THE WEEKS AHEAD WILL HAVE THE OPPORTUNITY TO TALK MORE ABOUT IT.
LET'S MOVE ON.
VIEWER FROM STEARNS COUNTY, AND I'M GOING TO DIRECT IT TO YOU, SENATOR BAKER, BECAUSE IT'S ADJACENT TO YOUR AREA.
THIS IS A VIEWER THAT'S CONCERNED ABOUT NURSING HOME ISSUES.
THIS PERSON IS ON A NURSING HOME BOARD, FUNDING AND REIMBURSING ARE PROBLEMS, REIMBURSEMENT IS OFTEN LATE AND INADEQUATE.
NURSING HOMES AREN'T ABLE TO MEET THE DEBT RATIOS AND MULTIPLE NURSING HOMES HAVE CLOSED IN THE PAST YEAR, MIGHT BE AS MANY AS 17.
WHAT'S GOING TO HAPPEN ON NURSING HOME FUNDING ISSUES.
LET'S START WITH YOU, REPRESENTATIVE BAKER, AND WE WILL MOVE AROUND THE VIRTUAL TABLE.
>> THAT IS SUCH A GREAT QUESTION THAT THE CALLER HAD.
THERE'S NOBODY HERE ON THIS PANEL THAT WILL ARGUE THAT WE HAVE THAT ONE SOLVED AT ALL.
WE DON'T.
WE NEED TO MAKE SURE THAT WE ADDRESS THE ISSUES OF THE WORKFORCE SHORTAGE.
THE REIMBURSEMENT AS WELL.
THE GREAT BILL WE DID BACK IN 2015 TO REALLY GET OUR SERVICES BACK UP TO A COST BASIS FOR THESE NURSING HOMES WAS REALLY OUT OF THE BOX THINKING IT WAS REALLY WELL THOUGHT THROUGH.
I WAS A PART OF HELPING CRAFT THAT BACK IN MY FIRST YEAR.
WHAT'S HAPPENED NOW IS ABOUT 18 MONTHS LATER WHEN THE CATCH-UP PART OF THAT SERVICE FEED AND HOW DO WE PAY FOR NURSING HOMES TO GET THEM CAUGHT UP AGAIN, IT'S DELAYED IN HOW THEY GET THEIR FAIR REIMBURSEMENTS TO TODAY'S DOLLARS.
A LOT OF THE NURSING HOMES ARE PAID BETTER THAN THEY USED TO.
NOW TODAY, 7, 8 YEARS LATER, IT HAS GONE VERY FLAT AND BACKWARDS BECAUSE THE INFLATION FACTOR HAS REALLY HIT NURSING HOMES HARDEST.
AGAIN, THE REIMBURSEMENTS WHAT WE PAY THEM IS A SINGLE SOURCE RATE IN MINNESOTA.
PRIVATE PAY IS PAYING THE SAME THING AS MEDICAID, MEDICARE RATES THAT ARE PAYING.
WE NEED TO INCREASE THOSE THROUGH REIMBURSEMENTS AND WE NEED TO MAKE SURE WE LOOK AT THAT AGAIN.
ALSO, THEY HAVE TO GET THE REIMBURSEMENTS WITH CURRENT COSTS MORE QUICKLY TO THE NURSING HOMES SO THEY CAN PAY THE BILLS THAT ARE MORE REFLECTIVE OF TODAY'S COSTS.
AGAIN, WE NEED MORE PEOPLE TO BE IN THOSE NURSING HOMES.
A LOT OF THE FOCUS THIS YEAR IS TO TRY TO IMAGINE WHAT WE HAVE TO DO TO GET THOSE NEW ENTRY LEVELS, THE PCA'S, PERSONAL CARE ATTENDANTS, IN THE 22 TO 25-DOLLAR A RANGE AN HOUR IS WHAT WE ARE GOING TO HAVE TO PAY TO GET THEM.
WE HAVE TOO MANY NURSING HOMES WITH A WING THAT'S EMPTY, 100 BED UNIT AND ONLY USING 70 ROOMS BECAUSE THAT'S ALL THE STAFFING THEY HAVE.
BUT YET THEY HAVE PEOPLE WANTING TO GET TO THE DOOR.
IT'S A HUGE LIFT THIS YEAR.
IT WILL BE COSTLY, AND WE HAVE GOT TO MAKE IT ONE OF OUR ISSUES BECAUSE IT'S PLUGGING UP OUR HOSPITALS.
THERE'S NO PLACE FOR PEOPLE TO GO IN RECOVERY FOR SOME SHORT-TERM NURSING STAY.
WE HAVE TO REALLY FOCUS ON THIS, I THINK, IN THE NEAR TERM, AND I HOPE WE GET ON THIS RIGHT AWAY.
>> Barry: SENATOR WEBER.
>> CERTAINLY.
I THINK NURSING HOMES ACROSS THE STATE ARE EXPERIENCING THE SAME PROBLEM.
IT'S BEEN A PERENNIAL PROBLEM, ONE THAT KEEPS COMING BACK ANY TIME THERE'S A SOLUTION THAT'S PUT FORTH AND WORKS FOR A WHILE.
BUT WE HAVE ALWAYS BEEN, IN TERMS OF OUR MEDICARE, MEDICAID PAYMENTS, I REMEMBER WHEN I WAS EVEN GOING INTO THE HOSPITAL BUSINESS, WHEN I WAS ON THE LOCAL HOSPITAL BOARD, ON THE COUNCIL, WE ALWAYS FOUGHT THIS DEEP RURAL DISCRIMINATION THAT'S OUT THERE FOR PAYMENTS.
