Decrease in federal funding may have impact on service
By: Matt Kirdahy
Medicare cuts made by the federal government mean local nursing homes such as The Elms of Cranbury are going to have to re-evaluate how they run their facilities.
The Elms of Cranbury is losing almost $25,000 a month in funding as a result of a decrease in Medicare payments, according to the state Department of Health. The cuts became effective on Oct. 1, 2002.
Anita Dietrick, administrator and owner of The Elms, said the cuts could affect the quality of care for her residents. She said The Elms might lose medically trained staff members, increasing the nurse-to-patient ratio. In addition, the facility might not be able to buy more expensive new medical equipment, meaning equipment on site might not be as up to date as staff would like. She also said social activities could be limited because there is no one employed to supervise them.
"I pride myself in this facility because of the good things that we do here for people," she said. "It’s my baby. And to see it suffer like that just hurts."
According to a press release from The Centers for Medicare and Medicaid Services, the cuts are a result of two expired federal programs that boosted payments to nursing homes. Expiration of the payments will result in $1 billion less in payments to the 13,583 nursing facilities nationwide, 327 of which are in New Jersey.
CMS is a federal agency within the U.S. Department of Health and Human Services that runs the Medicare and Medicaid programs, which benefits about 75 million Americans.
Medicare is a federal health insurance program for people 65 years of age or older. Patients covered by Medicare are eligible for special care in a skilled nursing facility, a semiprivate room and exposure to all of the rehabilitative services provided by the facility.
At The Elms, Medicare accounts for 60 percent of total revenue, according to Deanna Evju, business office manager. Residents on Medicare pay a $105 co-pay a day for every day spend at the home over 20 days. There are currently 44 Medicare residents at The Elms.
Currently, there is one nurse for every six to eight residents. Ms. Evju said that could climb to one nurse for every 12-15 residents at The Elms as nurses leave and the cuts prevent the facility from hiring replacements. She said there would be no layoffs, but that nurses tend to get discouraged and leave the industry when there are cuts like these.
"It’s not humanly possible to care for that many people 24 hours a day," Ms. Evju said. "How can we be expected to provide the quality of living and service that we’ve been offering with these cuts?"
She said the cuts also will affect the kinds of recreational activities the facility can provide on the weekends. Ms. Evju said that the lack of funds makes it difficult to hire people to oversee weekend activities such as shopping, bingo and even singing.
"The atmosphere in this place is going to change for the worse and the residents are going to feel it the most," she said.
She also said that the medical tools and instruments used to care for residents are going to become dated and upgrades are not going to be made because they are too expensive. One example is a Hoyer Device. Ms. Evju said the device helps residents whose ailments prevent them from being mobile to sit up and walk around. She said the device costs $2,200.
She also said that The Elms supplies their residents with high-end mattresses that can cost as much as $4,000. These special mattresses prevent bed sores that might be treated using brand name medication that’s been replaced by less-effective generic brands.
"Those are just some of the necessities we provide at The Elms," she said. "It might not be so easy now to say that we need to order a new Hoyer device because of these Medicare cuts."
Ms. Dietrick has been the administrator at The Elms for 20 years. She said she has always paid her employees well because of their outstanding work. She said she shivered when she heard about the cuts.
So far, she has cut her own pay to help offset the funding cut, she says. In most situations, when a business goes through tough times, it often is the employees who are the first to feel the burden, she said. But Ms. Dietrick says she is doing everything she can to prevent that from happening.
"I had to take a cut in pay in order to keep my staff at their current salaries," Ms. Dietrick said. "They deserve every bit of what they make because of what they do here at The Elms. It’s by no means an ‘easy’ job."
Other cuts will affect the amount of maintenance that can be performed on the facility, including painting, landscaping and other areas.
If there are any more cuts, then Ms. Dietrick said she might lose all of what little faith she has left in the system.
"If I can’t provide the care that these people deserve, then why should I run such a facility that demands a certain quality of care we can’t provide," she said. "It hurts me to see something like this."

