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LTC Bullet:

Kudos to Kiplinger's

Thursday August 19, 1999


Amidst all the hullabaloo and hopefulness about tax cuts and budget surpluses, it is easy to overlook the already serious deficiencies of Medicaid's long-term care benefits.

Following are excerpts [and our occasional commentary] from an article titled "Money Problems Put Spotlight on Quality of Nursing-Home Care" in the August 1999 issue of Kiplinger's Retirement Report. Thanks again to Kiplinger's for another splash of ice water in the faces of people who are in denial about the cost and quality risks associated with long-term care.

"Most nursing homes depend on government payments for a big part of their income. But those payments aren't keeping up with rising costs, putting many homes and residents at risk."

"More than two-thirds of residents in nursing homes rely on Medicaid…yet its payments account for only 48% of nursing home revenue, according to the American Health Care Association (AHCA). Medicaid typically pays 80% of what private patients do, which is $15-$20 a day less than the actual cost of care, says AHCA spokesman Tom Burke."

[For a 100-patient home with an average Medicaid census of 67, these numbers equate to a loss of $366,825 to $489,100 per year. Not surprisingly, quality of care is suffering, especially for Medicaid patients.]

"…Medicaid residents may experience a lower quality of service, food and care than other patients, say eldercare advocates and consultants."

[In an amazing turnabout, even Elma Holder of the National Citizens' Coalition for Nursing Home Reform, acknowledges that...] "It's only good business sense that they give private-pay patients better services."

"In Florida… state regulators decertified 11 nursing homes from Medicaid last year (up from 3 in 1997), and are on track to boot even more this year." [Nevertheless…]

"Despite mounting evidence that those on Medicaid are receiving poor care in some nursing homes, Largo, Fla.-based elder-law lawyer W. Sean Scott says he is seeing more seniors looking to qualify for Medicaid to protect their assets…. [L]awyers continue to find ways to help their clients avoid spending their life savings on nursing-home bills by qualifying them for public assistance."

"'Medicaid has serious downside risks,' according to Stephen Moses, president of the Seattle-based Center for Long-Term Care Financing. Unlike private-pay patients, Medicaid patients do not get private rooms, will likely face a longer wait to get into a facility and may find that some nursing homes reject them altogether."

[Says Bethesda, Md.-based health care consultant Michael McDermott:] "Any nursing home operator will pick a private-pay patient over a Medicaid [patient]. This attitude filters down to the staff and it affects Medicaid patients' quality of life on a day-to-day basis."

[What more evidence do smart consumers need to avoid Medicaid planning and to seek out private long-term care insurance coverage as the solution?]