Carmel, CA Medicare/Medi-Cal Taking Kinder Approach To Improving Nursing Homes And Recovery Centersby Richard Kuehn on 08/18/12
Traditionally, regulators have used sanctions such as citations, fines and other punitive measures to get nursing homes to improve their quality of care. Over the next several years, however, Medicare plans to use a more friendly approach which would switch more to a pay-for-performance model. This is similar to what Medicare and many private insurance companies are doing or plan to do with hospitals and large medical groups. Some states already pay a small bonus (from 60 cents to $6.16 per patient per day) if facilities live up to certain standards. Most believe that this type of program could be effective, but the payments would have to be much larger. Medicare only pays for a short stay in a nursing home following a hospital visit, but the quality of these "recovery centers" can vary dramatically. It will be difficult to change the quality of care to be certain. "A number of states have attempted this, but most programs have been short-lived and haven't really made much of a difference," David Grabowski, a professor of health policy at Harvard Medical School and lead investigator for the Medicare demonstration project," told USA Today. Medicaid, another government program which helps the poor (Medi-Cal in California) has already implemented a standard specifying that at least 50% of Medicaid-certified beds be in private rooms. That's a step in the right direction but nursing homes have a long way to go. At Family inHome Caregiving, we often visit clients and potential clients in recovery centers. Some of them are clean and the staff are nice, while others can be terrible. One that I visited literally had something like a cattle call, where patients were lined up, put in the shower, and hosed down. That's no way to treat our senior citizens.