Report: Nursing home costs to increase up to $177 million

By Mary Garrigan, Journal staff | Monday, November 10, 2008

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South Dakota's elderly population will double in the next 15 years, seeing 24 percent of the state's residents over the age of 65 and fueling big demand for nursing home beds and other long-term care services, according to a state task force report issued Monday.

The accompanying growth in Medicaid-funded nursing home costs is expected to cost the state anywhere from $120 million to $177 million more over the next 15 years, the Continuum of Care Task Force said in its report to Gov. Mike Rounds and the South Dakota Legislature.

The task force, created in response to a 2007 statewide study evaluating South Dakota's long-term care system, was charged with finding solutions to the concerns raised by the study. The task force issued numerous recommendations, some of which will become legislative proposals for the 2009 Legislature to consider, according to Ron Kortemeyer.

Kortemeyer, a nursing home administrator from Rapid City, was one of more than 100 task force members made up of state agency officials, industry representatives and advocates for the elderly.

One of those concerns is a geographic mismatch between the communities where skilled nursing home beds are needed and where those beds are currently located. The largest increases in elders by 2025 will be in just two areas: Rapid City and Sioux Falls, while many nursing homes in smaller communities are facing falling occupancy rates.

By law, the state has limited its skilled nursing home beds to 8,083, although not all of those are in use. There has been a moratorium on nursing home beds in South Dakota since 1988, although in 2003 an exception was made for the construction of a nursing home on a Native American reservation.

The task force suggests realigning moratorium bed levels through a voluntary system based on reimbursement rates. Overcoming the discrepancy between moratorium beds available and the number of licensed beds the state can accommodate needed nursing facility growth in areas of the state where demand is expected to exceed current bed supply, the task force said.

It also recommends prioritizing which nursing home facilities would be allowed to add beds and advocates for funding mechanisms to help Medicaid-strapped nursing homes pay for needed infrastructure. The federal Title 19 program pays 58 percent of the care for South Dakota nursing home residents.

The entire task force report can be found at http://dss.sd.gov/ltctaskforce.asp.

"I believe the task force's recommendations provide a good road map to meeting the changing needs," said Deb Bowman, secretary of the Department of Social Services.

The public can learn more about the recommendations at informational meetings in coming weeks. The first is scheduled from 6:30 p.m. to 8 p.m. Thursday, Nov. 20, at the Best Western Ramkota, 2211 N. LaCrosse St., in Rapid City.

On Monday, Nov. 24, from 6:30 p.m. to 8 p.m., an informational meeting will be available via Dakota Digital Network at locations in Hot Springs, Spearfish, Pierre, Chamberlain, Mobridge, Aberdeen, Brookings, Huron, Madison, Mitchell, Vermillion, Watertown and Yankton.