National and state long term care advocates said that the deep funding cuts contained in the Children's Health and Medicare Protection Act of 2007 (CHAMP Act), which was passed by the U.S. House of Representatives last night, would directly threaten the health and well being of the nation's oldest, sickest nursing home residents, and vowed to make restoration of the 2.7 billion dollars five-year Medicare funds that are so critical to seniors' quality of care a top priority during Congress' August recess.

"These are the wrong cuts, at the wrong time, directed at the wrong patient population of highly vulnerable seniors. We intend to ensure that Members of Congress are made aware during the August recess that these cuts could seriously jeopardize the health and well being of their oldest, sickest constituents," said Bruce Yarwood, President and CEO of the American Health Care Association (AHCA).

AHCA supports the reauthorization of the Children's Health Insurance Program (CHIP), but fervently objects to how the House chose to pay for it in the CHAMP Act. "While the broader objectives of the bill are worthwhile, it is irresponsible to finance the expansion of health insurance for our children with major Medicare cuts to our seniors - especially disproportionate cuts that would force beneficiaries and providers in just five states to bear the brunt of the costs."

The AHCA President and CEO is referring to analysis of Congressional Budget Office (CBO) data* that finds beneficiaries and providers in Florida, New York, California, Texas, and Ohio would suffer 33.1% of the total nursing home cuts-approximately $895 million over five years. The top ten state-specific, five-year cuts in order of magnitude are: Florida - $205 million; New York - $184 million; California - $183 million; Texas - $168 million; Ohio - $155 million; Illinois - $147 million; Pennsylvania - $140 million; New Jersey - $102 million; Michigan - $101 million; and Indiana - $88 million.

Yarwood remarked at the irony of House leadership's attempt to portray the CHAMP Act as beneficial to "America's Greatest Generation" despite the fact that it cuts the very same funding that, just over 24 hours prior to the House vote, the Centers for Medicare & Medicaid Services (CMS) increased by 3.3% to ensure that quality improvement gains made by skilled nursing providers could be sustained.

Yarwood said, "While CMS has correctly recognized and acted upon the fact that the long term care profession faces dramatic increases in labor, energy, liability, and capital costs, the House leadership has patently ignored these fundamental economic realities - to the detriment of 'America's Greatest Generation' and future retirees. This stark disconnect between the realities recognized by CMS, yet ignored by House leadership, will be a major point of discussion throughout the August recess." Yarwood expressed appreciation for the efforts of those who recognized the impact such cuts could have and who tried to strip the $2.7 billion, five-year Medicare cuts from the CHAMP Act.

State long term care leaders also criticized the Medicare cuts, and said federal lawmakers will be called upon by their constituents to address these steep funding cuts during August recess.

"Nursing homes and our vulnerable residents are dependent upon adequate government funding for our collective survival, and the unfortunate action taken by the U.S. House of Representatives will be poorly received by Florida's senior and long term care community," predicted William J. Phelan, Chief Executive Officer of the Florida Health Care Association (FHCA). "Furthermore, this shortsighted legislation neglects to take into account how Medicare helps to bridge the growing funding gap between the actual cost of providing quality long term care and Medicaid reimbursement for that care. In effect, the CHAMP Act represents a 'double-whammy' hit to funding care for very fragile seniors in their 70s, 80s and 90s - one that's totally unjustified."

"We should agree that our nation's vulnerable populations on both ends of the age spectrum deserve quality health care," commented Texas Health Association President Tim Graves. "Surely Congress can find other ways to pay for children's health care than cutting the funds that America's seniors rely on for their own care."

Dr. Stuart H. Shapiro, President and CEO of the Pennsylvania Health Care Association (PHCA), said, "Both our children and our most at-risk seniors deserve quality health care - but expanding the budget for children's health care should not be placed on the backs of Pennsylvania's elderly. With the Commonwealth's seniors slated for five-year, $140 million Medicare cuts, PHCA will be contacting all of Pennsylvania's federal legislators over the August recess regarding this critical issue, and we will vigorously pursue a resolution to this troubling budgetary development."

The Health Care Association of New Jersey's (HCANJ's) President and CEO Paul Langevin pointed out that the $102 million Medicare cut to New Jersey seniors would undermine the future viability and capacity of New Jersey's long term care infrastructure at a time when baby boomers are beginning to enter our retirement system in large numbers. Langevin said, "Our efforts to modernize and refurbish aging facilities and equipment, acquire and implement new technologies to accommodate advances in medical practices, and meet the increasingly complex care and rehabilitative needs of our state's oldest seniors will be severely constrained. Supporters of the CHAMP Act have little basis to claim this legislation is elder-friendly."

The AHCA President and CEO said that further scrutiny and discussion of this legislation will reveal the enormously negative impact it would have on seniors and those who care for them in rural, suburban, and urban settings." The more we evaluate and speak out about the financing details of the CHAMP Act," said Yarwood, "the more we will find that seniors nationwide - and those who care for them - have an enormous stake in ensuring these Medicare cuts are rescinded."

Yarwood concluded, "The overriding lesson of the past ten years - since enactment of the Balanced Budget Amendment (BBA) in 1997 - is that when Medicare funding for skilled nursing services is stable, quality of care and services improves. When Medicare funding is cut drastically as is the case with the CHAMP Act, our nation's long term care infrastructure deteriorates - to the detriment of the Greatest Generation as well as future retirees." AHCA will make every effort to work with Congress to rescind these cuts as the legislative process moves forward.

*Computed by AHCA Reimbursement and Research Department using CBO data from Estimated Effect on Direct Spending and Revenues of H.R. 3162, the Children's Health and Medicare Protection Act, released on July 30, 2007, and Medicare day distribution data from CMS Skilled Nursing Facility 100% claims data from 2005.

The American Health Care Association represents nearly 11,000 non-profit and proprietary facilities dedicated to continuous improvement in the delivery of professional and compassionate care provided daily by millions of caring employees to 1.5 million of our nation's frail, elderly and disabled citizens who live in nursing facilities, assisted living residences, subacute centers and homes for persons with mental retardation and developmental disabilities. For more information, please visit ahca

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