Medicaid and Senate Bill 6807

There was an understandable uproar recently when the Poulsbo assisted living facility, Liberty Shores, abruptly issued eviction notices to 11 residents for whom the facility was receiving Medicaid payments. Just as abruptly, the facility announced some 10 days later that it was reversing the decision to withdraw from the Medicaid program.

The Liberty Shores scenario grabbed my attention because when my mother was there, the care was so costly that I easily imagined her landing in the Medicaid category, and we discussed the possibility with management during the admission process. We moved my mom to an adult family home after just under a year, which upgraded her care without increasing her costs. When she died, her assets were intact. But we might just as easily have kept her at Liberty Shores, with me functioning under the assumption that we could convert her to Medicaid when she ran out of money.

So when I read about the evictions, and their later cancellation, the topic attracted more than passing interest for me. In fact, the federal Medicaid program, for which people must be essentially indigent to qualify, pays significantly less than most facilities’ costs for daily care. The gap between what Medicaid pays for each qualified resident and what the boarding home pays must be made up somehow. The facility might reduce costs, or fees for private-pay residents could increase. Cost control is a relentless challenge in our healthcare system, and can mean cutting back on services.

It was Senate Bill 6807 that precipitated the Liberty Shores decisions. Passed mid-March in the legislature, 6807 stipulates that boarding homes operating under a Medicaid contract must not discharge already-enrolled Medicaid residents if the facility decides to withdraw from the Medicaid program. The evictions were issued just before the governor was to sign the bill, but rescinded after the state determined the residents would be covered by 6807 regardless.

For now, the Medicaid residents can remain at Liberty Shores, even if the facility decides to withdraw from Medicaid in the future, and all boarding homes must disclose to you in writing what the law requires with respect to their Medicaid contracts. These events should remind us that our system is stressed and not consistently protecting its most vulnerable members, or making a Medicaid contract attractive to boarding homes. Imagine how much more stress there’ll be when we boomers, 25 percent of the population, begin needing care: a topic for another column.