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Medicaid Dilemmas – Part 1

by Tom aka Rusty Rustbelt

Medicaid Dilemmas – Part 1

Medicaid is a federal/state program covering poor people, with general services for all ages and long-term care (nursing home) services for the indigent elderly.

State budgets are extremely tight, and many states are cutting reimbursements, including nursing home reimbursements.

The majority of long-term nursing home residents (as opposed to short stay rehab patients) end up being Medicaid funded.

A typical long-term resident is an 84 year widow, suffering from moderate senile dementia, having ambulation problems and problems with activities of daily living (eating, dressing, bathing), with late onset diabetes symptoms, osteoarthritis and congestive heart failure. So, grandma is not a candidate for home care or assisted living.

Many residents are in much worse health. Some receive joint services from the facility and from hospice.

Nursing homes have the toughest regulatory regimen of any health care providers, including piles and piles of mandatory paperwork by nursing and administrative staff.

So, not much room to cut (the best profit comes from selling the facility later). Now what?

In Part 2 we will discuss the possible next phase for state Medicaid budgets.

(The wife, aka the world’s greatest nurse, works part time in long-term care, and will now do more work and take a pay cut. She understands the deal, but one of these days she is going to hang up her stethoscope, a real tragedy for the elderly. Maybe she will become an investment banker – nah, too honest.)
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Tom aka Rusty Rustbelt

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