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Report: Low Medicaid reimbursement rates lead to private duty nursing shortage in Colorado

Private duty nurses give home-based care for patients with complex needs. Low Medicaid reimbursement rates are causing nurses to seek higher paying jobs, leaving families in vulnerable positions.
Posted at 1:20 PM, Mar 03, 2024
and last updated 2024-03-04 07:48:59-05

ENGLEWOOD, Colo. — Low Medicaid reimbursement rates are causing nurses in Colorado to seek higher-paying jobs, leaving families in vulnerable positions, according to a new report.

Amid crunching numbers and sending emails from the kitchen, Rod Schiller keeps an eye on his 13-year-old son, Luke, on a monitor.

Luke is hooked up to several machines in the bedroom.

“He does not eat without care. He doesn't go to the bathroom, you know, without help. He’s non-ambulatory. He can't turn over in the bed without somebody helping him. He is totally dependent on a good care provider,” Schiller said.

At one point, a machine beeps.

“His shaker just finished, so I’m going to do his cough assist,” Schiller explains.

Luke got his first home nurse when he was a toddler. Since then, it’s been a revolving door of nurses.

“We've had nurses that will stay two weeks, and they'll leave. Or we've had nurses that we want to leave,” said Schiller.

It’s a problem that’s only getting worse.

A new analysis done on behalf of the Home Care and Hospice Association of Colorado shows the state has some of the lowest reimbursement rates for private care nurses.

Colorado’s Medicaid RN payment rate is $7.05 below the median. For licensed practical nurses, the rate is $9.04 below the median.

The analysis shows that Colorado needs a Medicaid rate increase of 37.8% for RNs and 52.1% for LPNs to attract sufficient private duty nurses.

“It's really difficult to attract and recruit those nurses when we're competing against other settings that can offer better rates,” said Brent Hogue, area vice president for Maxim Healthcare Services. “Nurses have so many options. There's a caregiver shortage, that the nurses have so many options. And our ability to attract and retain the caregivers for this setting really relies on better rates in the state of Colorado.”

Report: Low Medicaid reimbursement rates lead to private duty nursing shortage in Colorado

Luke qualifies for round-the-clock care, but at the moment, he only has a nurse on four days and nights of the week. His family steps in to fill the rest.

Schiller said he realizes they’re fortunate to be able to do so, as other families may not have that luxury.

“You may not, depending on your job, you may not be able to have a job,” he said.

That’s why they’re calling on lawmakers to make a change.

The Joint Budget Committee heard public testimony in February from some of the families impacted by the shortage.

Luke’s mom Amy Wiedeman was there, sharing the family’s experience in front of lawmakers.

Wiedeman works full-time as a city planner for Centennial and often pulls all-nighters on the nights she takes care of Luke.

While Schiller has the ability to work remotely on days he takes care of Luke, he tells Denver7 he sometimes works 80 hours a week on top of caring for him.

It's a necessary sacrifice, but one he willingly makes for his beloved son.

“If Luke doesn't have good care, and if children like Luke don't have good care, not only do they not thrive, they don't live. I mean, you know, it can be fatal,” said Schiller.

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