As Number of Frail Elders Grow, Nursing Home Industry Expresses Concerns About Unrealistic Expectations

"$2.7 billion, five-year cuts to Medicare contained within the House of Representatives' Children's Health and Medicare Protection Act of 2007 should be soundly rejected."

Yrene E. Waldron, executive director of Delaware Health Care Facilities, the statewide association of Delaware nursing home owners, wrote an article highlighting the enormous pressure faced by her industry.

"I am concerned about the future of our country's and Delaware's elderly and disabled. As the executive director of the Delaware Health Care Facilities Association for the past decade, I remain concerned about future access to services, including long-term care services."

The list of issues and concerns is long:

•Shortages of nurses, attendants, dentists, pharmacists, and paraprofessionals, and physicians who no longer accept Medicare or Medicaid.

•Unrealistic, zero tolerance by agencies at the direction of the Center for Medicare and Medicaid Services for "human errors by direct-care providers and other professionals."

•Shrinking federal reimbursement for Medicare and Medicaid.

•Eligibility changes regarding what is considered medically necessary by Medicare, Medicaid and other private insurers and to qualify for Medicaid long-term care.

Current regulatory and oversight trends assume that fraud, neglect, exploitation and abuse are the norm rather than the exception. This punitive trend is not only fueling a continual exodus of caring and committed individuals from our profession, but will in the near future, translate to a lack of bed availability for those who will need services.

Our health care sector, like others, faces never ending "demonstration projects" and "pilot programs" from the Center for Medicare and Medicaid Services. Typically these programs, touted as improvements, end up as funding cuts or service restrictions.

After years of rhetoric, the time has come when providers of health care across the continuum are being impacted by looming cuts to the Medicare and Medicaid programs. Unfortunately, most in our community who will need long-term care services in the near future, are totally unaware of the coverage and access problems that await.

Results of the Genworth Financials new "2007 Cost of Care Survey" found the average national cost of care in nursing homes, assisted living facilities and home-based care increased 15 percent since 2004. This should serve as a reminder to every American that they should begin planning for their own long-term care needs, and take more personal responsibility for their own retirement.

The staggering costs of retirement can quickly overwhelm one's savings in a disastrous manner. With 77 million baby boomers rapidly approaching the age when many will require long-term care, Congress and state legislatures must pass laws enabling citizens to equip themselves with the tools necessary to pay for and receive care in the most appropriate setting.

A separate poll found that 75 percent of Americans have made no long-term care plans and 59 percent are concerned about the cost. Almost half of the respondents mistakenly believe that either Medicare or their private health insurance will pay for their long term needs. Most health insurance and the federal Medicare program generally do not cover long term care.

With Americans living longer, and with those 85 and above America's fastest growing demographic, there will be an ongoing, consistent need for facility-based skilled nursing care.

We have all known for a long while about the predicted "Tsunami of Elders" that is coming. It is now at our health care shores.

The American Health Care Association and the Delaware Health Care Facilities Association pledge that our top issue is ensuring $2.7 billion, five-year cuts to Medicare contained within the House of Representatives' Children's Health and Medicare Protection Act of 2007 are soundly rejected as part of any final Children's Health Insurance Program financing package.

While we believe that children should be covered, we do not believe it should occur on the backs of the elderly and disabled. We must work in partnership and demand better policies. The elderly and disabled deserve no less, but each of us must become informed and get involved by learning the issues and communicating your expectations to your congressional delegation and Legislature.

Tell them you expect better.

Comments on any and all posts to this blog, should be sent to Bob O'Toole at bob@elderlifeplanning. We'll also publish your comments to the blog if you wish to respond publicly.