money they could put into the facility and make improvements and hire better people and the Medicaid patient gets better care."

There would be minimal effort on the part of the district to participate in the two-year program, which ends in August 2016, according to Young.

The government has a number of upper payment limit programs that healthcare providers can participate in to obtain more money than the Medicaid rate, programs that require the provider to jump through more hoops for the additional money, according to Jackson.

"In order to qualify for that program, the hospital district has to be involved in the operation of the nursing home to some extent," Jackson said. "We have to be part of the license. We have to be accountable."

Essentially, the district would send the Medicaid rate for the number of beds to the government each quarter and would get the Medicare rate back about 10 days later, according Jackson. "You don't just send up money and hope everything's OK. You are told by the government when and how much to send up."

The nursing homes must meet certain quality measures to be able to participate and if they fall below those, will be ineligible, Jackson said.

The district will be personally touring the nursing homes and has protection from tort cases with insurance and a cap on damages, Jackson said.

According to the Texas Department of Aging and Disability Services, during the most recent inspections of College Park Rehab and Hilltop Park Rehab, both facilities were found to be out of compliance with federal and state regulations, but there were no deficiencies that caused residents actual harm or immediate jeopardy.

Willow Park Rehab, a newly built facility inspected in September, was found to be in total compliance with regulations.

It was too early in talks to know how many beds would be involved and how much money the arrangement would involve, district staff said.

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(c)2014 Weatherford Democrat (Weatherford, Texas)

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