Yes. There's rampant discrimination by nursing homes against people eligible for Medicaid. It has become obvious that issues of access, dignity and even survival have taken a back seat to owners' self-serving efforts.
Despite federal law, some nursing homes still require preadmission contracts in which a relative must guarantee to pay the private rate -- sometimes for up to two years -- before the nursing home will accept Medicaid.
When patients become eligible for Medicaid, some nursing homes transfer them or relocate them to a wing reserved for Medicaid patients. Patients may have to go 100 miles or more to find a home.
And nursing homes feel free to withdraw from Medicaid, even for present residents.
In Michigan, the federal and state governments spend about half a billion dollars a year on nursing-home care. In Medicaid's first five yers, there was a 70 percent increase in the number of beds.
Since the industry is basically government-created and government-maintained, and the resource is scarce, eligibility criteria shouldn't be set by the industry.
What the nursing homes are really doing is setting social policy. They're saying we don't care if the government has declared someone eligible for Medicaid, we will determine when he or she can first enroll and get the benefits.
That's why I've introduced legislation requiring nursing homes to notify all residents of their Medicaid rights, participate fully in Medicaid -- no beds exempted -- as a condition of licensure, and accept applicants on a first-come, first-served basis. -- Perry Bullard Michigan state representative (D-Ann Arbor)
No. Our job is to let patients know they're loved and respected, keep them clean, dry, and well-nourished, and help them do as much as they can as well as they can for as long as they can. That's been our credo for many years.
Our rates are set to provide adequate, competitive compensation to our employes, plus a return of about 6 1/2 percent. It's been our experience that the amounts provided by the county or state over the years haven't been adequate to provide a level of care that would meet our standards.
In the early '80s, we found that the so-called level of profit -- which was $1 a day per patient when the cost of care was about $10 a day -- was reduced even further as the cost rose to $39 a day.
This year, with 30 percent of our patients on Medicaid because they'd run out of funds, we found we were caring for them at about $1.60 a day below our rock-bottom costs.
Our oldest patient, who has been with us for 28 years, has been cared for on Medicaid for the last 15 years -- much of that time at less than our cost.
We've never asked anyone to move. That's our policy. But we've had to become selective about new admissions, because if our census ever got to be 60 percent or 80 percent Medicaid, the quality of our care would have to deteriorate. We're not willing to make that compromise.
Rep. Bullard's bill would force us into an almost guaranteed mediocrity. We're not sure we'd want to continue.
In other states, similar legislation has been circumvented by lying and cheating. We're not willing to do that -- and I don't think other nursing-home administrators should be forced to. -- Lloyd Johnson Owner, Whitehall Nursing Homes, Ann Arbor and Novi, Mich.