We've Got The County Covered

SAVING SWEET: A LONG-TERM GOAL

The nursing home industry is in trouble, especially rural nursing homes that have managed to not succumb to the struggles of the last 3 ½ years. In 2022, 12 nursing homes in Montana closed; one of those was just down the road from us, in Malta.

Rural nursing homes made up 31% percent of all nursing home closures since 2020, according to American Health Care Association data. That rate peaked in 2022, with 37% of that year’s closures involving rural providers, even though 13.5% of the nation’s roughly 15,000 nursing homes are considered rural, according to the Office of Management and Budget.

The data reveals that during the pandemic, an overall decline in the number of nursing homes accelerated by nearly four times. Specifically, from 2020 to present:

• 579 nursing homes closed,

• More than 21,000 residents have been displaced by closures,

• 30 more U.S. counties became nursing home deserts,

• Two out of five closures had four- or five-star ratings, and

• Only three new nursing homes have opened in 2023, compared to an average of 64 each year between 2020 and 2022.

Pope Benedict XVI once said that “societies are judged by how they treat the elderly.” Perhaps the same observation can be said of governments. Without adequate support, be it deliberate or an oversight, Montana’s elderly are being cast into a future of uncertainty.

Montana’s governor made a slightly condescending comment regarding the closing of so many nursing homes in Montana when he attributed those closures to “poor business models”; a comment that is not exactly pertinent nor accurate. The closures had more to do with inadequate Medicaid reimbursement and lack of community share of funding than anything else.

Sweet Home, as it is affectionately referred to by locals, began as the brainchild of Lloyd D. Sweet, a gentleman who resided in Chinook as a youth and planned on returning to live out his golden years. That dream never came to fruition, but his legacy lives on through an endowment that helps to sustain Sweet Home, the part of his dream that was realized.

Unfortunately, Sweet Memorial Nursing Home (SMNH) is not exempt from the plight of Montana’s nursing homes. Mr. Sweet, as encompassing as his business plan was, did not anticipate the fallout from a global pandemic that depleted the national workforce, forcing facilities to rely on contract personnel to meet the federally mandated staff-to-resident ratio, at exorbitant and unsustainable rates.

Chinook was fortunate to have had the financial investment donated by Mr. Sweet long ago. But how does any administration maintain and update a well-used but aging facility without a major influx of cash at times without decreasing that fund balance? At least 50% of SMNH residents are Medicaid patients where there is no profit or, even worse, inadequate reimbursement. How does a community facility expect to last when neither funds nor encouragement are received from the local government or community at large consistently?

Continued on Page 8: Sweet Nursing Home

Besides inadequate reimbursement from the state Medicaid program, Sweet Home must turn around and pay the state a $15/day bed tax on each nursing home resident. For illustrative purposes, this was the crumb that the state tossed nursing homes in July 2023: a $49 per day increase in Medicaid reimbursement rates. At first glance, that doesn’t sound too bad. However, on average, more than 50% of Sweet Home residents are Medicaid reimbursements. In a 42-bed facility with 21 Medicaid beds, that equates to $1,029 per day. Then, the state levies a $15 per day bed tax on EVERY occupied bed, greedily reclaiming $630 per day, leaving a trifling $399.

Sweet Home is one of the few private, stand alone, non-profit nursing homes; we provide jobs for 55-60 people and beds for up to 42 people who need our services. The fastest growing segment of the population in Montana is 65 and older. Perhaps the time has come for the community to assume a vested interest in their future and help sustain these services. Rural nursing homes like Sweet are closing at alarming rates, not just in Montana. Please help us continue to provide the loving care we are so well known for.

There is a movement beginning for consistent volunteer help at the nursing home, and we are asking community members to remember us for donations as well (donations are tax deductible), whether it be in memory of a loved one or just because. We, as the Board of Directors, are looking into fundraising efforts as well, to help maintain the necessary level of operating funds. Sweet Home also has an Amazon “wish list” that we would be happy to give anyone information about. Community member help could also come by letters & constant communication to government officials to improve Medicaid reimbursement rates and do away with the bed tax nursing homes must pay.

We humbly put this information out to the public so that more people are aware of our precarious situation. The pandemic years were hard on our finances, and as we fight back from financial losses, while trying to maintain and update our facility on top of below cost reimbursement, we are forced to lean on our community for their support.

Leviticus 19:32 “Stand up in the presence of the aged, show your respect for the elderly and revere your God. I am the Lord.”

Respectfully,

Rebecca Shackelford, Administrator

Sweet Memorial Nursing Home Board of Directors

President, Art Kleinjan

Vice President, Shirley Brockie

Secretary, Sandy Miller

Treasurer, Dan Friede

Angie Billmayer

Denny Overcast

Richard Cronk

Mary Pyette

Shawna Billmayer.

If you would like to know more about volunteering in our activity department, please contact Betty Billmayer at (406) 390-4935 or (406) 357-4100.

Sweet Memorial Nursing Home is a non-profit 501(c)3 organization that you can make tax deductible donations to. If you would like more information about this, please contact the nursing home or one of the Board Members.

Here are phone numbers and email addresses of legislators that can be contacted regarding the Medicaid reimbursement rate and bed tax issue:

LOCAL AREA SENATORS AND REPRESENTATIVES:

Rep. Casey Knudsen, HD 33

(406) 390-0274

casey.knudsen@legmt.gov

Rep. Jonathan Windy Boy, HD 32

(406) 945-1805

jonathan.windyboy@legmt.gov

Rep. Josh Kassmier, HD 27

(406) 781-5386

josh.kassmier@legmt.gov

Senator Mike Fox, SD 16

(406) 399-0479

michael.fox@legmt.gov

Senator Mike Lang, SD 17

(406) 654-7357

mike.lang@legmt.gov

Senator Russ Tempel, SD 14

(406) 265-0990

russ.tempel@legmt.gov

INTERIM BUDGET COMMITTEE SECTION B,

PUBLIC HEALTH & HUMAN SERVICES

Rep. Bob Keenan

(406) 250-4111

bob.keenan@legmt.gov

Rep. Jane Gillette

jane.gillette@legmtlgov

Rep. Mary Caferro

(406) 461-2384

mary.caferro@legmt.gov

Senator Carl Glimm

(406) 751-7334

carl.glimm@legmt.gov

Senator Dennis Lenz

(406) 671-7052

dennis.lenz@legmt.gov

Senator Christopher Pope

(406) 581-8739

christopher.pope@legmt.gov