Senators, Sandhill residents tout bills to address ‘care deserts’ due to closings of senior care centers across Nebraska

LINCOLN — Eleven state senators, as well as rural residents who now drive hours for medical care, called last week for an end to the expansion of “care deserts” in Nebraska.

Those are counties, which now number 15, that no longer have a skilled nursing home or assisted living center.

One care desert is in Nebraska’s wide-open Sandhills, where the closure of a nursing home in Mullen two years ago has forced residents to drive 90 miles or more for medical care.

Jeanne Gentry, who lives north of Hyannis, said their home is two hours from help for a health emergency or an injury on their ranch.

‘Tragic results’

“You have to make a choice,” Gentry said, “does a (medical) situation deem traveling that far?”

But not all medical needs can be taken care of at home, she added, describing how it might take a minimum of an hour for a local ambulance to reach their ranch if someone had a heart attack. The long drive to a hospital — and the delay in care — can lead to “tragic results,” Gentry said.

She added that she needed rehabilitation at a care center after a recent surgery, which ended up being an eight-week stay, 2½ hours away in Broken Bow.

“If you don’t live in a care desert, it’s difficult to understand our situation,” Gentry said.  

In the last three years, 12 nursing homes and 17 assisted living homes have closed in Nebraska, said State Sen. Myron Dorn of Adams.

That leaves 15 of the state’s 93 counties without such care centers, which is a crisis situation, Dorn said at a press conference Thursday.

Long drives to visit loved ones

It forces families and friends to travel further to see loved ones, and visits, he said, have an important impact on a person’s health and well-being.

“We can’t continue at this pace,” Dorn said. “We have to try and find a way to stop this cycle.”

The senator has introduced two bills to address the issue and attempt to halt the closure of more skilled nursing and assisted living facilities by improving the state’s reimbursement rates for care.

Public hearings on Legislative Bills 941 and 942 are scheduled Tuesday before the Legislature’s Appropriations Committee.

Bill address ‘gap’ in reimbursement

LB 941 would increase the current Medicaid reimbursement rates for care at an assisted-living facility based upon recent recommendations of a study done on behalf of the Nebraska Health and Human Services Department. The study recommended a 17% increase in the provider rates.

LB 942 would appropriate funds to DHHS to increase Medicaid reimbursement by 5% for nursing facility care. The current gap between reimbursement and the actual cost of daily care is nearly $50, according to the Nebraska Health Care Association, and the bill would help narrow, but not close, the gap.

It’s important that care is reimbursed adequately, said Jalene Carpenter of the Health Care Association, to prevent more care centers from closing.

Dorn added that inadequate Medicaid reimbursement not only can force closings, but also hifts the cost of care onto non-Medicaid residents, thus forcing up their costs.

About 60% of all residents in nursing homes in Nebraska are covered by Medicaid, Carpenter said.