TULSA, Okla. (AP) _ A fee paid by nursing home residents to increase staffing levels and pay for additional nursing home inspectors has raised millions of dollars since it was enacted last year.
But the ``quality assurance'' fee is being criticized as unfair by some families whose loved ones are housed in private-pay nursing homes that don't benefit from the fee.
``It is a terrible tax burden on a minority that is uncalled for,'' said Margaret Swimmer of Tulsa, whose mother is in an assisted-living facility and may eventually require a private-pay facility. ``It is just not equitable.''
The fee, also called a provider tax, was approved by the 2000 Legislature as part of a health care initiative designed to improve the quality of care in state nursing homes. Funds are paid on a per patient, per day basis and are used by the state to leverage additional Medicaid dollars.
The fee increased this month from $4.90 a day to $5.90, said David Branson, financial manager for the Oklahoma Health Care Authority. As of May 31, the authority had collected $31 million from the fee, which matched with federal dollars for a total of $100 million, spokesman Nico Gomez said.
But the relatives of patients in private-pay facilities that don't accept Medicaid said they are concerned about the financial stability of loved ones who have saved for their retirement and are not eligible for Medicaid.
``As an Oklahoma resident, we need to provide adequate funds to get Medicaid reimbursement,'' said Barbra Weikel of Tulsa, whose mother, Dorothy Blackwell, lives in one of about a dozen private-pay nursing homes in the state.
``But I think that is the job of the taxpayers,'' Weikel said. ``It is grossly unfair to tax a few people who prepared.''
She said the fee undermines people's ability to plan for their futures. Some spouses who have a loved one in a nursing home are spending down their assets in order to pay the fee, she said.
Under federal rules, a state can enact a quality assurance fee only if all nursing homes participate, even homes that do not take Medicaid clients. Efforts to exempt the private-pay homes died in the final days of the 2001 Legislature because of the threat to Medicaid funding.
The Oklahoma Health Care Authority, the state's Medicaid agency, has asked the Center for Medicare and Medicaid Services if it can return money generated by private-pay facilities without violating federal rules.
In September, staffing ratios for all nursing homes in Oklahoma will be tightened according to state guidelines. Homes that accept Medicaid get additional funding to pay for the staffing increases while private-pay homes do not.