Shelby County Today: Incoming State Rep. Shofner Tours Focused Care at Center

Soon-to-be state representative for Texas’ District 11 Joanne Shofner recently visited Focused Care at Center to meet with senior residents and long term care team members to learn more about skilled nursing care and the overall challenges in health care delivery.

“Mrs. Shofner spent nearly 2 hours with us asking questions about the needs of skilled nursing care and listening to our answers,” said Hollie Adams, Executive Director of Operations for Focused Care at Center. “I am hopeful when the legislature convenes in January that we have a state representative who understands how long term providers strive to deliver quality care with compassion and what we need to help us do that.”

Adams outlined what many Texas skilled nursing providers are asking state legislators for in the 89th legislative session beginning January 14, 2025:

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McKnights: ‘Crying wolf’ or dying breed? Incentives often ignore plight of rural skilled nursing operators

For Mark McKenzie, CEO and founder of Focused Post-Acute Care, a lack of physicians and advanced practice clinicians to care for patients at his 26 Texas facilities is the most pressing issue. If the government would pay more for them to drive to and treat patients at his mostly rural facilities, he could work with hospitals to capture more of the locals being sent miles away from home for skilled care.

Nationally, the only physician add-on available, however, is for doctors associated with rural clinics, or those willing to create a clinic of their own.

“No physician’s going to do that for one patient. Delivery of healthcare and being reimbursed for healthcare as a provider should not be that difficult … but we make it difficult in our processes,” said McKenzie, who has for years lobbied lawmakers on the idea of a critical access label or “safety net” designation that sends more financial resources to rural nursing homes at risk of closure.

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Skilled Nursing News: ‘Astronomical’ Medicare Advantage Denials, Pre-Auth Issues Cause Outcry from Nursing Homes

The Medicare Advantage preauthorization process and denials of care are a growing concern across the continuum, and nursing home operators and advocates — as well as federal lawmakers — are pushing more urgently for change.

Such concerns are not new, and already some action has been taken: the Centers for Medicare & Medicaid Services (CMS) has sought to stop diversions of patients away from skilled nursing facilities while ensuring more consistency between MA and traditional Medicare.

Nevertheless, these forthcoming changes haven’t eased the headaches faced by nursing homes nor allayed fears by advocacy groups. And legislative efforts to reign in MA plans need to be stronger, nursing home operators and advocates say.

“Insurance providers won’t pay for patients to stay because, per their guidelines, they were well enough to go home … it is just astronomical, the amount of patients that are discharged too early because the insurances will no longer pay,” said Laray Fayad, Regional Director of Care Connect and Census Development at Texas-based Focused Post Acute Care Partners (FPACP), which operates 27 nursing homes.

In the end, the burdens of cost and care are shifted to providers of health care across the continuum, Fayad told Skilled Nursing News, and quality gets compromised while rehospitalizations go up.

Click Here to Read the Full Article Written by Zahida Siddiqi at SkilledNursingNews.Com!

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