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Nursing Home For Brain Injured Patients Threatened By WA Budget Cuts

In Snohomish, Washington there's an old tuberculosis hospital that's now a private nursing home for brain injured patients.

It's one of the oldest facilities of its kind in the nation – and the only such place in Washington. But the future of Delta Rehab - and other Washington nursing homes - could be imperiled.

That's because of recent budget cuts ordered by Washington's legislature and governor - cuts that are now the subject of a lawsuit. Olympia Correspondent Austin Jenkins reports.

The first thing you notice about Delta Rehab is the architecture. This sprawling facility – built in 1918 - looks like a Swiss Chalet.

Today it's home to 120 patients – most of them victims of devastating brain injuries. Guys like Jim Hirst who barely survived a 1987 car wreck. He was riding shotgun. His girlfriend was driving.

Jim Hirst: “She fell asleep at the wheel and my head hit the telephone pole. I was given 24-hours to live and then I was in a coma for three months.”

Hirst has lived at Delta Rehab for the past twenty years.

Jim Hirst: “They feed us, clothe us and give us our proper medication.”

But Delta Rehab's future is uncertain. This year majority Democrats in the Washington legislature passed a budget that cuts the state's nursing home reimbursement rate by five percent – or an average of eight dollars per day, per patient.

That might not sound like much. But Delta Rehab's director, Chris Walsh, says it amounts to a nearly half-million dollar per year cut to his facility.

And he's already running in the red because what the state currently pays him doesn't cover all his costs. To prove it he hands me a piece of paper.

Chris Walsh stands with his brother Mike who was Delta Rehab's first brain injured resident.

Chris Walsh: “This is a profit and loss statement, which is a business statement. So the loss year to date is $70,000 so far – that's real, real, real dollars. Okay?”

Walsh's special challenge is that all of his residents are on Medicaid. That means his only source of income is from the state.

Most nursing homes have a mix of Medicaid and private pay clients. For now the state's $8-a-day reduction is on hold because of a lawsuit filed by several nursing homes.

Delta Rehab is not one of them. Walsh worries if the lawsuit is unsuccessful he might end up owing the state a refund retroactive to July 1st – when the rate cut was supposed to take effect.

Chris Walsh: “Where am I supposed to get that from? There is no sugar daddy, there's no big corporation. This is just us. We are a single small business.”

Delta Rehab isn't the only Washington nursing home potentially on the brink of collapse.

According to the Washington Healthcare Association, which represents nearly 200 nursing homes, at least two other Medicaid-heavy facilities in Central Washington may not survive a rate cut. That message is now filtering back to Washington lawmakers.

Kelli Linville: “I don't think any of us were prepared for the magnitude of the cuts and what those cuts really meant.”

Democratic State Representative Kelli Linville chairs the House budget committee. She says lawmakers had to make tough decisions this year to close a nine billion dollar shortfall. But she adds they're prepared to come back next January to make adjustments as needed.

Kelli Linville: “You know it was a very, very difficult session and we tried to be as fair as we could and we are not all-knowing and unintended consequences have happened every year of the 16 years I've been here so I don't expect that all of our decisions are perfect.”

In the meantime, the nursing home lawsuit and two other cases are preventing the state from implementing several million dollars in budget savings.

That has Democratic Governor Chris Gregoire concerned. She says for every one dollar the state can't save today, two dollars in cuts will be necessary down the road.

Chris Gregoire: “So even a 30-day temporary restraining order is a huge financial burden on us and there's millions of dollars wrapped up in those lawsuits.”

Back at Delta Rehab, director Chris Walsh takes me out to a back loading dock to meet someone.

Chris Walsh, Delta Rehab Director: “This is my brother Mike, Mr. Rock-and-Roll.”

Sitting in the sun is a bearded man in a wheelchair blasting Bruce Springsteen out of a portable radio. This is where the story turns personal.

Mike Walsh was Delta Rehab's first brain-injured resident. The Walsh brothers' grandparents founded this facility in the 1950s and ran it as a traditional nursing home.

Then Mike was severely injured in a car accident in the 1970s. After that the Walsh family transformed the facility into a home for the brain injured. Now the weight of that history rests heavily on Chris Walsh.

He says with the rate cut looming the future of this place has never been so uncertain.

Chris Walsh: “We have struggled and have achieved great care here. It's a happy place to be. We're not going to cheapen that. We're going to try and survive. You'll have to excuse me.”

What Walsh doesn't want to compromise is Delta Rehab's five star-rating from federal regulators. It's a point of particular pride since the place runs on a shoe-string with second-hand equipment and long-time employees who could make more elsewhere – but are loyal to the Walsh Family and its mission.