Causes include low Medicaid rates, shortage of nurses
Iola Living Assistance’s (ILA) Board of Directors voted Dec. 11 to close its skilled nursing facility (SNF).
ILA’s assisted living facilities, The Willows and Living Oaks, will remain open.
According to Nicole Barrett, ILA’s administrator, decreasing occupancy levels, an escalating shortage of direct care workers and inadequate Medicaid reimbursement rates have created an untenable situation making the SNF no longer financially viable.
“Our average SNF resident occupancy rate a few years ago was 76-84%,” Barrett said in an email sent to the Waupaca County Post Wednesday, Dec. 18. “However, the SNF’s current annual occupancy rate is 44%.”
In Wisconsin, 17 skilled nursing facilities have closed their doors in 2019.
Inadequate Medicaid reimbursements
Rural facilities like ILA also struggle serving low-income persons receiving Medicaid.
LeadingAge Wisconsin, which represents nonprofit senior living and care providers, reported an average loss of $78.58 per day per Medicaid resident in 2018.
Wisconsin skilled nursing facilities have the second-highest losses for Medicaid reimbursement in the United States.
ILA averages 60-75% Medicaid days on an annualized basis, thus creating a significant cash flow shortage, according to Barrett.
“The recent and much needed Medicaid rate increase provided by the legislature and signed into law by the governor, unfortunately, came too late to help ILA,” Barrett said.
“While the decision to close the SNF was very heart-wrenching, I am extremely confident to report that Iola Living Assistance Inc. did everything possible to follow its mission, and maintain this level of care within our community for as long as possible,” Barrett said. “Years of positive leadership from the Board of Directors and CEO/administrators lead to the complete continuum of care for the elderly within our community.”
Tranisition to assisted living facilities
ILA began providing skilled nursing care in 1965, and in 1990 increased its bed count to 50 beds.
Later in 1994, a 12-unit independent living apartment complex was constructed for seniors over 55 years old. In 2008, Living Oaks was completed, creating the corporation’s first assisted living facility.
Most recently, ILA opened its second assisted living facility, The Willows, in April of 2019.
Many provider organizations have shifted their focus from operating larger and heavily regulated nursing homes to more modern residential facilities.
These facilities, like Living Oaks (RCAC) and The Willows (CBRF), can often care for people who formerly would have sought nursing home care.
Currently, ILA’s skilled nursing facility has 19 residents. Five will shift their care to Living Oaks or The Willows, pending clinical assessments.
“For residents for whom assisted living is not an appropriate option, we will strive to ensure alternate care settings are secured,” Barrett said.
Community support
Barrett noted ILA has seen astonishing community support throughout the years.
“It has allowed us to continue to follow our mission and provide ‘good old-fashioned neighborly care,’” she said.
Barrett said ILA has had a large, positive economic impact on the Iola-Scandinavia community.
As the SNF census trended down the last few years, ILA shifted more jobs over to its assisted living facilities.
“While there will still be job loss within our community from the skilled nursing facility closing, the impact has been greatly minimized,” Barrett said.
An estimated 23 people will lose their jobs as the facility shuts down.
Barrett said ILA’s leadership has created various long-range plans for renovation of the soon-to-be vacant building.
“Our commitment to our community’s older results remains strong and unwavering,” Barrett said.