Ballard Care and Rehabilitation Nursing Home is taking action after a proposed state budget cut recently announced in Olympia could mean a drop of as much as $800,000 for Ballard Care alone.

The nursing home is proposing to the legislature an adoption of a quality maintenance fee that would then be matched by federal funds and can be returned to skilled nursing facilities in the form of an add-on to their current rates.

State lawmakers have proposed more than $90 million in Medicaid nursing home cuts over already reduced reimbursement levels across Washington state.

“The nursing facilities are lagging far behind the current rate of inflation, “ said Angie Davis, administrator of Ballard Care and Rehabilitation Center. “We suffer regularly from high cost of food, medical supplies, insurance for caregivers, liability insurance and utilities.”

Davis said they have suffered a 3.2 percent decrease in their Medicaid rates since April 1, which accounted for $19 a day for Medicaid residents in Ballard Care and Rehabilitation alone.

They are facing another 5 to 6 percent decrease in Medicaid rates in addition to that starting July 1.

“We were scheduled for an increase in our nursing facility rates for Medicaid in July 2010, which we can no longer look forward to,” Davis said. “The cuts for Ballard is equivalent to 25 full-time positions for certified nursing assistants.”

Esther Kamara, a certified nursing assistant of 19 years at Ballard Care, said she had seen many changes from the past in the facility just because of money, costs and government cuts.

“The government should know that we’re taking care of lives,” she said. “Right now the workload for one caregiver is about 12 to 13 residents; just imagine when you come at 6 a.m., you have to get them dressed, brush their teeth, give them a shower. How can you do that when you cut caregivers?”

Davis said their chances in adopting a quality maintenance fee, which is similar to a provider tax that skilled nursing facilities have used and paid for years, is a possibility because 40 other states in their union have adopted this measure and have executed it successfully.

The fee would have Ballard Care pay a provider tax. The state would then return that money and for every dollar the state returns to them the federal government would match $1.25, essentially costing Washington nothing and restoring their rates, said Bill Miller, regional vice-president of Washington SunBridge Care and Rehabilitation.

This is a fee that facilities are currently not paying in Washington.

“Without the change the Medicaid rate currently falls $35 below the cost of actual provision of care in Washington and 60 percent of our population are Medicaid funded,” Davis said. “ With the tax thats a change of $75 a day under actual costs, it’s very significant.”

Miller said they will target other sources like Medicare, as well looking into other cuts like putting off the purchase of state of the art equipment and repairing rather than replacing damaged equipment.

“It’s not our position to propose different ways for the legislature to solve their problems, so we’re not trying to pick which ones they choose,” Miller said. “We’re saying here’s an option for us and this will help us, will cost the state nothing and will restore funding we’ve already lost.”