My mother died in October and she was on my mind during Thanksgiving last week. She had dementia for more than a decade; she was physically up and around until shortly before her death. While my sisters and I miss our mother, at 94 her death came quite naturally without pain or being bedridden except for the last couple of days.
I am thankful for the care, support and attention my mother received while living at a local nursing home, Woodlawn Care Center, in Newport. I write to thank the staff there and those that work in other nursing homes in our region. My experience has been that residents receive excellent care because of the individuals who serve them.
My mother was in the nursing home for four years and given that it is located near the route of my daily treks back and forth on John Stark Highway, it was convenient for me to stop by almost daily even if for just a few minutes. I saw up close the care provided to my mother and the other residents.
It was the special gestures of friendship, attention and love that were beyond the routine that so impressed me. Whether a resident had visitors frequently or not, all residents seemed to be treated well and with great care. It would be unfair to identify individuals, but I built a friendship with some of the staff that allowed for candor and a forthrightness about my mother’s situation as time took its toll. On her last night, one staff member asked for permission to read some bible passages to my mother.
I know there are exceptions to what my family experienced at one facility but in my role as State Senator I hear many comments about many subjects including nursing homes. I believe I am accurate in saying that most of us have had positive experiences.
So, at this holiday season, I wanted to recognize those who serve our seniors and others residing in nursing homes. It is an around the clock task every day of the year. For all those who do this important work I offer my personal thanks.
The headline on Charlie Arlinghaus’ column in the New Hampshire Union Leader read "Our state budget process is a farce." Arlinghaus’ column and the recent Governor’s hearings on departmental budget requests signal starting points in the biennial process of positioning, debating and passing a budget over the next seven months.
The hearings are just a step in a process that began on Oct. 1 when department heads provided the governor with a maintenance budget. Spending as we are now, with built-in cost increases, would drive the cost of running the government up by more than 30 percent. That’s simply not where we are going to be when a budget agreement is reached..
Folks like Charlie Arlinghaus can call the process farcical, but the Oct. 1 budget proposals and the Governor’s public hearing are statutory requirements. What is not required by law is the Governor’s request that departments come in with a second budget … one that would reduce their cost of operations by 5 percent over what they are spending this year.
You can be sure the new legislature with a veto-proof majority is looking for a government that will operate with less spending. That will insure that new and increased taxes and fees will not be on the agenda as we move toward a balanced budget to be approved next June.
There will be many challenges. One will be Medicaid reimbursement to our nursing homes. County facilities rely heavily upon Medicaid payments for reimbursement of a large portion, but not all, of the costs of caring for their residents. Costs not covered by Medicaid or other revenue end up as an expense in county budgets that gets passed on to the property tax payers.
Private nursing homes also receive reimbursement payments for their Medicaid-eligible residents. Their losses caused by state Medicaid reimbursements that do not cover costs are made up by charging private paying patients more or providing other services that generate revenue from other payers.
There is a delicate balance between state reimbursement rates and how much a public or private nursing home facility can absorb in losses. Medicaid is a major budget item. It provides services to many low income individuals and families, but payments for nursing home care is the highest cost item.
If the number of people eligible for Medicaid in nursing homes increases over the next two years, what does that do to state costs? Do you hold down reimbursement rates from the state? Will that push more costs onto county property taxpayers? Can private facilities continue to serve Medicaid residents or will they move away from the nursing home business?
Add to those questions the fact that for every dollar the state commits to nursing home reimbursements, the federal government matches with another dollar or more. The result is that for every dollar the state cuts in payments we leave a dollar of federal money on the table.
What may be a farce to one person is the beginning of a serious, long dialogue over some very important questions about how we spend the state’s money in the next biennium. Reimbursement rates to private and county nursing homes will be one of those questions.
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