Many of South Dakota’s nursing facilities contend with mid-century infrastructure and a chronic lack of staff. With some on the verge of closing, some lawmakers say consolidation is the path forward.
Under House Bill 1014, long-term care centers would be eligible to apply for assistance and designation as a “regional” facility from the state Department of Human Services.
Sen. Jean Hunhoff, R-Yankton, co-sponsored the bill. While health care staffing issues are well documented across the state, she said aging facilities aren’t helping.
“A consistent message in those recommendations were those facilities," Hunhoff said. "Right now, 80 percent of the facilities we have are 50 years or older. If you’ve been to a nursing home you know what they got – they have the ‘L’ shape, they’re not designed for operational efficiency. This is an opportunity we want to provide, have that access, and encourage that. The end product is going to be a facility that services the individuals, meets with their needs, and we all want that for our family members.”
Speaker of the House and co-sponsor Hugh Bartels, R-Codington, said it’s a matter of updating the model nursing facilities utilize.
“What this bill would say, if two of them merge within 60 miles of each other or there’s not an ability to merge, and they need a new facility, we would step up and pay 100 percent of the depreciation costs for that new facility," Bartles said. "Having been on appropriations for four years, I think there’s usually enough excess money in the Medicaid budget to pick up two or three of these mergers – and they’re not going to happen overnight.”
Opposing voices argue current state law already allows consolidation to happen so long as the state won’t come out in the red. Steven Kohler with the Bureau of Finance and Management said the bill introduces risks to state finances.
“When they consolidate there’s economies of scale, there’s mergers, that will allow them to perhaps increase that rate while still being budget-neutral for the state," Kohler said. "In fact, the other issue that’s concerning about this bill is there’s no limit to what that full cost would be. While we talked about an $18-million potential cost of a building, this bill says the state pays whatever that building costs.”
In response, co-sponsors suggested additional rule-making authority be considered by the House appropriations committee. The bill was advanced to appropriations with a do pass recommendation on a 13-0 vote Thursday from the House Health and Human Services committee.