LTC Bullet: Can NHs Make Gold Out of Straw?
Wednesday July 22, 1998
Evidence continues to mount that anyone who expects quality long-term care must be able to pay privately and avoid government financing.
The New York Times reported today that President Clinton will offer legislation to improve the quality of care in nursing homes. The legislation calls for new criminal background checks, a national abuse registry, improved nutrition and hydration training, and reauthorization of the Nursing Home Ombudsman program.
The Administration also announced a series of new penalties, new inspections and tougher oversight for nursing homes, including the threat to cut off federal nursing home inspection funds to states that have poor records of citing nursing homes for substandard care. "Whenever we find evidence that a nursing home is failing to provide its residents with proper care or even mistreating them, we will fine that facility on the spot," said Clinton. Clinton also ordered evening and weekend inspections "so there is no time to hide neglect and abuse," he said.
Unfortunately, quality care is not something nursing homes can wish into existence. Quality costs money. Medicaid pays for 70 percent of all nursing home patient days, but reimbursement rates are typically 80 percent of private-pay rates and often less than the cost of providing the care. How can the government expect Medicaid dependent facilities to deliver high quality care when the government won't pay for it? It can't. The Administration should focus on encouraging private financing alternatives to Medicaid if improving quality is the real goal.
Is it fair to equate Medicaid dependency with inferior care? The following excerpt from John Wasik's article "The Crisis in Long-Term Care" which recently appeared in Consumers Digest Magazine (6/98) tells the story:
"Although many nursing homes provide a decent level of care, far too many facilities are abusing and neglecting patients who, to pay their nursing home bills, must rely upon Medicaid.... There's too much evidence to suggest that Medicaid patients are receiving substandard care, which not only shortens their lives, but forces them to live in inhumane conditions during their last days."