District health officials are hoping that the opening of two new nursing homes next month will turn a severe shortage of nursing home beds here into a surplus--at least for the moment.
The addition of about 600 new beds when the two privately owned nursing homes open may be enough to eliminate much of a long waiting list of patients who need care but who do not require intensive--and expensive--hospital treatment, the officials say.
In the past, some patients have had to wait for years in hospitals before being placed in nursing homes, according to health professionals. With Medicaid and Medicare picking up a good part of the tab, this has cost the government large sums of money for a higher level of care than these patients required.
While nursing homes in the District charge an average of $1,800 a month, according to D.C. government figures, a recent survey by Blue Cross found that hospital costs in D.C. average $472 a day.
"There should be a movement of money from acute-care hospitals to nursing homes" because of more availability of beds, said Paul A. Lavigne, head of the D.C. long-term care administration. "I'm counting on seeing a reduction of Medicaid costs ."
The projected surplus of regular nursing home beds will not immediately correct another, more difficult problem of finding beds for patients needing a great deal of care or specialized care: people with emotional problems, including psychiatric patients from St. Elizabeths Hospital; mentally retarded persons from Forest Haven; and children in need of nursing home facilities.
But District officials believe that an excess of regular beds could lead to a competitive situation in which some homes could be persuaded to convert to specialized treatment.
They also say that patients requiring heavier nursing home care, who now have the hardest time finding a bed, may start getting accepted by homes which now reject them as too difficult to deal with.
"Now we have a situation of surplus. . . . They nursing homes may have to take heavier care patients," Lavigne said.
"I can't say how long it will take to place the heaviest care patients," he added, however. "I would like to think that everyone on the waiting list can be placed by January 1984, but I can't say that."
In the past, the average waiting time once placed on the waiting list has been three months, but this average is misleading because the lightest-care patients may be placed in a matter of days while a heavy-care patient might be left waiting in a hospital for two years, Lavigne said.
Earlier this year, the long-term health care administration estimated there were 3,217 nursing home beds and a need for 3,728, for a shortage of 511.
The District's Central Referral Bureau (CRB), through which Medicaid patients must be referred, currently has a waiting list of more than 200 patients in hospitals.
But two private nursing homes are due to come on line in September: the Grant Park Nursing Home in Northeast and the Washington Nursing Facility in Southeast, with a total of 596 beds between them.
Some health-care professionals caution that the projected surplus may be short-lived, however.
"Those beds will be filled so fast, there will be a shortage again soon . People will come out of the woodwork," predicted Stephen H. Lipson, executive director of the D.C. Hospital Association.
Others say it is difficult to imagine an excess because patients have been lining up at nursing home doors for years but say that only time will tell how many of these patients are listed on more than one waiting list, possibly giving an impression of more need than there is.
In the meantime, the CRB has been holding meetings of representatives of the two new nursing homes and the 12 D.C. hospitals in an attempt to get them to agree to an orderly way for patients to get into the homes, rather than each hospital scrambling to get their patients in.
"At one time, it was everybody for himself. . . . All the hospitals have been competing for a scarce resource," said Lavigne. "This is the first time we have gotten the nursing homes talking to each other and to the hospitals and to the CRB."