Troubled vets home’s budget draws criticism

Friday, April 6, 2001 | 11:09 a.m.

CARSON CITY -- Amid construction problems regarding the state veterans home in Boulder City, legislators are voicing their displeasure with the home's proposed $20.8 million two-year operations budget.

A shortfall of up to $2 million is possible, and members of a Senate-Assembly budget subcommittee on Thursday told officials of the veterans home to resolve discrepancies and develop firm figures.

The subcommittee chairwoman, Assemblywoman Vonne Chowning, D-North Las Vegas, complained, saying, "You can't tell us any numbers."

The 180-bed veterans home is scheduled to open in early July. So far, 151 people have expressed interest in entering the facility, which has faced construction problems and delays.

Veterans Affairs Commissioner Chuck Fulkerson and Home Administrator John Sias say many entering the home will need acute care. This would mean Medicaid would be required to pay higher rates. Figures are based on operations of other veterans homes across the nation.

State Medicaid officials say most patients would require only intermediate care, which allows for lower payments. Their figures were based on the average expenses for a Medicaid patient.

Sias said the Medicaid figures "do not reflect the real-world of care of a skilled nursing home." Men suffer more acute problems, relating to weight, diet and bed sores, he said.

No one who represented Medicaid testified.

Fulkerson said Medicaid pays anywhere from $101 to $231 a day for the care of indigent patients, depending on the level of care. He said the budget could be $1.4 million to $2 million short if the Medicaid projections are accepted.

But he and Sias said this is a skilled nursing home that requires a higher level of care for its patients.

Chowning ordered a meeting of veterans, Medicaid, budget and legislative officials to iron out the differences. She said the Legislature cannot approve a budget that could lead to the closure of the home.

Sias emphasized that the level of care and the reimbursement rate is a "moving target" because nobody knows at this point what level of care each patient will require.

Of the 151 persons who expressed interest, Sias expected one-third might not quality for various reasons. And those admitted to the home will have to pick up some of the cost, depending on their income. "There is no free ride," Fulkerson said.

For instance, a veteran with no dependents might have to forego all of his or her pension, except for $90 a month spending money, Sias said.

The committee also told Fulkerson and Sias to firm up numbers regarding how much the Veterans Administration will pay per patient.

The veterans officials are to report back to the committee later.

Ed Gobel, president of the Council of Nevada Veterans Organizations, complained there could be a "$1 million hole in the budget."

A frequent critic of the operation, Gobel complained that the Veterans Home construction was reduced when problems arose, but the Lied Library at UNLV went over budget.

One cutback resulted in four patients sharing a bathroom instead of two. "The veterans in Southern Nevada have had no voice," he said.

Because of the problems associated with the home, Chowning said that the Interim Finance Committee would require quarterly reports on the home's finances.

Of the $20 million two-year budget, $7.7 million comes from the state, the remainder from Medicaid, the Veterans Administration and patient revenue.