THEY THOUGHT BECAUSE WE WERE OUT IN THE COUNTRY, WE DIDN'T HAVE THE KIND OF COSTS THAT THEY HAD IN THE BIG CITY.
YET, WHAT WE ALWAYS FOUND OUT IN MY AREA, WE WERE COMPETING WITH THE LARGE HOSPITALS OVER IN SIOUX FALLS, SOUTH DAKOTA.
WE WERE HAVING TO PAY HIGHER RATES TO GET OUR PERSONNEL.
WE WERE NEVER GETTING CREDIT FOR THAT TYPE OF THING.
THERE'S BEEN AN INJUSTICE IN THAT REIMBURSEMENT SYSTEM FOR A LONG TIME.
ALSO, YES, WE NEED TO MAKE SURE THAT WE ARE TRAINING THE PEOPLE, FUTURE STAFFING THAT WE NEED.
RIGHT NOW WHEN YOU SEE WINGS OF OUR NURSING HOMES SITTING EMPTY JUST BECAUSE THEY DO NOT HAVE THE STAFFING, YOU KNOW, THAT IS A SERIOUS PROBLEM.
SO THERE ARE MULTIPLE AVENUES THAT WE HAVE TO ADDRESS IN ORDER TO DEAL WITH THE PROBLEMS IN OUR NURSING HOMES.
QUITE FRANKLY, ALL OF OUR RURAL AREAS CONTINUE TO LOSE NURSING HOMES EVERY YEAR.
>> Barry: SENATOR MCEWEN, WE TALKED ABOUT IT ON THIS PROGRAM BEFORE.
BUT TELL OUR VIEWERS YOUR THOUGHTS ON THIS ISSUE.
>> IT HAS REACHED A CRISIS POINT.
I HAVE BEEN TO A COUPLE OF THE NURSING HOMES IN DULUTH AND TALKED TO THEM ABOUT THIS.
AS SENATOR WEBER SAYS, THERE'S A TREMENDOUS WORKFORCE PROBLEM.
I THINK WHERE WE MAY HAVE DIVERGENT OPINIONS BETWEEN MYSELF AND MY COLLEAGUES, PERHAPS.
BUT MAYBE IN WHAT WE ARE TALKING ABOUT FOR THE SOLUTIONS FOR THAT.
WE CAN'T FORCE PEOPLE, EITHER THROUGH TRAINING OR JUST TELLING THEM WE NEED THEM REALLY BAD, TO GO AND WORK A DIFFICULT JOB FOR A VERY LOW PAY AND HARDLY ANY BENEFITS.
WE CAN'T DO THAT.
WHAT WE HAVE TO DO IS MAKE SURE WAGES ARE RAISED TO A LEVEL WHERE THOSE TREMENDOUSLY DIFFICULT CARE JOBS ARE PAID WHAT THEIR LABOR IS WORTH, WHICH IS A LOT.
IT'S THE KIND OF JOB THAT PEOPLE SHOULD BE MAKING A LIVING THRIVING, FAMILY SUPPORTING WAGE OUT OF.
RIGHT NOW THEY ARE BEING PAID AS IF THEY ARE DISPENSABLE.
YOU CAN'T BLAME PEOPLE FOR LEAVING A JOB WHERE THEY FEEL DISPENSABLE.
WHAT WE NEED TO DO IS ACT AS A STATE TO MAKE THOSE JOBS GOOD JOBS AND TO MAKE SURE THAT PEOPLE HAVE THE BASIC SAFETY NET UNDERNEATH THEM TO SUPPORT THEM AND THEIR FAMILIES, ALSO, SO THEY CAN STAY IN THESE CARING PROFESSIONS.
THERE'S A NUMBER OF PIECES WE CAN DO.
IT REALLY IS ABOUT SUPPORTING OUR WORKFORCE SO THEY CAN DO THIS WORK.
WE CAN'T JUST DRAG PEOPLE IN THERE AND MAKE PEOPLE DO THESE JOBS.
WE HAVE TO MAKE THE JOBS ATTRACTIVE TO DO.
>> THE OTHER THING, BARRY, WE NEED TO REMEMBER IS QUITE FRANKLY IT'S GOVERNMENT THAT HAS CREATED THE DISPARITY IN THAT IN THE EMPLOYEE SALARY ANYWAY.
OUR NURSING HOMES ARE DEPENDENT ON WHAT THE GOVERNMENT PAYS FOR OUR PEOPLE TO BE THERE THROUGH MEDICARE, MEDICAID.
IF THERE'S ANYONE THAT HAS LET OUR NURSING HOMES DOWN, IT IS GOVERNMENT.
>> IF I MIGHT VERY QUICKLY, TOO, I THINK IT ALSO GOES BACK TO THE QUESTION YOU HAD ABOUT THE SURPLUS AND DISCUSSION WE HAD, WE HAVE THE SURPLUS.
WHAT DOES IT MEAN?
WHAT DOES IT REFLECT.
WHAT IS THE BEST COURSE OF ACTION.
I STAND BY WHAT I SAID EARLIER.
WHAT THE SURPLUS REFLECTS IN LARGE PART IS THAT WE HAVE BEEN UNDERFUNDING OUR BASIC GOVERNMENT SERVICES FOR YEARS.
THIS IS A PERFECT EXAMPLE WHERE WE COULD BE USING THAT MONEY.