It Takes a Village

As the legislature axes Medicaid, nursing homes close

By Beth Chapman, Administrator, Arbor Village

The legislature has cut—again—the reimbursement rate that Medicaid pays nursing homes. In just the first two weeks of April, those cuts have resulted in five nursing homes closing their doors and two more declaring bankruptcy.

At that rate, Oklahoma could be in for a serious crisis—nursing home beds won’t be available to those who need them.

Medicaid’s 2011 reimbursement rate averages an estimated $125.95 per resident per day, according to Rebecca Moore, executive director of the Oklahoma Association of Health Care Providers (OAHCP), based in Oklahoma City.

The average cost of care is about $143 per resident per day, she says, so nursing homes are losing about $18 per day for every resident on Medicaid, and, believe me, it adds up.

The nursing homes that are typically closing first are those in rural areas—which is extra painful because that’s where the percentage of people over age 65 is skyrocketing.

Elderly residents, who may have been part of that small town or community all their lives, will be forced to leave them now, at the end of their lives.

Perhaps even worse, there’s something called “transfer trauma,” which happens when a frail resident is moved out of their familiar environment. They may get sick or depressed, or they may even die.

On top of that, their friends and families have to drive farther to visit them, and that may result in fewer visits, which can be a lifeline to a resident who is now living in an unfamiliar community.

The cuts to SoonerCare health programs also don’t make a lot of sense. Because every dollar the state spends on the Medicaid program is matched by $3 from the federal government, the money the agency will save by reducing payments will mean a total cut to the state’s Medicaid program of three times that once those matching federal funds are taken away.

“The budget sure is scary for all of us,” Rebecca told me. “We’re afraid that if there are any more cuts, several more homes will close.”

Many, if not most, nursing homes are barely managing to pay their expenses as it is. In the past six years, more than 100 nursing homes in Oklahoma have closed. And if many more nursing homes shut their doors, it will be increasingly difficult for frail elderly people unable to live alone any longer to get the care they need, especially in rural areas.

Beth is the Administrator at Arbor Village. Arbor Village provides long term care and rehabilitation at 310 West Taft in Sapulpa. You can contact her at or visit their website at