• 530.541.3420 | 2170 South Avenue, S. Lake Tahoe, CA

Barton Health's Chief Nursing Officer Asking for Community Support to Help Pass AB900

Healing Garden outside Barton Memorial Hospital’s Skilled Nursing Facility.

Dear Community Members,

In recent months, Barton Memorial Hospital’s Skilled Nursing Facility has been challenged with keeping patients, staff and the facility in its entirety, safe from the effects of the California senate bill, AB97. If passed, this bill would create devastating cuts to reimbursement for Medi-Cal services provided by distinct part skilled nursing facilities (DP/SNFs) throughout the state, including South Lake Tahoe’s only long- term-care-facility located at Barton Memorial. This bill requires a two-thirds vote in both the State Assembly and Senate before it goes to Governor Brown for action. It will first be heard in the Assembly Health Committee on Tuesday, April 30. Since AB 900 is considered an “urgency” bill, it would take effect immediately if Governor Brown, signs it into law by July 1. Barton Health is hopeful the State Assembly and Senate seriously considers this bill. In reality, to sustain continued operations of our high-quality long-term-care services … AB900 must pass on Tuesday.

AB900, would stop the proposed budget cuts to Medi-Cal reimbursement [AB97] for medical services provided by hospital-based skilled-nursing facilities (Distinct Part SNF’s). Barton Memorial’s Skilled Nursing Facility is of-that-type and has predominately a population of Medi-Cal patients. At present, our licensed 48-bed skilled-nursing and short-stay rehabilitation facility often runs at full capacity. It provides care for aging adults offering private & semi-private rooms, 24-hour-care, activities, and programs that maintain and/or improve independence. In 2012, our Skilled Nursing Facility was awarded five-stars from Medicare, only given to the top 10% of nursing homes in the nation.

Cuts in reimbursement would force Barton Memorial to reduce capacity or close services completely as the acute-care reimbursement simultaneously declines with health care reform. 2011’s AB97 reduced Medi-Cal reimbursement rates for DP/SNF to rates applicable in the 2008-2009 rate year, less 10%, effective June 1, 2011, resulting in an effective rate decrease for most facilities of 25%. Cuts of this magnitude will have a devastating impact on the access of Medi-Cal beneficiaries to medically necessary skilled-nursing services. If AB900 does not pass, our skilled nursing facility may not only face cut-backs or closure, but will have to pay to the state of California (retroactive to June 2011) the amount of reduced reimbursement. Barton has been setting aside money for this very issue, however, losing those funds will impact our overall operations, drive up cost for the provision of acute-care and possibly jeopardize the future viability of Barton as the sole health care provider for our community. Part of the most vulnerable population Barton serves is the elderly and those with severe chronic disease. According to Barton’s 2012 Community Health Needs Assessment Report, 13.7% of the community in Barton Health’s primary service area are 65 years and older. Of this population, 76.9% are Medicare Supplement Insurance dependent (compared to the U.S. benchmark of 75.5%) which does not provide coverage for long term care needs. Surrounding facilities on the California West Slope have in recent years, decreased their long-term-care bed capacity and California residents do not qualify for Nevada Medicaid.

Barriers to long term-care-access would impact family members of elderly patients, forcing elderly residents to be removed from their loved ones and housed in facilities miles away from home. The distance disparity is complicated by geography (surrounded by four mountain passes), weather/road condition variability, and transportation challenges within the local community. Per the 2012 Barton Community Health Needs Assessment, 9.8% of primary service area adults lack transportation compared to 7.7% nationally.

If long term care services are forced to close, unemployment rates would rise, (current local unemployment is at 16.7%) adding to the ongoing threat of departure of local residents on the South Shore. This would negatively impact the fiscal landscape of our local economy which already suffers from a 5.2 million dollar deficit. Reduction of services could impose further erosion of our rural community resources, imposing a trickle-down effect to local businesses relying on tourism.

Barton Health is dedicated to educating our community on the effects of health care reform and its impact on Lake Tahoe residents and our surrounding areas. As the safety-net provider of health care for the South Lake Tahoe community, we rely on our local residents to make their voice heard on these concerns and issues. It is imperative that our district state legislative representatives become educated about the importance of AB900 and understand how vital the Barton Skilled Nursing Facility is to our community. We plan to keep you informed of the progress of AB900 and other changes related to health care reform.

Mary Bittner,
Vice President of Nursing and Ancillary Services
Barton Health

We encourage you to contact our local legislators and urge them to vote for AB900: Sen. Ted Gaines, email: senator.gaines@senate.ca.gov and Assemblyman Frank Bigelow, email.