Friday, July 23, 2004

Panel offers other uses for empty nursing beds

Child care, women's shelter among ideas

The Associated Press

COLUMBUS - Battered women, drug-addicted teenagers and aged nonviolent convicts needing a halfway house with medical services are among those who could fill Ohio's empty nursing home beds, said a state committee recommending ways to change how Medicaid pays for the homes.

Nursing home industry leaders said the idea put forth this week is commendable but likely wouldn't be used much.

Meanwhile, the panel member representing consumers said the plan doesn't go far enough to control rising costs.

Nursing homes and prescription drugs are the fastest-growing part of Medicaid, the state-federal insurance program for the poor.

Nursing home expenses have increased by 61 percent over eight years while the number of people in homes has declined by 7 percent, said Orest Holubec, spokesman for Gov. Bob Taft.

The Legislature required the group - made up of lawmakers and representatives from the nursing home industry and the agencies overseeing them - to submit recommendations by July 30. It made several proposals in a plan issued Wednesday, a week early, but said work will continue through the end of the year on changing the Medicaid formula for nursing homes.

Ohio is one of a few states that puts that formula into law, instead of leaving it up to the state agencies. The law hasn't been reviewed since 1992, said Rep. Shawn Webster, the Hamilton Republican who led the committee.

Meanwhile, the industry is serving fewer, but sicker, patients.

The committee's job is to "right-size" the system to fit the changing role of nursing homes, Webster said. "If there's money-saving in that, that's wonderful."

Mary Butler, who has muscular dystrophy and advocates to move people out of nursing homes, represented consumers on the panel and disagrees with the plan's stated goal to come up with ways to slow the expense growth.

"We need to stop, period, and look at why is there vacancy," said Butler, of Elyria, who works at an independent living agency in Lorain County. "People don't want to go to nursing homes, and if there is money to assist them in their homes with some of the tasks they can no longer do, they would much rather stay at home."

Butler wants the approach advocated by Gov. Bob Taft, who tried in past budgets to remove the funding formula from the law, leaving it up to the Department of Job and Family Services to set the rates.

Webster said that was never an option for the committee, because there's too much disagreement over taking the formula out of the law.

Despite declining occupancy, costs for labor, prescriptions and increasingly specialized medical care keep going up, said Norm Dreyer, executive director of the Ohio Academy of Nursing Homes.

The committee suggested relieving funding penalties for declining occupancy by allowing a home to temporarily convert unused beds for another use, such as a child care center, women's shelter or halfway house.

Dreyer said the recommendations were good ideas but tough to implement, especially if they would require costly renovations.

Peter Van Runkle is executive director of the Ohio Health Care Association, one of the state's three nursing home trade groups. He said using the empty portions to provide services for disabled adults while their home caregivers are away is the most likely to work because the customers are similar.

"If you start bringing in other populations, it does have a lot of ramifications and does have to be done very carefully," Van Runkle said.

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