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A suit on reimbursement policy.

Nursing Homes Long Term Care Management

| May 01, 1988 | COPYRIGHT 1988 Vendome Group LLC. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Meanwhile, a group of 11 Washington State nursing homes themselves went to court in late November. They sued the state.

They challenged the system by which the state reimburses nursing homes for the lower of: (1) costs for the previous year plus an inflation factor (prospective) , and (2) "audited allowable costs," a portion of actual expenditures. If the rate paid on a prospective basis exceeds what homes actually spend, the nursing homes, of course, have to pay back the difference. The system does not work the other way around.

That's the way the law reads, the Department of Social and Health Services rebutted, pointing out that it is required to reimburse only what an economical and efficient operation -as the Social/Health Services sees it-would spend. It further contended that Washington pays a higher portion of nursing home costs than do most other states.

The case began in late November in a county superior court, but the state had the case moved to U.S. District Court; it brought in the U.S. Department of Health and Human Services (HHS) as third-party defendant. The suit was filed as a class action on behalf of all homes, but many opted out, a right which the Washington Association of Homes for the Aging (WAHA), representing nonprofits, fought to maintain. Karen Tynes, executive ...

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