Next Avenue had an interesting article on how 4 states have lowered nursing home admissions. Nursing home care is the most expensive form of long-term care. According to the 2017 Genworth Cost of Care report, a private room in a nursing home now costs an average of $97,455 per year. A semi-private room runs more than $85,000.
“If you are hospitalized at age 65 or older, there is a one in five chance you will be discharged to a nursing home. Certain states — like Minnesota, Maine, Oregon and Connecticut — have implemented policies that lower the chances of getting “stuck” in a nursing home, said Wendy Fox-Grage, a senior strategic policy advisory with the AARP Policy Institute and co-author of “State Strategies to Reduce the Risk of Long-Term Nursing Home Care After Hospitalization.” The new report, released Oct. 6, highlights some of those innovative policies.
Minnesota: ‘Return to Community’
Minnesota uses “community living specialists” to work with older adults to get them back to their communities. The community living specialists, who are nurses or social workers, assist the nursing home to identify new residents who may want to return home. Then, after the residents return home, the community living specialists follow up with them to make sure they are getting the services and support they need over the following months.
Another Minnesota initiative lauded in the report is its Performance-Based Incentive Payment Program. This program rewards nursing homes with incentive payments for designing projects to lower their numbers of long-term residents.
Oregon: Downsizing Nursing Homes
Oregon does a better-than-average job of keeping people out of nursing homes by providing services in the community: just 3.3 percent of state residents age 85 and older live in nursing homes. (The national average is 9.5 percent, according to the AARP report.)
A 2013 law provided a financial incentive for nursing homes to buy another facility and then take the excess capacity out of use — a process known as “buy and close.” Some providers have diversified into hospice care, assisted living, home health and independent living, the report said.
Connecticut: Home Care for Older Adults
Connecticut’s Home Care Program for Elders provides financial assistance for home care services so older adults can delay or avoid going to a nursing home. There are varying levels of service depending on a person’s financial resources, but unlike other programs, those who don’t qualify for Medicaid are not automatically excluded.
The services may include housekeeping, companion services, home-delivered meals, a personal emergency response system, adult day care, assisted living, mental health counseling and minor home modifications. Family caregivers can receive payments of between $42.58 and $107.06 per day.
The program “represents a significant state investment in the delivery of home care services to people who, despite being at risk for nursing home admission, do not qualify for Medicaid,” the report said.
Maine: Getting to People Early
Maine has been working since the 1990s to limit nursing home admissions to the people who most need them, according to the report. It does that, in part, by mandating medical assessments before admission. Maine also provides prospective residents and their families with a “community plan of care,” which gives information about services they may be able to use instead of going to a nursing home.
The program also provides individuals with a service plan that has estimates of how much the home care services will cost. The service plan doubles as an authorization for payment by Medicaid, if the person qualifies, or the state-funded home- and community-based care services program.