Children’s care center officials confident of reaching funding deal

Michelle Swafford

Wednesday, June 1, 2005 | 11:19 a.m.

The Las Vegas Valley's only skilled-nursing home for children said recently its doors would likely stay open even though it has already closed one wing and is losing money.

Kids Care, a division of TLC Care Center, said it has been contemplating closing part of its 28-bed pediatric unit because of inadequate Medicaid reimbursements, which is the primary funding source for many of its patients. The center closed a 28-bed unit last fall because it was losing money.

The center's executives have been meeting with the state Medicaid office to find a solution.

Kids Care was started three years ago at 1500 W. Warm Springs Road in Henderson by local real estate developer Leslie Dunn and seven other owners. The children's unit is a separate center within TLC's adult skilled-nursing center and is adorned with themed murals that include sparkly eyed sea horses, butterflies, elephants, dogs and penguins. Colorful umbrellas hang from the ceiling where some of the children play and watch television.

The patients are at Kids Care for varying reasons such as automobile accidents, drug addiction, head trauma and child abuse and all of them need continuous care and supervision, TLC and Kids Care Administrator Linda Gelinger said.

Caring for those kids requires a lot of one-on-one time with nurses and other costly care, Kids Care representatives say.

"We have to take them a lot of times to the doctor and you have to send a nurse with them," Dunn said. He estimates that cost about $250 per day for the nurse.

"We have to eat the costs," Gelinger said, adding that most corporations won't take on such a center because of the challenges associated with operating it.

TLC receives between $160 and $170 per day for adult patients, which is considered "adequate," Dunn said.

Kids Care would be eligible for higher Medicaid reimbursements if it were licensed as a rehabilitation center but that would require the facility to be rebuilt, Dunn said.

Chuck Duarte, administrator of Nevada Medicaid, said the center receives $176 per day for less sick patients, which is the standard rate. Nevada Medicaid pays $494 per day for children with medium-level medical needs and $619 per day for the most critical patients, which often involves a ventilator, he said.

"I can't subsidize the lower acuity-care children with higher rates that are for the high-acuity children," Duarte said. "But we can look at the current rates."

Nevada Medicaid staff met with Kids Care officials last week to discuss possible solutions such as appealing the current reimbursement rates, Duarte said.

It is uncertain at this point whether Nevada Medicaid would approve Kids Care's request for higher reimbursement, he said.

If the state does not increase its reimbursement rates Kids Care would have to look at alternatives, which could include placing the children in other skilled-nursing homes outside of Nevada, Gelinger said.

"We can't take care of the children with just a standard rate," she said. "We're hoping they'll work with us to work on the reimbursement rate."

She said she believes the state and the center can come up with a workable plan that benefits the children and the community.

Many of the center's children are considered to be less acutely ill by state standards but the children are reassessed every six months to determine their level of care and the equivalent reimbursement rate, she said.

Children typically stay at Kids Care for an average of four to six months after they are released from the hospital, Gelinger said.

Hospitals focus on short-term stays while the skilled-nursing home is a place where patients can recover and transition to home care.

That's exactly why William "Tommy" Thomas is being treated at Kids Care. The 12-year-old boy had a freak bicycle accident last November and damaged an artery near his pelvis with the bicycle handlebar.

Thomas was admitted to Kids Care on March 8 after being hospitalized for months. After his accident he was in a coma and once he woke up he was unable to speak, eat, walk and do many basic skills, his mother, Laura Rowe said.

Shortly before he arrived at Kids Care, he went on solid foods and was working with a speech therapist, Rowe said.

"At TLC he started to talk but there was no sound," she said. "He would whisper it. He found sound about three weeks ago."

Thomas has surpassed his family and medical team's expectations, Rowe said.

"When he got to TLC they just took him and ran with it," she said. "He's done so much in a few months. He's surpassed what anyone expected him to do."