DaytonDailyNews.com

Local hospital and nursing home officials say they will lose tens of millions of dollars in revenue at a time when they're already hard-pressed to staff their facilities under new fees proposed by Gov. Ted Strickland to cover escalating Medicaid costs.

Hospitals in Montgomery County expect a $25 million drop in revenue under the proposed biennium budget for 2010-2011 while five nursing homes in the county will lose more than $1 million each, officials said Friday, March 13.

Several Dayton area hospitals have recently announced staff reductions because of declining numbers of privately insured patients. "I can't imagine things getting any better with our losing $25 million from our community," said Bryan Bucklew, chief executive of the Greater Dayton Area Hospital Association.

Statewide, hospitals expect to lose $411 million in revenue under the governor's plan, resulting in lost jobs, higher patient costs and the closure of some facilities, said Tiffany Himmelreich, a spokeswoman for the Ohio Hospital Association.

Ultimately, employees and consumers will pick up the tab, she said. "Basically, they're balancing the Medicaid budget on our backs."

Nursing homes say they will lose $187 million statewide, said Alan Melamed, a spokesman for the Skilled Nursing Care Coalition of Ohio. "I don't think there's any question that there will be (nursing homes) closed" as a result of the plan, he said.

Melamed said five facilities in Montgomery County — Bethany Lutheran Village, Mercy Siena Woods, Maria-Joseph, Miami Shores of Moraine and Vandalia Park — stand to lose more than $1 million each under the governor's plan.

"Beyond that, it gets down to staffing and trying to care for people in an environment that gets more and more expensive ... because the acuity of ("patients') conditions is increasing," Melamad said.

The governor "crafted a budget that was full of tough choices and shared sacrifice," said Amanda Wurst, a spokeswoman for the governor's office.

The increase in state franchise fees for large Medicaid providers enabled the state to "provide essential services for Ohioans at a time when those services are needed most," including boosting funds for schools, lowering college tuition and increasing access to health care.

Kettering Health Network chief executive Frank Perez told reporters Friday that the network of five hospitals is eliminating about 55 positions, mostly through attrition, as part of a hiring freeze that began in October.

"We are only replacing direct patient care positions as they open," Perez said.

He also said that "executives will not have salary increases this year" and "it's very likely" they will not have bonuses, either, "although the board (of trustees) has not made the final decision."

Perez said the network — which includes Kettering Memorial, Sycamore and Greene Memorial hospitals and Grandview and Southview medical centers — expects to lose $20 million in revenue from a drop in both patient volume and in privately-insured patients. The network's total net revenue is $780 million, he said.

Children's Medical Center is eliminating 50 full-time positions over the next six months and Wilson Memorial Hospital in Sidney is trimming 23 full-time and part-time jobs. Other hospitals here say they are taking a close look at patient volumes and staffing.

Medicaid, the health insurance program for the poor and disabled, is funded through combined state and federal dollars.

Under the governor's two-year budget plan for 2010-2011, all Medicaid providers — including hospitals, nursing homes and managed-care companies — would pay $1.3 billion in franchise fees in order for the state to collect a larger federal match, which ranges from 50 percent to 90 percent.

Medicaid providers would get some of their assessment money back but not all of it, hospital and nursing home officials said.

As the recession worsens in Ohio, state officials are projecting that Medicaid rolls will increase by 173,000 over the two-year budget. Medicaid currently provides health coverage to 1.8 million Ohioans at a projected cost of nearly $12 billion for the fiscal year ending June 30, or nearly one-quarter of the state's total budget.

Contact this reporter at (937) 225-2437 or jdebrosse@DaytonDailyNews.com.