The Nursing Home Profits and Losses measure shows the percentage of the 35 Vermont Nursing Homes which accept Medicaid, which have significant annual losses in excess of $100,000. The Division of Rate Setting (DRS) receives the nursing’s homes profit/loss data from its audited annual financial statements, which are received with each provider’s annual cost report submission, used to set the Medicaid rate.
This measure can be a useful indicator of:
- Nursing home providers’ financial health and ability to continue operating and serving Vermonters;
- Potential quality issues stemming from not having adequate cash to pay its vendors resulting in cuts to critical services; and
- The adequacy of the Medicaid nursing home rates in terms of whether they cover the cost of services that the nursing homes provide.
Vermont Medicaid resident days make up 61% of total nursing home days in the 35 Vermont nursing homes that accept Medicaid. Vermont Medicaid is the overall largest customer to these nursing home providers and the providers are dependent on Medicaid revenue derived from the per diem rates set by DRS. Medicaid rates are a large driver of nursing home financial health and whether the nursing home makes profits or losses. Losses indicate that the provider is not taking in enough revenue to cover its costs, and sustained losses year-after-year raise concerns that the nursing home is being depleted of its financial resources and that the quality of services is potentially at risk due to lack of funds to pay for them. When DRS observes large, continued losses at a nursing facility, it notifies its partners at DAIL and DLP. These Departments are responsible for monitoring the quality aspects of the facility and DRS works collaboratively with them to closely monitor the facility for any problematic changes to the services that it provides to its residents. There is a clear link between nursing home financial health and quality, which allows DRS and its partners to minimize the impact a nursing home’s poor financial health has on the quality of care it provides its residents.
The measures are taken from providers annual cost report submissions, many of which were delayed for several months due to COVID. We granted many extensions to providers who needed extra time to complete their cost reports. Due to that delay, the measures are not yet available.
Last updated 10/15/20