SNF Digest: Idaho Medicaid Cuts Generate Strong Response

Steve LaForte, a principal and the CFO at Cascadia Healthcare, the largest post-acute care operator in Idaho, along with company CEO and Founder Owen Hammond and Tim Nelson, a principal and COO at Cascadia, penned an op-ed to the state’s largest newspaper to object to the state’s recently implemented 4 percent cut to Medicaid reimbursement rates for SNFs and other providers. Below is the op-ed as it ran in the Idaho Statesman.

Idaho Medicaid cuts for nursing homes are unsustainable. Crisis looms

Opinion By Steve LaForte, Owen Hammond and Tim Nelson

The state of Idaho recently implemented a 4% cut to Medicaid reimbursement rates for skilled nursing facilities and other providers. Now, just weeks later, another 4% cut is scheduled to take effect on Sept. 1. For policymakers, these may look like routine budget decisions. But for Idaho families, the reality is unavoidable: every reduction in reimbursement translates directly into reduced access to care.

At Cascadia Healthcare, we operate skilled nursing and post-acute facilities in communities across Idaho – from Boise and Nampa to Twin Falls, Lewiston, Idaho Falls and Coeur d’Alene. Here in the Treasure Valley, families rely on facilities like Wellspring Health & Rehabilitation in Nampa or Shaw Mountain of Cascadia in Boise to care for parents and grandparents. These are not abstract line items on a budget spreadsheet; they are places where Idahoans live, heal and depend on trained caregivers every single day.

Between 75% and 100% of the funding for that care comes directly from Medicaid reimbursement. When those rates are reduced, there is no way to make up the difference. Facilities like these cannot raise private rates to offset the cuts; there is no other revenue stream. Instead, we will be forced to reduce staff or accept fewer residents in order to comply with federal staffing requirements. In practical terms, that means fewer beds available for Boise-area families and seniors across the state, longer waitlists and potentially the closure of facilities.

Right now, about 25,000 Idaho seniors and their families rely on long-term care. In the not-too-distant future we know what’s coming: the “silver cliff,” as Baby Boomers age into a period of life where they are more likely to need post-acute and skilled nursing care. Instead of preparing for this demographic surge, these cuts weaken the very infrastructure we will need to handle it.

This isn’t just about seniors. It’s about the entire health care system. When nursing facilities can’t take patients, Idaho hospitals — from St. Luke’s in Boise to smaller community hospitals — struggle to discharge patients, clogging emergency rooms and reducing access for everyone. Rural towns are especially vulnerable; if a small skilled nursing facility in Orofino or Kellogg closes, families may have to travel hours to find care. Some argue these cuts are modest, or that long-term care providers should “tighten their belts.” The truth is Idaho facilities are already reimbursed at roughly 82 cents on the dollar for the cost of care. There’s nothing left to trim. A cut to Medicaid reimbursement doesn’t eliminate inefficiency, it reduces care. It means fewer nurses on the floor, fewer aides to help residents with daily needs, and fewer resources for rehabilitation, therapy, and quality-of-life programs. It’s worth remembering that federal lawmakers have made clear that Medicaid savings should not come at the expense of seniors and long-term care. And funding tools like provider taxes, which Idaho and nearly every other state use to draw down additional federal dollars, are legitimate, federally approved mechanisms. They are not waste or fraud. Without them, our already underfunded system collapses further.

Idaho prides itself on strong families, thriving communities, and caring for our neighbors. These cuts run counter to those values. They undermine the ability of caregivers the nurses, aides, and staff who show up every day in our facilities, to do their jobs. The truth is, these cuts send a troubling message to Idaho families: when it comes to caring for your parents and grandparents, you’re on your own. We urge Gov. Brad Little and the Idaho Medicaid Office to reconsider. Exclude long-term care and skilled nursing facilities from these reductions. Protect the funding that ensures Idaho seniors can remain in their communities, near their families, with the care they deserve. Once a facility closes, it rarely reopens. Once a caregiver leaves the profession, it is hard to bring them back. These are not short-term adjustments; they are long-term losses and they will be felt in every community in Idaho.

Idaho families deserve better. Let’s work together to find a better way forward.