By Colleen Quinn

State House News Service

BOSTON -- Hundreds of nursing-home advocates gathered at the Statehouse Thursday in an effort to convince lawmakers to boost Medicaid reimbursement rates beyond 2005 expense levels, and increase funding so caregivers can get pay raises.

William Bogdanovich, president of Broad Reach Healthcare, a group of Cape Cod-based nursing homes, said "obviously, a lot has changed since 2005" and reimbursement rates "have not come close to keeping up with the changes in expenses that we have."

The state's biggest and most costly program, Medicaid provides a range of services, with a focus on health care for low- and medium-income people living in Massachusetts. The program competes for available funds with all other programs and services paid for out of the state's annual budget, and providers of Medicaid services have long complained that state reimbursements don't cover the actual costs of care at facilities.

In his budget, Gov. Deval Patrick proposed cutting nursing-home spending by $20 million in fiscal 2015. House lawmakers adopted an amendment, filed by Rep. Thomas Golden, D-Lowell, to increase funds $47 million over Patrick's proposal and advocates are now pushing to get senators to do the same when they debate the budget next week. Sen. Harriette Chandler, D-Worcester, filed an amendment to increase nursing-home funding.


According to the Massachusetts Senior Care Association, there is a record-high $37 per day gap between Medicaid reimbursements and the cost of care for each patient, and Massachusetts ranks fourth-worst in the nation for funding nursing-facility care.

The proposed increase would bring state Medicaid reimbursement rates up to 2007 cost levels, according to advocates. About 70 percent of nursing home residents have their care paid for by the state, according to Tara Gregorio, vice president of government relations for the Massachusetts Senior Care Association.

"A facility's ability to invest and pay staff depends on state funding," said Gregorio.

The association says it represents 50,000 staff who care for more than 100,000 people per year.

Peggy Papulis, 55, has lived in a nursing home in Westboro for the past year. Papulis was diagnosed with multiple sclerosis when she was 19, and her aging parents found it difficult to care for her at home because she needed constant care.

Papulis traveled to the Statehouse to talk about how important it is for her to have continuity of care from staff. When someone needs help with daily hygiene because of a disability it is important to build a relationship with the caregiver, and feel comfortable, she said. If staff quit frequently because they are not making enough money, it makes living at a nursing home more difficult, she said.

Her mother, Mary O'Brien, 78, said staff make all the difference in someone's care.

"You want a continuity of staff," she said.

Bogdanovich said the ability to foster a relationship between a caregiver and a nursing-home resident can make a big difference in someone's quality of life.

Ned Morse, president of Massachusetts Senior Care Association, said for individuals whose home is a nursing facility, they need 24-hour, seven-day-a-week care.

"In order to staff appropriately, we obviously need adequate reimbursement," he said. "And unfortunately, the governor's budget has cut us. And therefore it is critical to get funding support by the Legislature."

Morse said advocates hope the Senate budget will look more like House funding levels.

"It is critical reimbursement reflects real costs and not costs of 2005, 2007, 2008," he said.