A Bad Nursing Home Bill
Wednesday, January 7, 2009 at 03:22PM HB113 submitted by Rep Wendelboe has got to be one of the worst bills I've seen so far this year. Fran Wendelboe a republican who received an A+ rating last year from the NH Liberty Alliance so I wouldn't expect such a bill from her but sure enough here is it.
Basically this bill extends a moratorium on nursing home beds out to 2013. RSA 151-C:4 created a moratorium on nursing home facilities starting in 1995 and was due to expire in 2009.
What does this mean? It means new nursing homes are not being built and as the baby boom generation ages and demand for nursing homes increases, new facilities are being prevented by the NH state government from opening. Basic economics here folks... increase demand while keeping a flat supply results in increased cost.
And we look to government as the solution for increased health care costs? Wake up and smell the coffee, government IS the reason for increased health care costs. This bill is just one more example of why. There is no free market to drive down costs. There is a closed government controlled market where they directly impact the cost you are stuck paying.
I am writing to express my outrage and total frustration at the lack of nursing home beds in New Hampshire.
I was just informed this past week that there has been a moratorium for at least the last five years in New Hampshire. What are people to do? With the population growing older I cannot believe that any state would issue a moratorium on nursing home beds. When I called Concord I was told that the state wanted to save money by having the people cared for in their own homes. I don’t know anybody who would rather be in a nursing home than in his or her own home. However, my mother is not swallowing correctly and to bring her home and take the chance of having her choking and possibly dying is not worth the risk. She also has a mild to moderate form of dementia.
My mother just turned 94 years young in October, and up until May she was driving a car. However, in June she became somewhat confused and disoriented, and in August she suffered a TIA or small stroke. She was admitted to Portsmouth Hospital and around the end of August she was transferred to St. Andre Health Care in Biddeford, Maine, because that was the only facility that would take her for rehabilitation care.
Around the end of September, I was notified that my mother would not be covered under Medicare from Oct. 2 on because she was not showing enough improvement to keep her on Medicare and that I would have to private-pay at a rate of $231 a day. I don’t know about most people, but I cannot afford to pay over $7,000 a month for nursing home care.
When I was first notified that her Medicare would be cut off I started looking for nursing home care in New Hampshire. My mother has been a resident of New Hampshire and Portsmouth since 1964, and therefore does not qualify for Medicaid in Maine.
That's the real impact of this moratorium. If we want to help lower costs and increase quality then let the free market solve the problem as clearly the government solutions are only making things worse.
Rick Barnes
Fran reported emailed back a constituent explaining why she put this bill up. Here is the context of the email (note: this was posted to another forum so I cannot confirm the validity of it but I have no reason to doubt that it is authentic):
Dawn, thank you for the request for info. I had heard thru the grapevine that some are concerned that this bill interferes with competition. Not the case at all. If nursing homes were a free market, that might be true, but it isn’t. It is heavily controlled and regulated by the government.
About a decade ago we had one of the highest number of beds per capita in the country and one of the highest per day rates. Private nursing homes encouraged elderly people to sell their homes (and shelter the money to the kids) and they would self pay for a year or so and then run out of money. (this is called spend down) And then they are eligible for Medicaid coverage of their nursing home costs---and then come onto the public dole.
So we tightened the regs of who are “sick” enough to go into nursing homes and started reforming those who would give their money away for their heirs.
The push became for more people to stay in their homes instead of going in nursing homes....better for them and less costly. This reduction in demand has allowed us to not add more beds that are not needed. Right now we pay only a PORTION of nursing home costs on Medicaid and the rest is picked up by the private payers until they spend down.
Controlling the supply in a market like this protects taxpayers from heavier subsidized folks in nursing homes.
If you need more info or sources, let me know.
fran
I put part of it in bold to highlight the real problem here. It's not that we had too many nursing homes, we didn't. The problem is the government is too willing to hand over yours and my money to cover expenses others accrue.
And this government "solution" to a government created problem is now creating new problems by limiting the amount of space for those who truly do need nursing homes (as evident by the letter I posted in the main article). Sorry Fran but even hearing your response I still see this as one of the worst bill submitted this year.
Health
Reader Comments (1)
It is not only the worst Bill but also the cruelest. There are a number of reasons people find themselves needing nursing home care and those reasons are not only confined to the baby boom aging process.
There are conditions which would warrant admission into a nursing home or skilled rehabilitation center for prolonged stays or even a life time. Several diagnoses include but not limited to: Huntington’s Chorea, Organic Brain Syndrome, Parkinson’s Disease, Head Injury MVA, CVA with late effects, MS, Advanced Dementia, Renal Failure, and the list goes on with some requiring specialized facilities.
Many diagnoses can hit at any young age which would require admission to a facility and for patients to access their Medicare Part A and B benefits.
One would wonder if those with certain diagnoses, young or elderly, needing specialized facilities will be pushed out of state to obtain appropriate care. I have been in specialized facilities around the country during the course of my work; “children only” facilities, “motor vehicle accident” facilities with life long admissions of patients’ ages ranging from 17-49. Also, Brain Injury only facilities and Huntington’s Chorea facilities.
By flat-lining the supply of nursing facilities this cuts off a person’s option to utilize their Medicare Part A benefits based on their own or their family's choices. Instead, they will be pushed in directions they would not normally choose for themselves.
By doing some research you’ll find that some of the latest regulations in nursing homes, depending upon the patient diagnosis are designed to scoot the patient out the door much quicker than years past. A premature discharge from a facility can almost guarantee a re-admit or worse.
And although the assisted living trend has spiked sooner or later many of those residents could require nursing home services.