For 15 years, long-stay nursing home care by seniors enrolled in Medicaid has been plummeting. Although the reason behind it isn’t clear, there is likely a number of reasons.
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First, state Medicaid programs have been shifting care from nursing facilities to home and community-based settings; this is a step that many seniors prefer and often save money in the long run. Medicaid continues to spend more total dollars on nursing home care than on home care, but nursing facility use my Medicaid-eligible seniors has plummet one third, from 1.4 million in 1995 to just over 1 million in 2010.
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The second reason is that seniors’ enrollment in Medicaid is growing very slowly even though the overall older population is growing exponentially. The number of people 65 and older increased by more than 80 percent from 1975 to 2010 and the number of those over 85 (who are the most likely candidates to require long-term supports and services) has tripled. With that said, Medicaid enrollment by seniors increased by just 18 percent from 1975-2010. This comes at great contrast so younger Medicaid beneficiaries, who have increased by more than 200 percent.
And a third reason could be that nursing homes would prefer providing post-acute and rehabilitation services opposed to long-stay care. This could be due to the fact that Medicaid pays an average of only about $125 per day for a long-term care resident, while Medicare pays $500 or $600 per day for a post-acute short-stay patient. As a result, a number of nursing home operators are shifting beds from long-term care to more lucrative rehab and post-acute.
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Christopher J. Berry is a Michigan elder law attorney Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.michiganelderlawattorney.com/ or call 248.481.4000
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Elderly and often disabled people who depend on the service provided by Area Agency on Aging Region IV will have to resort to putting their names on a waiting list.
In March, older people who are physically unable to leave their homes took a hit with Federal budget cuts that resulted in reduced hot meals. As a result, sequestion funding for the senior nutrition program in Berrien, Cass and Van Buren counties has been reduced $61,310 this year, or 8.4 percent.
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Elderly and often disabled people who depend on the service provided by Area Agency on Aging Region IV will have to resort to putting their names on a waiting list. Christine Vanlandingham, fund and development officer for the agency, based in St. Joseph, said it’s heartbreaking to require the wait.
“They don’t need a meal in six months. They need it now,” she said.
The agency is forced to cut the number of meals it provides by 19,361 through Sept. 30, the end of the government’s fiscal year.
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Meals on wheels programs provide nutrition for housebound people over 60 while giving them social contact. Most of the seniors have few outside visitors.
“For someone in a rural area that’s the only person they see all day,” Vanlandingham said. “It’s certainly a social contact but it’s also a safety check.”
The state provides money for senior nutrition programs. After several years of severe cuts, funding is scheduled to increase 2 percent statewide in 2013-14. Across-the-board spending cuts of $85 billion enacted after Congress failed to agree on specific areas to make reductions, taking $38.7 million from meals on wheels programs nationwide. In Michigan, meals for the elderly programs were slashed $1.8 million.
Senior nutrition programs deliver savings to taxpayers by helping people remain in their homes when they otherwise might have to move into assisted-living residences.
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“These are physically frail individuals, certainly at-risk individuals,” Vanlandingham said. “This (meal) delivery helps them to continue to live in their own homes.”
At a rough cost of $5 daily for of delivering a hot meal to a person compares to at least $178 a day for Medicaid-supported nursing home care, Vanlandingham said.
During the 2012 fiscal year, Area Agency Region IV received $712,676 in federal support and $441,875 in state support for nutrition services for older adults, a total of just over $1.15 million.
Of the sum, $769,760 went toward meals delivered directly to senior citizens’ homes and $384,791 was used for meals in community settings.
Christopher J. Berry is an elder law attorney Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.michiganelderlawattorney.com/ or call 248.481.4000
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These changes are part of a concerted effort to offer improved protection to those who are receiving long-term care.
The National Plan to Address Alzheimer’s Disease has been updated by the Department of Health and Human Service, including its perspective on the vulnerability of older Americans who live in care facilities.
Because of the vulnerability of people with Alzheimer’s disease who live in care facilities, HHS stated, the department will increase its attention to this population via available studies. Included, will be an “in-depth analysis” that has implications for those providing care in assisted living communities.
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…”This will include an in-depth analysis of the National Survey of Residential Care Facilities to better understand the level of cognitive impairment among residents and the types of services provided in assisted living facilities,” HHS writes. “The results of these studies will be used to identify areas that the National Plan should address in future years.”
State Adult Protective Services field reports of elder financial abuse, however, not all of these programs cover residents of long-term care communities. State funding enables states to survey Medicare and Medicaid-certified nursing facilities, while state licensing agencies may investigate other types of care communities, like assisted living.
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These changes are part of a concerted effort to offer improved protection to those who are receiving long-term care.
“Congress must see to it that the necessary resources are committed to accelerate and prioritize the government’s efforts on Alzheimer’s,” said Harry Johns, President and CEO of the Alzheimer’s Association and member of the Advisory Council to the Plan. “Without these new resources, efforts in Alzheimer’s research, care and support will continue to be hampered to the determent of millions of families and the economic well-being of the nation.”
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Assisted living was not included as a care setting in the early forms of the plan, which prompted the Assisted Living Federation of America to introduce the plan via campaign.
Christopher J. Berry is an elder law lawyer in Michigan Dedicated to helping seniors, veterans and their families navigate the long-term care maze. To learn more visit http://www.michiganelderlawattorney.com/ or call 248.481.4000
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