Legislators must act to save long-term care in Iowa

Amid The Gazette’s legislative headlines this year, one story has yet to rise: Iowa’s Legislature must act to raise Medicaid reimbursement rates for long-term care. It’s the single biggest step to continue delivering quality care to all Iowans, and the system will crumble without a substantial increase.

I’m speaking up as the leader of West Ridge Care Center in Cedar Rapids, which is not what many would consider a typical nursing home.

We formed in 1992 when a local pharmacist saw the need for a private pay facility with private rooms. Our focus is on therapy — reshaping lives and restoring lost abilities after an illness or injury, returning people to their homes. Over time, we’ve accepted Medicare in connection with hospital services. In 2019, we opened our facility to Medicaid residents.

As I talk to other Iowa nursing home providers, more than half the people they serve are on Medicaid. With rapidly rising inflation, Medicaid rates have not kept pace with the rising costs of care.

When you look closely, Iowans’ reliance on an underfunded Medicaid system is leading to care access issues. Nearly three in four providers have limited or stopped taking admissions; more than a quarter have wait lists for new admissions.

This struggle to deliver long term care affects essential access to acute hospital care. Across Iowa, patients remain in hospital beds because, while they are no longer in critical condition, they are not well enough to return home. Limited long-term care facility admissions can leave people in a hospital bed for weeks or months, reducing space for those with a critical medical need.

Iowans on Medicaid deserve quality care, and caring staff must be paid for their skills and commitment. We must remain open for Medicaid patients.

Iowa saw a record number of long-term care providers close in 2022. As closures accelerate, more people travel further to get essential long-term care for a loved one. We’ll see bigger problems with the disintegration of families and communities. Every small facility is important to their community. It’s like losing the local school — a larger employer and a center of caring.

There are over 20,000 Iowans receiving long-term care at Iowa nursing homes today. Demand for long-term care is projected to increase by 16.7 percent by 2030, and an additional 17.6 percent by 2035. Everyone wants care to be there when they need it. I serve 54 residents today who didn’t think they would be in a skilled facility but are thankful today to have the option to receive the care they need in their local community.

Indeed, regardless of age, people need this system. We had a 50-year-old gentleman who had a work accident and stayed for three months of therapy; he never thought he’d be using this system. It was a challenging case, requiring a lot of care. There’s a lot of care beyond the doctor’s office and hospital. We’re part of a process to get people home successfully — to get the best health for patients. Our average length of stay is less than a year and continues to shorten.

Colleagues talk about it: why do we do what we do? There are easier ways to make money. We do this work because we are called to do it. It’s a calling, not a job. I can’t pay anybody what they’re really worth; these are people who know and care for one another. If we don’t support this work, then how do we respect the lives of our parents?

The time for a substantial increase in Medicaid reimbursement is now. Without it, access will deteriorate quickly. So, I ask that Iowans understand what we really do: give quality of life to those that we love.

Richard Curphey is administrator at the West Ridge Care Center in Cedar Rapids.

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