Sunday, October 04, 2009

Nursing homes could close due to federal, state budget cuts in Medicare, Medicaid, related to health care reform; more "filial responsibility"?


Cuts in Medicare and Medicaid funding associated with health care reform, compounded by state budget cuts and deep “Wall Street caused” recession will soon seriously impact nursing homes, according to the American Health Care Association and other health care experts. The AP story by Dave Collins appeared on Yahoo! today, link here. In fact, the AHCA has an “SOS” or “Save our Seniors” logo on its website, with an article, “Ask Congress to stop proposals that further cut nursing home care” link here.
A number of nursing homes have laid off employees, in an economy that generally needs more “person-to-person” workers, although it does not pay them well. Nursing home closures have already occurred because of Medicare rate cuts (which would apply mainly to skilled or SNF care), as well as state Medicaid cuts.

Many closures occurred in New England, and California a nursing home that serves former entertainment industry workers was closing because of financial losses.

Is this a question of lobbying groups crying wolf? Probably not. Demographics and economics are on a collision course. Families are likely to have to take care of their own much more in the future, as the infrastructure to outsource care to institutions and even home services could get overwhelmed. States would be likely to enforce their filial responsibility laws much more rigorously than before, and the whole notion of intergenerational “social contract” would need to be rethought, bringing in the childless.

Nevertheless, saner analytical heads are looking at this problem. The Lewin Group (I worked for its predecessor in 1988-1989) has a “Demographic and Service Need Projections for the Aging Population: 2020–2030 – A Projection Model for the Baby Boomers of San Mateo County”; for details go to this link.

I wonder how many people in Congress are connecting the dots on this one.

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