Alternative Care Options Face Battles
Posted by Kim on February 10th, 2008 / 
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Get them out.
More than a year after Connecticut received a multimillion dollar federal grant, a select number of elderly and disabled residents are expected to move out of institutions and into homes starting in May.
Last January, Connecticut was awarded $24.2 million to fund a pilot program called Money Follows the Person. The idea is to let people who need long-term care choose where they want to live, in a nursing home or other facility or with family and friends, and receive equal Medicaid funding with either option.
Currently, it costs Medicaid twice as much to care for an individual in a nursing home as it does at home, according to estimates from the Department of Social Services. But in Connecticut, only a third of Medicaid long-term care expenditures are spent on community-based services, according to the June 2007 “Connecticut Long-Term Care Needs Assessment Study,” which was conducted by the UConn Health Center. The remainder is spent on institutional care.
It seems to me that if it costs so much less to keep the elderly and disabled out of the nursing home, lets put a lot more effort into bringing these people back home.
One of the big problems with all of this is the nursing home industry lobby. They fight these alternatives and usually win.
Tennesseans can expect the nursing home industry to fight back or try to distract the state from such logical alternatives. Nursing-home officials are already suggesting the alternative-care concept is ripe for abuse. In fact, the industry’s legislative motivation appears to be focused more on caps on liability from lawsuits. This comes as officials have begun to crack down substantially on violations found in nursing homes. Many people have pointed out how painful it has been for families whose loved ones are displaced by crackdowns that lead to government funds being pulled. The displacement of nursing-home residents has certainly been unfortunate, and the state probably could have handled the crackdown better, but the bottom line is, violations have been found. The industry should work on compliance.
Does one ever get the feeling the “industry” is concerned only about money? We should get that feeling. Because it is all they care about; and don’t ever be fooled that the money goes to good care because it doesn’t. It goes into the bank accounts of owners and share holders. CNA’s, at least, never see the benefits of the so called industry; and, any CNA will tell anyone who asks neither to the residents.
February 11th, 2008 at 10:24 am
I am from Tennessee, and I had a meeting with my state representative last month about nursing home reform, less than 3 hours after the Tennessee Healthcare Association had taken him to lunch (my former boss was one of the folks with THCA). The representative told me my 3-point plan for NH reform in Tennessee (requiring each NH to have policies and procedures in place to address CNA retention, mandatory staff education on the survey process, and requirements for the NH’s QA committee to actually achieve some sort of measurable gain and actually have accountability and transparency) was much better and actually achieved something, instead of THCA’s plan to impose cap limits on lawsuits and mandate the use of arbitration agreements in admission contracts. My representative, whose day job is as a nursing home litigator (he’s one of those people on TV who will be happy to sue the NH because momma fell, or got a bedsore, or just because there isn’t enough staff) said that there are actually very few lawsuits against NH in Tennessee. He also said that it would be tough to get this 3-point plan through due to THCA’s massive lobbying power, even though he promised to try. I suppose that THCA is trying to carry on AHCA’s nationwide vision for reducing liability. But I still say that they should fix problems rather than to waste 10 times more money passing the buck.
February 11th, 2008 at 8:58 pm
Matt, I have always believed if people were serious about fixing the problems most nursing homes have, they would ask the CNA’s for solutions. And act on those ideas.
CNA’s see it all- they know who is working, who isn’t. They can and often do the work of other depts- housekeeping, laundry, kitchen…even maint tasks. I believe this is why we see such success with Eden type facilities: The aides are do it all in each neighborhood and there is no need for these other depts…there is really no need for much of the layers of fat we see at some nursing homes either…do they really need unit managers and then charge nurses and then a Head Nurse manager and then an ADON and then, phew, a DON?? NO.
Not at all. Passing the buck becomes a way of life in these places. Punitive attitudes cause aides and everyone else to leave; when they learn to remove the punishiment factor and bring in the LETS LEARN from THIS, things could get better too. But, above all, better pay and benefits and respect must come first. Until that happens, things will remain the same.
February 12th, 2008 at 11:50 am
Patti, I agree with you wholeheartedly.