Low Medicaid Rates Limit Beneficiaries’ Access to Assisted Living Facilities, Quality Care

More than 700,000 elderly and disabled Americans receive health care in residential care communities, such as assisted living facilities. As the population ages, this number will grow.

A new study by RTI International found that low Medicaid payment rates for services in assisted living and similar settings discourage residential care providers from serving Medicaid beneficiaries, which limits their access to community-based residential care.

The study found that some residential care settings limit the number of Medicaid residents they serve or decrease operating expenses in ways that may also reduce quality of care.

“Medicaid payment rates only cover services in residential care settings; they do not cover room and board,” said Michael Lepore, Ph.D., senior health policy and health services researcher at RTI and lead author of the study. “One of the access barriers is the difficulty that Medicaid beneficiaries have paying for room and board in residential care settings because of their low incomes. This situation dissuades residential care providers from serving Medicaid beneficiaries.”

Residential care settings are community-based homes or facilities that offer room, board and care services, the most popular being assisted living. Compared to nursing homes, these settings often are less institutional and are often the preferred setting.

If Medicaid beneficiaries with long-term service and support needs cannot access residential care settings, then nursing homes may be their only option, ultimately costing taxpayers more money because Medicaid payment rates for nursing homes are higher.

The study, published in the Journal of Housing for the Elderly, found barriers that influence Medicaid beneficiaries’ access to state-licensed residential care include Medicaid reimbursement rates for services, the supply of Medicaid-certified residential care settings and beds, and policies that affect room and board costs for Medicaid beneficiaries.

Researchers examined Medicaid policies in all 50 states and the District of Columbia, interviewed subject-matter experts, and conducted four state case studies informed by reviews of state policies and stakeholder interviews.

“States need to ensure their Medicaid rates for residential care services are sufficient to maintain an adequate supply of these settings and beds available to Medicaid beneficiaries, while also safeguarding quality of care and taxpayer resources,” Lepore said. “Higher Medicaid rates may encourage more residential care settings to serve Medicaid beneficiaries, which may help reduce nursing home use by older adults and people with disabilities and potentially reduce Medicaid spending on long-term services and supports.”

Assisted Living: Ready To Go Where Everybody Knows Your Name?

Do you avoid using your basement steps or attic steps because you fear you’ll trip or fall? Does the arthritic pain in your legs prevent you from getting into the bathtub? Are you losing weight because you no longer have the energy to prepare your own meals? Are you finding it difficult to make the needed repairs on your home?

seniorcitizenIf you answered “yes” to any of these questions, you may be at a point in your life when you need to start considering an alternative living arrangement. And the operative word here is living! Remember the theme song to the TV show Cheers? “You want to go where everybody knows your name.” Aren’t you ready to take a break from all your worries?

Wouldn’t you like to get away?

Assisted living may be the answer for you. It provides older adults with trained caregivers who help them with daily chores such as bathing, grooming, putting on clothes, preparing meals, laundry, and housekeeping. And the settings vary from high rise apartment complexes to college dormitory-style to one-story residences.

And no, this is not your grandma’s nursing home. Residents are not all patients. They are independent and mobile, for the most part. However, there are nurses or nurse practitioners on-site or in close proximity to the complex. Many facilities are close to hospitals and medical complexes.

As described by a well-known Gainesville assisted living facility, “We’ve created our assisted living environments and services with all of the details that have been clinically proven to produce positive outcomes in the health and lives of seniors.”

Assistant living facilities are increasing in number to keep up with the growing population of older adults who are living longer due to their healthy lifestyles and access to good medical services. According to the U.S. Department of Health and Human Services Administration on Aging, 39.6 million people in 2009 were over 65 years old, and made up 12 percent of the U.S. population. The agency predicts that people over 65 will become 19 percent of the population by 2030.

And they’re always glad you came

Besides one-on-one care giving, assistant living residences also offer communal activities, such as “movie nights,” “game nights,” musical concerts, exercise classes, day trips, and specialized services for seniors. These activities are designed for residents to have social interaction, stay active, and be mentally stimulated. Transportation to grocery stores, medical, and other personal appointments is available for those who cannot drive or do not have their own personal vehicles.

Our troubles are all the same

Fellow residents know the same songs, enjoy the same old classic movies, and don’t get bored at the thought of playing board games. You won’t have to explain who Dwight D. Eisenhower, Clark Gable, or Chubby Checker were. Common interests, common goals, and yes, even common problems bind everyone into a cohesive, supportive community.

As for the costs, well that depends on a variety of factors including the size of the complex, the type of care provided, and amenities offered. Do a little research by phone and online; ask for recommendations from your local agency on aging or other senior agencies; and talk directly to people who live in these facilities to determine which one will best meet your needs.

You do not have to continue struggling to take care of yourself or your spouse. Consider assisted living and get the help you need to maintain a healthy lifestyle. And enjoy living where everybody knows your name.

Assisted Living Facilities: Grandpa Is Not Resting On His Laurels!

By Deborah Nguyen

Enjoying Retirement
Enjoying Retirement

While there may have been a time when assisted living facilities were basically a place to send an elderly relative when you simply couldn’t care for themselves any longer, that’s now a thing of the past. Assisted living can now provide access to loads of fun activities, an active social calendar and even opportunities to learn new things. In fact, more and more elderly people are opting for these kind of facilities for their golden years.

Assisted Living: A Brand New Life

While care homes are helpful for those who need a little bit more help or need access to regular medical attention in their older years, they also have excellent benefits for the elderly. Oftentimes older people who live on their own can feel isolated, or become stuck in a rut. Living in a facility such as Chateau Vestavia assisted living, can provide access to all sorts of fun activities, group outings and regular contact with others, making it ideal for any older person.

Social Access

Studies have shown that regular social activity can go a long way to helping to stave off memory loss and even Alzheimer’s disease. Being a part of an assisted living community allows a senior to have access to other peers, especially those who share the same interests. Retirees can join others for group meals, classes and outings to meet new neighbors. New residents will be making friends in no time.

Physical Activity

Keeping fit and physical into their later years can go a long way to keeping a retiree from aging before their time. A healthy weight and regular exercise can keep their heart healthy, as well as prevent the aches and pains that come along with getting older. Many facilities have gyms, pools and staff on site so residents can create their own exercise program. Staff can also give advise on losing weight and staying healthy.

Eating Right

As people age, they may be cooking for one for the very first time in years or they may just not want be bothered with making decent meals. This can be detrimental for their health, and an assisted home can help with that. Many offer group mealtimes, where diners can take in a balanced meal with friends. Apartment-style homes are often equipped with a kitchen, and nutritionists and helpers can offer advice on how to make great meals that will keep people in tip-top condition.

Group Trips

Just because a person is getting older doesn’t mean they can’t get out and about. While many seniors may not be able to drive anymore, assisted living facilities will offer social activities for groups such as trips to go sightseeing, visit national monuments or even to connect with nature. Getting out helps keep the mind stimulated, and prevents elderly people from having that “cooped up” feeling.

The image of the dank, boring care facility is truly one of the past. Today’s elderly clients are more active both physically and socially, and these homes are stepping up to the mark to provide services to match. Be sure to view any home you’re considering fully and ask any questions you might have. Chances are there’s a match for you.

Photo Credit: http://www.flickr.com/photos/doughay/5696872679/

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