Two dozen Upstate nursing homes have agreed to accept a total of $1.8 million to settle a dispute with state officials over delays in processing Medicaid applications.
The payments are part of the $12 million that the South Carolina Department of Health and Human Services offered to pay 148 nursing homes throughout the state last month to avoid litigation. As of Friday, 138 nursing homes had agreed to the proposed settlement, said Colleen Mullis, the department’s deputy communications director. She said the money for the settlement is coming from funds that her department has received for nursing homes in the past but did not spend.
The nursing homes are being reimbursed for costs incurred while caring for residents before state officials finished processing their Medicaid applications, Mullis said in an email. Medicaid is a joint federal-state program that assists families and individuals with limited incomes.
Medicaid covers the costs for about 70 percent of the state residents who are in nursing homes. The Health and Human Services Department received $600 million in this year’s state budget to pay for the nursing home care of Medicaid recipients. That money came from multiple sources, including $151 million from the state’s general fund.
Mullis said her department handled 9,800 Medicaid applications last year for nursing home residents.
According to federal regulations, the least complex Medicaid applications should be processed with 45 days. More complex applications can take 90 days or longer to process, Mullis said.
“New document management and eligibility systems have created processing delays in some cases,” Mullis said. “Most of the challenges have been technical in nature, but there has also been a need to provide additional training on the new technology.”
Mullis said her department has made a number of policy and procedure changes to improve processing times and lessen the burden on applicants.
Fourteen nursing homes in Greenville County, five nursing homes in Anderson County, four nursing homes in Pickens County and one nursing home in Oconee County have accepted the state’s settlement offer.
Ellenburg Nursing Center in Anderson will receive $169,578, which is the largest amount among Upstate nursing homes and the second highest total in the state.
Lyndon Ellenburg, the center’s administrator, said the processing of Medicaid applications for residents at his nursing home seems to be going more smoothly.
“It is not as big of a problem as it was two years ago,” he said Friday.
Seneca Health and Rehabilitation Center is one of the 10 nursing homes throughout the state that had not accepted the state’s settlement offer as of Friday. Diane Parson, the center’s administrator, said she has been told that the nursing home’s legal team intends to agree to the settlement.