JEFFERSON CITY — A state agency that provides nursing home care for military veterans is seeking an outside consultant to determine if the operation needs to be overhauled.
In a request issued Thursday, the Missouri Veteran’s Commission suggested some or all of its nursing homes could be revamped to include assisted living facilities, more day treatment services and more short-term care options.
“MVC must transform how it delivers veteran elder care, ensure the services offered meet veteran needs, and transform its operational model with efficiencies, and revenue maximizing opportunities,” the request notes.
The commission, which includes members of the Legislature and appointees of Gov. Mike Parson, has been grappling with significant staffing issues brought on by a combination of low pay, a national nursing shortage and the COVID-19 pandemic.
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In hopes of stemming the problems, the agency received a $50 million boost in its budget in July. But in August the Post-Dispatch reported that it had only opened half of its available beds because of staffing shortages.
The population of veterans at the homes was 684 in January, compared with 666 on Aug. 1. The agency is licensed by the federal government to have a total of 1,238 beds.
Hiring a consultant could be viewed as one way to get a fresh set of eyes on a taxpayer-funded service that has been struggling in recent years.
“The contractor shall assist the state agency with identifying ways to properly scale the current homes operation, which offers long-term skilled nursing services with 1,238 beds to an operation that provides an integrated continuum of elder care services which meet the needs of 21st Century veterans,” the proposal says.
The new consultant could build on the work of a 2020 report that found many of the veterans on a waiting list for beds did not actually need 24-hour skilled nursing care.
That report said adult day care could “accommodate a wider variety of needs than a skilled nursing facility, and provides a level of flexibility for veterans and their caregivers that a skilled nursing setting cannot match.”
According to the agency, there are an estimated 413,000 veterans living in Missouri. The agency said it wants the consulting firm to provide a “next generation operating model” to provide “a path to transformation.”
The nursing homes are located in Cameron, Cape Girardeau, Bellefontaine Neighbors, Mexico, Mt. Vernon, St. James and Warrenton.
Veterans living at the facilities pay a monthly fixed rate of $2,345 for room and care, meals and other personal care needs. In July, commissioners discussed boosting that amount.
While the revenue model MVC is currently operating under has not changed in at least 40 years, the proposal notes that services have evolved.
“While nursing home care is an important part of the elder care continuum, the contractor must explore additional ways to serve veterans,” it noted. “The contractor shall determine how to optimize the next generation operating model through appropriate case mix, census, staffing and outside resources.”
In May, the House and Senate approved a budget that pumped $53 million in additional funds to the agency in a bid to reverse its problems. Included in the spending was money to hire an additional 40 certified nursing attendants, who are paid a base salary of about $16.20 per hour.