Minneapolis Veterans Home gets much-improved progress report

Now that the home is finally improving, a new question arises: Should its finances shift to Medicaid for federal funding?

By WARREN WOLFE, Star Tribune

Last update: January 20, 2009 - 9:27 PM

Care quality and finances have improved at the Minneapolis Veterans Home after years of problems, a state commissioner told a Senate committee Tuesday. "But I don't expect you to trust what I say," he added.

"You've been given many promises in the past. I understand that we have to earn your trust," said Clark Dyrud. His Department of Veterans Affairs took over Minnesota's five state-owned veterans homes in 2007 after years of problems at the Minneapolis home.

Committee members have been sharply critical of the Minneapolis home for years as it has moved in and out of compliance with federal and state nursing home regulations. Between 2005 and 2007, the home was cited for 66 state violations and fined $42,300.

Tuesday's hearing came two weeks before a team of health officials from the U.S. Department of Justice begins an on-site investigation to see if care problems persist at the home.

"I want to congratulate you on what seems to be an improvement in care," said Sen. Linda Berglin, DFL-Minneapolis, head of the Senate Health and Human Services Budget Division. "But it's clear we still have some issues," she added.

Among them are whether to keep the 400-bed Minneapolis home intact, and whether the veterans homes should shift to Medicaid for federal funding instead of the federal Department of Veterans Affairs.

Improving care

Citing efforts to improve care at the Minneapolis home, nursing director Jill Smith said new data show that while the rate of falls among veterans there is nearly twice that of similar homes, its rate of fractures from falls is about half that in other homes. Similarly, the Minneapolis home's rate is less than half that of other veterans homes for bed sores and significant weight loss.

Nevertheless, the Minneapolis home has been unable to hire enough staff to control overtime costs -- about $2 million a year in a $35 million budget -- department staff said.

That was among the issues cited in a recent legislative auditor's report, which found sloppy accounting and fiscal management, including weak overtime controls.

As the Legislature struggles with a nearly $5 billion budget deficit, Berglin urged the department to act quickly to study shifting its finances to the Medicaid program.

That likely would increase the homes' federal funding, but it would require many administrative changes that "might overwhelm" the Minneapolis home, which is still adopting new financial systems, said Deputy Commissioner Gilbert Acevedo.

A shift to Medicaid financing also would change rules that now let veterans give away their assets as they move into veterans homes instead of paying for their own care.

"The question may be whether [the homes] will be overwhelmed more by getting [into the Medicaid system] or by getting by with less resources," Berglin warned.

Warren Wolfe • 612-673-7253

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