Do You Really Want to Depend on Medicaid for Your Long Term Care?

What does government-paid long-term care actually provide? And just how effective is that care?

The New York Times reports that “Since 2013, nearly 6,500 nursing homes — four of every 10 — have been cited at least once for a serious violation, federal records show. Medicaid has fined two-thirds of those homes. Common citations include failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores.”

Many health care advocates support these penalties as effective plans to monitor and maintain acceptable levels of care. Objections from the nursing home industry, however, have resulted in a significant reduction in these fines. The industry’s main trade group, The American Health Care Association, complained that the federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

As a result, the federal government is now scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury. The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death.

Burning the Medicaid Candle

We seem to be burning the Medicare – Medicaid Candle from both ends. Medicare and Medicaid fund most of U.S. nursing home care. We know they are not an endless well of money. On the patient side, Medicaid doesn’t pay enough per patient day for nursing homes to provide good care. Medicaid-funded nursing homes cannot hire enough caregivers, because they cannot pay them enough.

As my colleague Stephen Moses aptly describes, “Beatings will continue until morale improves!”

Many people expect Medicaid-funded nursing home facilities to provide them with long-term care. Medicaid eligibility requires asset spend down. In addition, quality of care  is dependent on our financial resources. People who own long term care insurance (LTCi) have necessary funds and are far more likely to be able to avoid Medicaid, stay at home, or access quality assisted living if they need long term care.

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