Nebraska Department of Health and Human Services

Two representatives from the Nebraska Department of Health and Human Services were in Norfolk Monday to see what kind of changes could be made to help nursing homes and their residents.

The representatives, Jeremy Brunssen and Matt Litt, are evaluating nursing homes, how they serve residents who are on Medicaid and how the state appropriates money to help cover those residents.

“We’re visiting providers and nursing homes about updating the payment methodology for Medicaid,” Litt said.

On Monday, Litt and Brunssen visited Fremont, Elkhorn and Norfolk to present and talk to nursing home care providers.

Brunssen said as of now, individual nursing homes will submit cost reports to the state, and the state will calculate appropriations for each based on existing regulations and the department’s budget.

He said that under the current system and regulations, some nursing homes may receive less than half that of another facility that provides a comparable amount of care.

“It doesn’t really seem right to be paying one facility less than half another facility,” Brunssen said.

Litt said also that while the department’s budget was increased by the Legislature this year, some facilities received even less money than before.

“In our estimation, we should have equity and equality in the system,” Litt said.

The proposed solution is to set a base rate for all facilities and also incorporate incentives for high-quality care.

“Today, we don’t take quality at all into consideration when setting the rates and appropriations,” Litt said. “We want to start paying for quality.”

Nursing homes are rated by the state on a five-star system.

Litt said the tour offers an opportunity to meet the administrators of nursing homes, health care providers and elderly residents on Medicaid and see what their individual needs are.

“It helps add color to the way we’re updating the methodology,” Litt said.

Norfolk, so far, is among the largest communities Litt and Brunssen have visited. They said that in their travels to communities across the state, they’ve been able to see the unique nature of each nursing home and the communities they serve.

“Everyone seems to be a little bit unique,” Brunssen said. “It’s been interesting to see the differences and unique challenges. It’s not just based on community size, but how it’s run by administrators and directors.”

Brunssen said the recent ballot initiative to expand Medicaid in Nebraska has little effect on changing payment methodology for nursing homes and Medicaid recipients.

“These are two separate projects happening concurrently,” Brunssen said.

The approximately 90,000 Nebraskans who would be brought into Medicaid as a result of the approved ballot issue are largely a different demographic than the Medicaid recipients at nursing homes, Brunssen said.

Brunssen said the department hopes to put its findings together and create a new model and implement it by July of next year.