River Garden Hebrew Home in Jacksonville has been a vocal opponent of proposed changes to the Medicaid prospective payment system developed for the Agency for Health Care Administration. Now we may know why: their local state senator, Aaron Bean, has offered the facility a much more lucrative deal.

Martin Goetz, who serves as Administrator and Chief Executive Officer of River Gardens, has steadfastly voiced his opposition during public meetings held by AHCA to discuss the reimbursement plan developed for the agency by Navigant, a consulting firm that partners with health systems and governments to help stretch budget dollars as far as they can go.

Goetz and the folks at River Garden are unhappy that under Navigant’s reimbursement matrix, they would receive more money – an increase of 2% per year – which amounts to an extra $174,000 for the company. That’s apparently not a big enough lump of no-strings-attached taxpayer dollars, even though his nursing home has access to foundation funding and one of the more affluent populations in the state, which subsidize his operation to the tune of about $1.3 million per year, according to some sources.

Unlike most nursing homes in Florida, River Gardens doesn’t have to rely heavily on Medicaid payments to cover their costs of care. River Gardens has the luxury of subsidizing its low Medicaid rates with private dollars while lobbying to prevent other providers from having more equitable rates.

Enter Senator Bean. Under his proposal, filed as Senate Bill 712, sources say a number of other Medicaid-dependant nursing home facilities that are currently struggling to make ends meet would be forced to find other sources of funding. But not so with River Gardens, located in Bean’s district, because if Bean’s bill passes, Mr. Goetz’s nursing home will see a rate increase of 6%, which translates to a financial windfall of $580,000 in extra taxpayer funding, all without lifting a finger.

Senator Bean’s office did not respond to an email seeking comment for this story.

Ultimately, the House and Senate will have to decide the best way to stretch budget dollars as far as possible. In order to do that, experts suggest, it’s important to find ways to bring up the quality of care at as many facilities as possible. Bean’s proposal, sources say, does exactly the opposite: rewarding existing homes that already meet quality standards with even more money, while letting nursing homes in low-income areas lanquish.