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LTC Providers Shun Medicaid

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Publicly traded long-term care (LTC) providers have been talking about efforts to shift away from depending on government benefits programs, or patting themselves on the back for avoiding dependence on programs such as Medicaid from the start.

Now Eunice Park-Lee and other researchers at the National Center for Health Statistics, an arm of the U.S. Department of Health and Human Services (HHS), are reporting in an analysis of results from the 2010 National Survey of Residential Care Facilities that fewer than half of the facilities have any Medicaid patients.

The survey team looked at facilities with 4 or more beds. The survey sample included 3,605 facilities.

Medicare — a program that serves people age 65 and older and people with severe disabilities — provides skilled nursing facility benefits for patients who have left the hospital and may either return home or end up needing LTC services.

Medicaid provides genuine LTC benefits — nursing home benefits — for people who meet income and eligibility guidelines.

Some government officials, consumer group representatives and others have suggested that many middle-income people who cannot afford to save for a need for LTC services on their own would be better off relying on Medicaid nursing home benefits than buying private long-term care insurance (LTCI).

Park-Lee found when analyzing the 2010 survey figures that the United States has a total of 31,000 residential care facilities with 971,900 beds.

Only 43% of the facilities have residents receiving Medicaid LTC benefits. About 49% of medium-size facilities — facilities with 11 to 25 beds — have patients who are getting Medicaid benefits; only 32% of the facilities with more than 100 beds have any patients with Medicaid benefits.

Some people might prefer to live in smaller facilities, but the gap could cause problems for older people with severe problems or relatively specialized needs.

The researchers found that the largest facilities were far more likely than the medium-size facilities to offer services such as occupational therapy, physical therapy, and transportation to medical or dental appointments.

Patient use of Medicaid financing has gradually increased over the years, but the facilities “serve primarily a private-pay adult population,” the researchers say.

The researchers note that they will give more information about the facility residents in a report to be released later.