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Story Retrieval Date: 4/17/2015 12:13:58 PM CST

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 Marla Friedman/MEDILL

Janice Hack, 79, is a lively resident of the Carlton who "considers it an honor to have lived in Chicago."  Her home, however, could be gravely impacted by Congress' proposed Medicare cuts.

Medicare cuts imperil nursing homes, advocates say

by Marla Friedman
Oct 15, 2009

Janice Hack is a spirited, 79-year-old resident of the Carlton on the North Side – she started a bridge club, sings in the choir and plays Nintendo Wii.  However, her home could be at risk with Congress’ looming cuts to Medicare dollars used for skilled nursing care.

Fewer Medicare dollars will mean fewer opportunities to provide a high standard of care, said Rose Marie Betz, administrator of the Carlton Health Care and Rehabilitation Center on North Montrose.

“There’s no way you can keep all these nursing homes with the cuts; they will have to close,” she said. “And then the licensing agencies are going to have to find a place for them. Where are they going to put them? On the street?”

Betz doesn’t think the Carlton, with 244 residents and 24-hour nursing and rehab services, could maintain its level of staffing and benefits if Medicare dollars are slashed, which is part of health care reform proposals.

“The residents we get now are medically complex, not run-of-the-mill type of patients that are just residents,” Betz said. “They require skilled care and skilled rehab, which will certainly be cut.”

Betz said funding cuts would be especially detrimental to facilities in Illinois, where the Medicaid rates are significantly less than the actual cost of providing care.  Illinois’ average Medicaid rate of $118 per day is $25 to $30 less than actual costs, said Terry Sullivan, regulatory coordinator for the Health Care Council of Illinois.  Medicare funding is the primary way a facility makes up the difference.

Medicare is the federal medical coverage for people of all income levels who are 65 and over. Medicaid, funded jointly by states and the federal government, provides aid to low-income patients of all ages. 

“The worst case scenario is that facilities that are very dependent on Medicaid will have to reduce the amount of care that’s provided, or close,” Sullivan said.

Gerardo Cardenas, associate state director for communications at AARP Illinois, said health care facilities for the elderly have his agency’s support.

“AARP would fight against a proposal that would harm beneficiaries or that would deny nursing home residents the care that they need,” he said.

Betz hopes to avoid any proposals that might put the Carlton at risk.

“If they’re going to continue with this journey of theirs to cut Medicare, the elderly population in facilities and out of facilities is going to suffer,” she said. “No question about it.”