Monday, March 8, 2010

Nursing homes a critical part of the long term care continuum and funding must be protected

With Florida facing an increased demand for Medicaid-funded eldercare services, it is more important than ever for our state’s leaders to recognize the invaluable role nursing homes play in our local communities. This session, with Florida’s economy still facing declining revenues, legislators in Tallahassee will be forced to make tough decisions about how to allocate state funding, including how to secure the future of our state’s Medicaid program.

It is important to recognize that nursing homes are an essential part of our health care system. Caregivers in these settings provide life sustaining care and services for nearly 71,000 of Florida’s most frail and elderly individuals who can no longer care for themselves.

Today, nearly 60 percent of nursing home residents in Florida rely on Medicaid as an important safety net. Without it, these seniors would not have access to appropriate medical care; yet, they face a serious and worsening problem as the future of this vital program appears uncertain.

As discussions ensue over the next 60 days about how to balance the state’s $3 billion budget deficit and how to reform a broken Medicaid system, it is essential that all the facts are considered when evaluating long term care as part of the overall Medicaid program.

Currently, nursing home expenditures account for less than 15 percent of the state’s overall Medicaid budget, which is down from 19 percent in 2004. Additionally, the number of individuals relying on Medicaid to pay for the cost of their nursing home care is declining, with the number of days Medicaid patients spend in facilities dropping from 17.2 million in 2004 to 15.5 million in 2009.

Today’s nursing homes are providing care to more medically-complex populations than we have in the past, including increased levels of short-term patients seeking post-acute care following a hip replacement or stroke. Once rehabilitated, many of these patients return home as active members of their communities.

Much has been written about ways to save the state money by keeping individuals out of nursing homes for as long as possible. It’s important to remember that nursing homes have always supported the full continuum of long term care, which factors in appropriate placement to ensure seniors receive the proper care in the proper settings based upon their medical needs. Florida has always done a good job appropriately placing those who require nursing home care. Florida is the oldest state in the nation; yet, we have the second lowest percentage nationally of over-65 seniors living in nursing homes, at just 2.1 percent. That compares to a national average of just under 5 percent.

Long term care in Florida continues to make measurable improvements in quality care, which we are committed to maintaining and advancing. Regulations established in 2001, including mandated staffing levels, make certain that individuals residing in our state’s nursing homes are properly cared for. Along with that minimum number of hands-on caregivers attending to their needs, risk management programs, charting requirements, physician support and other aspects ensure that quality care. Proposals that suggest moving frail elders to less regulated and less medically-equipped settings is a dangerous proposition for those frail, vulnerable seniors who require 24-hour nursing care.

As millions of baby boomers approach retirement age and begin entering the long term care system, lawmakers must protect much-needed Medicaid funding for our state’s frail elders and the frontline caregivers who care for their needs. We cannot build reforms on the backs of our seniors who rely on us for the quality of care they expect and deserve.

J. Emmett Reed, CAE
FHCA Executive Director

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