Florida’s nursing homes care for the state’s most vulnerable population, nearly 71,000 individuals with complex medical needs who are unable to be cared for in any other setting.
Florida is one of the best states at ensuring individuals requiring long term care services receive the proper care in the least restrictive setting based on their medical needs. The percentage of over-65 seniors living in nursing homes compared to the total over-65 population is 2 percent versus 3.5 percent nationally
Today’s nursing homes serve an important post acute care role, with 84 percent of admissions coming directly from the hospital and one-third of those patients returning home following a short-term stay. Over 75 percent of the long term care population, however, has Alzheimer’s or related dementias with no one to care for them in any other setting. Most of the remaining individuals require 24-hour skilled long term care.
Since April 2009, the Nursing Home Transition Program has moved just a small number of individuals out of nursing homes and into home and community-based settings. The Florida Legislature’s research and analysis office (OPPAGA) has reported that just 1.3 percent of those who received nursing home care in 2009 (just over 700) had the potential to safely transition into community placements based on their needs assessment.
The effort to transition nursing home residents back to the community has required assisted living facilities (ALF) to offer a wider range of care; however, a recent study by the Claude Pepper Data Center [link to study - http://www.fhca.org/images/uploads/pdf/Claude%20Pepper%20Report%20on%20Managed%20Long-Term%20Care%20in%20Florida.pdf ]notes that the “typical” nursing home resident could not receive the appropriate medical care in an ALF where nursing services are limited and state and federal oversight of those services is less intense.
FHCA agrees that Medicaid is a program that needs reform; however, nursing home care is not the biggest cost driver in the Medicaid budget. Since 2001, nursing home expenditures have fallen from 19 % to less than 15% of the overall Medicaid budget.
The growth in Medicaid has not been caused by an increase in nursing home enrollment, but rather an increase in Florida’s unemployment, which is causing more individuals to rely on Medicaid as a safety net to cover their health care needs.
Medicaid long term care for frail elders is a very complex issue. Since this a vulnerable population, much of who need 24-hour skilled care that could not be provided elsewhere, reform must be done carefully and correctly the first time around. Florida Health Care Association will continue to be a willing partner with lawmakers as they work toward Medicaid reform.
Our focus will remain on preserving adequate reimbursement to ensure there are no negative effects on quality care and access to services for Florida’s nursing home residents.