Medicaid critical issue in Berks Heim's projected deficit

'Roughly 80 percent of our beds are Medicaid'

READING, Pa. - Berks County Commissioner Christian Y. Leinbach told a room full of people who are opposed to the sale of Berks Heim that the critical issue with the only county-owned nursing home is Medicaid. He said if Pennsylvania lawmakers can be persuaded to fund Medicaid reimbursement properly, he sees no reason to sell the Heim.

In December, Robert Patrizio, the county's chief financial officer, reported a projected $1.5 million deficit by 2020 and $8 million deficit in 10 years at the Heim.

"Roughly 80 percent of our beds are Medicaid," Leinbach said Thursday.

The commissioner added that the state's decision to flat-fund Medicaid reimbursement is the underlying cause of the Heim's financial issues. Medicaid bed rates have been flat three of the past five years, and counties have been advised that they should not expect any increases (and possibly decreases) in the next five years.

Leinbach explained that the driving force behind the flat funding is the state's decision to divide the commonwealth into three regions and gradually turn the health choices program, which covers the Medicaid reimbursement, into a managed-care model. The western region changed to the managed-care model January 1, 2018. The change is supposed to occur in the eastern region January 1, 2019, and the central region, which includes Berks County, January 1, 2020.

Leinbach recently learned there is an effort by several counties to reverse the state's decision regarding Medicaid funding. Four counties in the eastern region have refused to sign the current agreement. Leinbach said he supports going on record that Berks County will refuse to sign an agreement that doesn't adequately fund the Medicaid reimbursement. He said he is reaching out to other counties in the central region to ask if they will do the same.

"If the MCO (managed care organization) knows that every single county nursing home that comes into play in 2019 is refusing to sign the agreement and demanding that the governor and the administration appropriately fund the nursing homes, and on top of that we can get most if not all of the counties in the central region to go on record now that we are going to refuse to sign in 2019, that's significant," Leinbach said.

He said they hope that it will force the governor and the legislature to address the Medicaid reimbursement issue.

"If we can get the Medicaid reimbursement addressed, I don't see any reason to sell Berks Heim," Leinbach said.

Kelly Andrisano, the executive director of the Pennsylvania Coalition of Affiliated Healthcare and Living Communities (PACAH), will be at next Thursday's commissioners meeting to discuss the funding issue and to share with county employees and Berks County residents to let them know what they need to do to help reinforce our position.

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