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House of Representatives
Session of 2015 - 2016 Regular Session


Posted: April 14, 2015 02:07 PM
From: Representative Thomas H. Killion
To: All House members
Subject: County Nursing Home Share

In the near future, I plan to introduce legislation to repeal statutory provisions that require county nursing homes to pay ten percent of the non-federal cost of services for Medicaid residents cared for in those facilities.

Currently, Pennsylvania counties have those amounts funded through the Certified Public Expenditure (CPE) process, but this funding mechanism is not guaranteed year-to-year. In the past, county nursing homes received extensive funding through the Intergovernmental Transfer (IGT) process, and were able to cover the amounts they are required to contribute. While the IGT was phased-out years ago, the ten percent county nursing home share is still required, even though there is no such requirement for private nursing facilities. As evidenced by the increased frequency by which county homes have been sold or privatized over the past four years, it has become a struggle for many to stay afloat, yet the responsibility imposed upon them to pay the county share puts an additional burden on county homes of approximately $20 million per year.

Removing this continued burden from the county nursing homes would allow more counties to retain their county homes. Removal of this requirement would also free up the CPE funds generated by county homes to be paid directly to counties struggling with low Medicaid rates and high Medicaid populations. Cost report data from December 2013 showed that all but one county home had a Medicaid occupancy rate greater than 65%, and 17 of the 23 county homes had Medicaid occupancy rates over 75%. County homes are also required to accept Medicaid patients on day one, making them a vitally important safety net for Pennsylvania's most vulnerable and needy individuals. As more and more county homes privatize, it will become difficult to find suitable long-term skilled care for these persons. Eliminating the county share requirement would help ensure county homes can continue to serve those most in need.

Please consider joining me in sponsoring this legislation. Thank you!

Introduced as HB1062