Governor's Address Warrants Concern for Nursing Home Patients
Posted: 1/28/2008
Warwick, RI January 28, 2008 -
The following is a statement by Virginia Burke, CEO/President of the Rhode Island Health Care Association on Governor Carcieri's State-of-the-State Address:
As a Rhode Island taxpayer and the head of the state's largest association of nursing homes, I watched Governor Carcieri's State of the State address with close attention. His remarks about nursing homes were, of course, of particular interest. The Governor stated, quite rightly, that most ailing seniors would rather be cared for at home than be admitted to a nursing home. He followed this with the unsurprising statement that, when this is possible, it is ordinarily the better alternative. These unremarkable truths were followed, however, with a particularly troubling statement. That statement, which prompted this response, was that the Governor intends to reform long term care so that seniors will no longer "be forced into nursing homes because they need help taking medicine or services that can be provided in their own homes."
Seniors who receive nursing home care through the state Medicaid program are not in nursing homes because they need help with their pills. They require and depend on skilled nursing facilities to provide the continuous services they need. As a group they are far more acutely ill or disabled than nursing home residents of the past. They need 24-hour assistance with multiple activities of daily living like walking, dressing or feeding themselves. They often require complex medical care for chronic illness, wound care and extensive rehabilitation. They may have complicated conditions like tracheotomies, cardiac and respiratory problems, and/or cancer, to name a few. On top of that they may be dealing with dementia or Alzheimer's Disease, impaired movement or rehabilitative needs.
Certainly aging Rhode Islanders should be afforded choice in long term care options. They should not be admitted to nursing homes if their care can be managed safely and effectively at home. The members of our association have long been a proponent of consumers receiving the care they need in the least restrictive environment. In fact, we've been an active participant in the movement toward consumer choice, initiated by the Perry Sullivan legislation passed a few years ago. Enhancing home care options is not a novel idea, but rather something that health care providers, legislators, consumers, policy makers and State department heads have been working toward for some time. The problem is, however, that some people are too ill, too frail, and/or too disoriented and confused to be safely cared for at home. When this is the case, it is vital that good nursing home care be available.
You may wonder why this misperception of our patient population warrants your concern. The answer is because it presages funding cuts that may be based upon this or similar misunderstandings. Nearly three quarters of Rhode Island nursing home residents are paid for by Medicaid, a program which routinely pays less than the actual cost of care. Due to their heavy reliance on fixed government reimbursement, which fails to keep up with expenses, our members are hard pressed to figure out how to absorb further cuts, without affecting the quality of care and services provided.
So I'm joining the rank and file that the Governor predicted would come out of the woodwork to plead their case in response to the threat of imminent funding cuts. I hope to be able to plead that case effectively. While I commend the Governor's ambition to get our State back into fiscal shape, it bears mentioning that the "special interest groups who patrol the State House" that he warned us about, do so on behalf of real people, such as the vulnerable individuals living in our nursing homes. From my perspective, nursing home care providers work with a generation of Rhode Islanders who, after giving a lifetime of contributions to our state, look to those caregivers to be there for them in their hour of need.
With hard choices ahead, we humbly ask our legislators to understand the impact of their actions. In order to do that, they must truly understand the role that each member of the long term care continuum plays, how they are funded and what resources are needed to deliver the services and care they are charged with. We ask them to take steps to ensure that each of our long term care delivery options (including home care, assisted living, and nursing home care) receives the resources necessary to ensure the adequacy and safety of the care our citizens deserve. For our part, we invite them to tour their local nursing homes. Talk to the people who live and work there. Let their eyes and ears be the judge.
When first in office, Governor Carcieri addressed nursing home providers by saying, "We must not balance the budget on the backs of the elderly" and yet now, the care that many of them need is in peril. We look to him, and to the General Assembly, to protect the vulnerable population that we serve.
The following is a statement by Virginia Burke, CEO/President of the Rhode Island Health Care Association on Governor Carcieri's State-of-the-State Address:
As a Rhode Island taxpayer and the head of the state's largest association of nursing homes, I watched Governor Carcieri's State of the State address with close attention. His remarks about nursing homes were, of course, of particular interest. The Governor stated, quite rightly, that most ailing seniors would rather be cared for at home than be admitted to a nursing home. He followed this with the unsurprising statement that, when this is possible, it is ordinarily the better alternative. These unremarkable truths were followed, however, with a particularly troubling statement. That statement, which prompted this response, was that the Governor intends to reform long term care so that seniors will no longer "be forced into nursing homes because they need help taking medicine or services that can be provided in their own homes."
Seniors who receive nursing home care through the state Medicaid program are not in nursing homes because they need help with their pills. They require and depend on skilled nursing facilities to provide the continuous services they need. As a group they are far more acutely ill or disabled than nursing home residents of the past. They need 24-hour assistance with multiple activities of daily living like walking, dressing or feeding themselves. They often require complex medical care for chronic illness, wound care and extensive rehabilitation. They may have complicated conditions like tracheotomies, cardiac and respiratory problems, and/or cancer, to name a few. On top of that they may be dealing with dementia or Alzheimer's Disease, impaired movement or rehabilitative needs.
Certainly aging Rhode Islanders should be afforded choice in long term care options. They should not be admitted to nursing homes if their care can be managed safely and effectively at home. The members of our association have long been a proponent of consumers receiving the care they need in the least restrictive environment. In fact, we've been an active participant in the movement toward consumer choice, initiated by the Perry Sullivan legislation passed a few years ago. Enhancing home care options is not a novel idea, but rather something that health care providers, legislators, consumers, policy makers and State department heads have been working toward for some time. The problem is, however, that some people are too ill, too frail, and/or too disoriented and confused to be safely cared for at home. When this is the case, it is vital that good nursing home care be available.
You may wonder why this misperception of our patient population warrants your concern. The answer is because it presages funding cuts that may be based upon this or similar misunderstandings. Nearly three quarters of Rhode Island nursing home residents are paid for by Medicaid, a program which routinely pays less than the actual cost of care. Due to their heavy reliance on fixed government reimbursement, which fails to keep up with expenses, our members are hard pressed to figure out how to absorb further cuts, without affecting the quality of care and services provided.
So I'm joining the rank and file that the Governor predicted would come out of the woodwork to plead their case in response to the threat of imminent funding cuts. I hope to be able to plead that case effectively. While I commend the Governor's ambition to get our State back into fiscal shape, it bears mentioning that the "special interest groups who patrol the State House" that he warned us about, do so on behalf of real people, such as the vulnerable individuals living in our nursing homes. From my perspective, nursing home care providers work with a generation of Rhode Islanders who, after giving a lifetime of contributions to our state, look to those caregivers to be there for them in their hour of need.
With hard choices ahead, we humbly ask our legislators to understand the impact of their actions. In order to do that, they must truly understand the role that each member of the long term care continuum plays, how they are funded and what resources are needed to deliver the services and care they are charged with. We ask them to take steps to ensure that each of our long term care delivery options (including home care, assisted living, and nursing home care) receives the resources necessary to ensure the adequacy and safety of the care our citizens deserve. For our part, we invite them to tour their local nursing homes. Talk to the people who live and work there. Let their eyes and ears be the judge.
When first in office, Governor Carcieri addressed nursing home providers by saying, "We must not balance the budget on the backs of the elderly" and yet now, the care that many of them need is in peril. We look to him, and to the General Assembly, to protect the vulnerable population that we serve.
