County to fill Park Lane revenue gap

By Rod Haxton, editor

KanCare delays are biggest factor

Park Lane Nursing Home is once again faced with the prospect of not having enough money to meet its payroll and immediate bills, but this time it has nothing to do with low census or poor management.

This time the finger can be pointed to the slow disbursement of funds from the federal and state government agencies responsible for Medicare and Medicaid payments.

As a result, the Scott City facility is seeking about $161,000 in short-term funding from the county to cover current bills and payroll.

In a meeting with county commissioners on Tuesday, Park Lane officials said they haven’t received about $31,000 in Medicare Part B reimbursements from the federal government since November.

This wasn’t entirely unexpected.

It was in November that Park Lane began providing physical therapy services and became eligible for Medicare Part B reimbursement. Turner says they are still working out details in the filing of claims.

The nursing home will likely go through a similar process now that it has begun providing skilled care through Medicare Part A. The first Park Lane resident began receiving skilled care on Jan. 21.


KanCare Delays

However, the big culprit is the state’s new KanCare program that went into effect on January 1. There are 395,000 individuals on Medicaid in Kansas who have been assigned to one of three managed care organizations (MCO). Nursing homes in Kansas seek reimbursement for services provided to their Medicaid residents through these MCOs.

Billing for these services has been a “nightmare,” according to Park Lane office manager Nikki Cooper. The nursing home has not been reimbursed for just over $118,000 in billed services.

Prior to the start of KanCare, she says the nursing home would submit billing paperwork on Thursday and by the following Friday - eight days later - they would receive remittance. Park Lane has yet to receive a single payment since January 1.

“We aren’t alone,” says Park Lane Administrator Nicole Turner.

She has visited with a nursing home administrator with LeadingAge Kansas, an organization representing not-for-profit providers in the state, and been told other nursing homes are experiencing the same problem. Turner has also heard of similar reimbursement frustrations from H&M Healthcare, Inc., based in Texas, which is under contract to provide consulting services to Park Lane.

Texas adopted the MCO model for Medicaid recipients in March 2012 and there are still problems with reimbursement delays.

“The people at H&M tell me it’s been a very frustrating process,” Turner says.

Under KanCare, the state has approved contracts with three MCOs and assigned them to Medicaid recipients. Rather than dealing with one MCO who takes care of all the residents at Park Lane, Turner says they must work with all three MCOs.

When it comes to collecting money from the MCOs for billed services, Turner says the state has offered no help, or timeline when money will begin arriving. When told she would need to talk to the MCOs, Turner has been getting the runaround.

“One MCO I talked to said they didn’t think our contract had been finalized,” Turner says. “When the state made this move, there were concerns about whether we’d get our money on time. That’s what we’re up against.”


No Cash Reserves

Park Lane Nursing Home has been on thin financial ice for more than a year.

Frontline Management was having problems paying bills prior to its departure. The nursing home’s shaky financial situation contributed to the decision to end the management agreement with Frontline and also prompted the Scott County Rest Home board to sell off Park Lane Apartments.

“We sold Park Lane Apartments to pay the bills, but we can’t keep selling our assets,” noted board member Don Cotton.

Turner says they have been assured the money will be arriving, but they can’t delay paying a number of expenses, such as payroll and utilities. Representatives of the Park Lane board asked the county to provide funding to pay for some outstanding bills and to cover payroll. In addition to covering unpaid KanCare reimbursements, Park Lane is also seeking:

•$23,000 in a final payment to Nabholz Construction, which was the project manager for the new addition/renovation at Park Lane.

•$10,000 for a new stove and range in the kitchen.

•$7,325 for an industrial washing machine.

•$1,678 to replace a furnace in a room at Park Place Apartments.

Commissioners were told that furnace units in Park Place Apartments are obsolete and can no longer be repaired. Over time, each of the remaining 19 units will also need to be replaced.

Commissioners agreed to meet the nursing home’s cash shortfall in hopes state money will arrive soon. If there continue to be delays in KanCare and Medicare reimbursements, the Park Lane board may need to return to the county for more assistance.

“We’ll have to see where our finances are in another couple of weeks,” says Turner.

The commission was also advised that it will cost about $8,000 to correct a “design flaw” in the renovation which eliminated venting to the medication room. The vent is needed to maintain the medication room at proper temperature.

Representatives with Nabholz claim the design error was the architect’s fault, so they can’t be held responsible. This was not included in Park Lane’s request to the county.

In discussion with the Park Lane representatives, Commission Chairman Jim Minnix noted there is a line item in the county budget to assist with expenses related to the facilities. However, Minnix said the county has historically avoided providing funds for day-to-day operations.

“That would be an issue for our auditor to look at,” he said.

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